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Bad breath

Bad breath


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NHS Contents


Bad breath
Ear, nose and throat
Bad breath or halitosis is a condition where the breath has an unpleasant smell.
The most common causes of bad breath are the bacteria that build up on the teeth and gums as a result of food particles trapped between the teeth. These bacteria break down the food particles and as they do so they release sulphur gases which give rise to the typical unpleasant smell of bad breath.

Plaque and gum disease are also responsible. Plaque is a white creamy deposit that forms between the teeth that is a mixture of bacteria, food particles and dead gum cells. Gum disease affects the tissues surrounding the teeth where the tissues become inflamed and infected. Bacteria and plaque build up when someone does not brush and floss their teeth regularly and this can lead to gum disease and bad breath.

Eating certain strong foods such as garlic, onions and spicy foods can add to the problem as strong smelling substances released when these foods are digested are removed from the body in the breath.

A dry mouth can also cause the breath to smell. Saliva washes away food particles. When the flow of saliva slows down, for example during the night, food particles remain in the mouth where they are broken down by bacteria. This is why bad breath is common in the mornings.

Dry mouth itself can be caused by some medicines, or by continually breathing through the mouth and not using the nose. Smoking, drinking lots of alcohol, coffee or tea also causes bad breath as these dry up the flow of saliva. Some medical conditions, such as diabetes, liver or kidney problems, salivary gland problems, dry mouth (xerostomia), throat and chest infections can also cause bad breath.
People are usually unaware that they have bad breath and only begin to deal with the problem when they have been told that their breath smells or they notice the reactions of other people. For example, people moving or turning away when they start to talk, or they go to kiss them.
Correct brushing with a fluoride toothpaste is the best way of preventing bad breath and keeping teeth and gums healthy. The use of dental floss or interdental brushes last thing at night helps clean between the teeth and remove any food particles that cause bad breath.

Mouthwashes may help freshen the mouth and will mask bad breath, but they are only temporary measures. Good brushing and flossing is far more effective.

If medicines or medical conditions are a cause of dry month, there are products called artificial saliva that can be used to provide relief. These products are available in a range of formulations including liquids, gels, sprays and pastilles. Some moisten the mouth, others act locally to stimulate the secretion of saliva.
When to consult your pharmacist
If your bad breath is a result of poor oral hygiene your pharmacist will be able to recommend suitable toothpastes, toothbrushes and mouthwashes, and will be able to refer you to a dentist or dental hygienist in your area.

Your pharmacist will also ask you if you are taking any medicines or have any illnesses that could be causing bad breath and may suggest other suitable treatments or refer you to your doctor.
When to consult your doctor
You should have regular dental check-ups to prevent tooth and gum disease and prevent bad breath. If your dentist finds that your mouth is healthy, you may be referred to your doctor to find out the cause of your bad breath. Your doctor will be able to determine if you have other illnesses that could be causing the problem. Certain medicines, for example some antidepressants, will stop the flow of saliva and cause bad breath. Your doctor may decide to prescribe an alternative.

If a dry mouth is a cause of your bad breath, the dentist or doctor may prescribe artificial saliva products.
Living with bad breadth
It is not easy to tell if your breath smells, but if you suspect that it does try licking the inside of your wrist and smelling it. If the smell is bad, your breath probably smells too. You can also smell dental floss after flossing; if the floss smells your breath probably smells too.

If your breath does smell there are a number of things that you can do that will help. As one of the main causes of bad breath is the build up of bacteria in the mouth, keeping your teeth healthy and your gums free from gum disease is essential. You should brush your teeth and gums twice a day with fluoride toothpaste to remove the bacteria and plaque. Do not forget to brush your tongue as well, and use dental floss once a day to clean between the teeth. A mouthwash containing an antibacterial agent can also help, particularly when used last thing at night.

Visit your dentist regularly to help prevent dental decay and gum disease developing. Your dentist or hygienist will clean all the areas that are difficult to reach with a tooth brush, and will also show you how to brush your teeth properly.

If you wear dentures, take them out at night and clean them thoroughly.

If you smoke, try to give up. Smoking not only causes breath to smell but it is also one of the main causes of cancer of the mouth, lung cancer and cardiovascular disease. To give up smoking is one of the most effective ways of reducing these risks.

If you suffer from dry mouth, you should drink lots of water throughout the day and try and cut down on drinks such as tea and coffee, which are dehydrating. If increasing your fluid intake does not seem to be helping your dry mouth, your dentist may be able to recommend or prescribe an artificial saliva product. Sucking mints or chewing gum will only temporarily mask the smell of bad breath and may cause tooth decay if the mints or gum have a high sugar content. Instead, try chewing sugar-free gum. Chewing stimulates the flow of saliva and helps keep the breath fresh.

If you wake with bad breath, it may be because that you breathe through your mouth at night. Try sleeping on your side to encourage breathing through the nose.

If your partner, member of the family or close friend has breath that smells, you'll be doing them a favour by discreetly telling them. Not only will it save their embarrassment, but it will serve as a warning that they may have tooth or gum disease that should receive a dentists' or a hygienist's attention.
Useful Tips
  • Adopt a regular routine of brushing and flossing
  • Visit your dentist regularly
  • Give up smoking - see give up smoking section
Further information
The British Dental Health Foundation is an independent charity dedicated to improving the oral health of the public by providing free and impartial dental advice, by running educational campaigns and by informing and influencing the public, profession and government on issues such as mouth cancer awareness and fluoridation.

British Dental Health Foundation
Smile House
2 East Union Street
CV22 6AJ
Tel: +44 (0)870 770 4000 begin_of_the_skype_highlighting +44 (0)870 770 4000 end_of_the_skype_highlighting
Helpline: 0845 063 1188

Reviewed on 14 July 2010