When regular oral hygiene doesn't help, however, you may have a problem. "There is a difference between noticing your breath isn’t fresh versus chronic bad breath that is not going away no matter how much you brush or floss," says New-York-City-based cosmetic dentist Brian Kantor, DDS. The latter is what's known as halitosis and, according to Fariba S. Younai, DDS, professor of clinical dentistry at UCLA, in order to qualify as having it, your bad breath also has to be detected by someone other than yourself. Um, mortifying much?
- Brian Kantor, DDS, cosmetic dentist at Lowenberg, Lituchy & Kantor
- Fariba S. Younai, DDS, Dr. Fariba Younai is a Professor of Clinical Dentistry in the Section of Oral Medicine and Orofacial Pain in the Division of Oral Biology and Medicine. In 1997, she joined the faculty of UCLA School of Dentistry, where she currently serves as the Vice Chair of the Division of Oral Biology & Medicine and Section Chair of Orofacial Pain & Oral Medicine.
If you're one of the 25 percent of people who suffer from halitosis, it's important to get to the root cause of the issue—not only to stop it in its tracks, but because your bad breath may be trying to tell you something about your oral health or habits.
Keep reading for the common causes of bad breath—and what to do about each
1. Poor oral hygiene and dental issues
This type of bad breath is typically characterized, according to Dr. Younai, by a rotten-egg-type of smell due to the nature of the gases involved—specifically sulphur. Studies show that in 85 percent of cases, the cause is intraoral (as in, the result of either gum disease or a bacteria-ridden tongue coating). And according to research, that's because the tongue offers an ideal environment for the accumulation of pathogens. If you're not yet on the tongue-scraping train, it's time you hop on: A 2004 study showed the practice reduces the aforementioned bacteria coating, thereby improving odor.
Bacteria waste stuck between teeth or decaying teeth is also a common culprit for halitosis. Sure, brushing and flossing can help, but it's crucial you see the dentist regularly (one to two times per year) for a deep cleaning. "Dentists are able to clean under the tissue and small areas that at-home brushing and flossing don’t reach, which will help to eliminate the smell that is caused by decay and debris that are left behind for extended periods of time," Dr. Kantor says.
2. Severe dry mouth
Some medications, such as anti-depressants, as well as other factors like stress and, well, simply aging, can lead to halitosis because they disrupt natural saliva production, a critical cleanup component of your mouth's ecosystem. "Whenever natural saliva flow is inhibited—as is the case with certain medications—natural bacteria is allowed to have a field day on food substances stuck on your teeth," says. Dr. Kantor. "Normal salivary flow washes away a lot of this bacterial food complex."
If the cause is Rx related, you likely can't ditch your prescription. But Dr. Kantor advises you can mitigate the situation by getting choosy with your oral hygiene products. He recommends avoiding mouthwash that contains alcohol, as this will further dry out the mouth and allow bacteria to multiply and thrive. Instead, opt for a rinse meant for halitosis, which will keep the saliva and bacteria balance in check.
3. Medical conditions
Although the rotten egg odor is more common, halitosis can also have a fishy, overly sweet, urine- or acetone-like smell. And these unpleasant scents can have causes not related to your oral health, instead hinting at a more serious underlying condition, including diabetes (acetone, sweet), metabolic issues in the bowels (fishy), kidney or liver failure (urine or fishy), or endocrinological conditions. (Know though that these links are rare, and experts suggest you seek dental attention before assuming they're to blame.)
Dr. Kantor and Dr. Younai agree that the first step in diagnosing such an underlying condition is to eliminate causes related to your oral hygiene by visiting your dentist. "Dental issues are by far the most common reason for malodor and therefore they have to be ruled out before any systemic health issues are considered," notes Dr. Younai. But if you've leveled up your home dental care game and are still being consistently asked if you'd like a piece of gum, you might need to schedule some QT with your GP.
Originally published January 3, 2018
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