Most bad breath is caused by an overgrowth of anaerobic bacteria (strains that don't need oxygen to survive) in saliva that produce foul-smelling, sulfurous compounds. The bacteria - which coat the mouth, teeth, and tongue - release the compounds as they feed on food residue. Postnasal drip or infections such as sinusitis can also make your breath reek from bacteria, as can dry mouth, which leaves less saliva to wash away the food particles bacteria feed on and less moisture to mask odour. If you suspect your breath is a little less than fresh, lick the back of your hand, then smell it: If it has an odour, you know your breath does, too. The following steps can help.
- Brushing and flossing - Brush at least twice a day, and floss once daily. Don't be skimpy with floss: "Use a long strand and unwind it from one finger to another as you move from tooth to tooth to avoid taking bacteria out of one space and depositing it in another," says periodontist Dr Nico Geurs.
- Tongue cleaning - Use a toothbrush or tongue cleaner to scrape your tongue every time you brush, especially at the back, where bacteria are most likely to accumulate due to the rougher surface and lack of cleansing friction from contact with other mouth parts. One study found that tongue cleaning reduces sulfur compounds by more than a third.
- Avoiding certain foods - In addition to avoiding onions and garlic, steer clear of sugar to prevent bad breath. "Snacking on sweets provides waves of sugar that cause spikes in bacterial growth," says periodontist Dr Salvador Nares.
- Water - Saliva contains bacteria, but it also helps wash bacteria from the mouth. A dry mouth lets offensive microbes stick around, giving them more opportunity to release malodorous compounds. Sip water throughout the day to maintain saliva flow; this is especially important for older adults, as mouths tend to get drier with age.
- New toothbrush - Bristles become less effective at sweeping away food residue and bacteria over time, so replace your toothbrush every 2 to 3 months. And never share your toothbrush or use someone else's. This can introduce bacteria into your mouth, leading to bad breath, as well as gum disease and other dental problems.
- Rinses - Unlike many mouthwashes, OTC dry-mouth rinses help fight bad breath by moistening the mouth via ingredients like hydroxyethylcellulose and glycerin. Some also contain agents such as chlorine dioxide and zinc salts to reduce odour. Avoid rinses containing mouth-drying alcohol, says dentist Cheryl Mora.
- Prescription management - Dry mouth is a side effect of more than 400 prescription and OTC drugs, including some antidepressants, antihistamines, muscle relaxants and blood pressure meds. Ask your doctor if you can safely eliminate any of your prescriptions, reduce the dosage, or switch to a similar drug less likely to cause dry mouth.
- Routine cleaning - No matter how faithful you are with brushing and flossing, bacteria can still build up and form tartar, hardened deposits that can be removed only with a professional cleaning. See your dentist - who will also check for signs of gum disease, a potentially more serious source of foul breath - at least once a year.
- Periodontal treatment - When gums recede - due to underlying bone loss, aggressive brushing, or an infection below the gumline - pockets form where bacteria can accumulate, causing bad breath. Deep cleaning by a dentist can help. If gum disease is advanced, your dentist may recommend a periodontist for specialised treatment.
First published: 19 Feb 2020