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What’s causing your bad breath?

whats-causing-your-bad-breath-mainBad breath or halitosis is often caused by gum disease and dental decay. Here, dentist Dr Sej Patel gives his tips for preventing and treating bad breath.

What is Halitosis?

Halitosis is the medical name for bad breath – an embarrassing problem regularly affecting around one in four.

‘Bad breath isn’t just embarrassing and anti-social, in most cases it’s a sign of poor dental hygiene which can lead to gum problems and tooth loss,’ explains Dr Patel. ‘It can also be a sign of another underlying medical condition or a side effect of medication – so it shouldn’t be ignored.’

What causes bad breath?

‘Smelly breath is usually caused by bacteria combining with saliva in the mouth and breaking down food – releasing a gas with an unpleasant odour,’ says Dr Patel.

‘Poor oral hygiene is the most common cause,’ he explains. ‘Brushing and flossing keep this at bay normally, because it stops food becoming trapped between teeth and starting to decay.’

Sometimes it can be caused by mouth infections or types of indigestion / acid reflux. 

How can you tell if you have a problem?

Often the last person to know about it is you. One tell-tale sign is noticing people turning away from you when you’re talking to them.  Another is inflamed or bleeding gums.

A stale taste in your mouth lasting all day is another sign. So-called “morning breath” is normal – caused by reduced salvia flow at night – and can usually be banished with brushing, but if it lasts all day you may have a problem. 

You can always ask close friends or family for an honest answer about whether your breath smells. Try licking the inside of your wrist, leaving it to dry and give it a sniff – if it’s a bit whiffy you probably have bad breath.

What’s the solution?

‘Bacteria can also live in the rough surface of your tongue. Therefore, as well as brushing your teeth, cleaning your tongue can help control bad breath. Don’t rely on mouthwashes – they will only mask the smell and not tackle the underlying problem,’ says Dr Patel. 

Regular dental check-ups will ensure oral hygiene problems are picked up and treated early.

To further combat bad breath you should:

  • Regularly brush your teeth and gums 
  • Floss between teeth and/or use inter-dental brushes
  • Clean your tongue (use a tongue scraper – available from chemists)
  • See a dental hygienist regularly to remove tartar and plaque deposits

What are the other causes?

  • Strong-smelling food and drink. ‘Eating strongly flavoured foods, such as garlic, onions and curries, is likely to make your breath smell. Strong-smelling alcohol can also linger on the breath,’ says Dr Patel. ‘This type of bad breath is usually temporary and can be avoided by not eating or drinking these types of food and drink.’ 
  • Smoking. Smoking increases your risk of gum disease – another cause of bad breath. Stopping smoking can help prevent bad breath.
  • Fad dieting. Low-carbohydrate diets (including the Atkins and Dukan diets) are known to cause bad breath because they cause the body to break down fat, producing chemicals (ketones) that can be smelt on your breath. To combat this, cut calories but not whole food groups and eat regularly, for slower but more sustainable weight loss.
  • Drug side effects. According to, prescription drugs can cause bad breath, particularly nitrates used to treat angina, chemotherapy medication and phenothiazines (tranquillisers). 
  • If medication is the cause, your GP may be able to recommend an alternative.
  • Medical conditions. Although much less common than poor dental hygiene, bad breath can be caused by a mouth infection, indigestion /acid reflux or illness, including dry mouth, known as xerostomia, which affects saliva flow. This causes bacteria to build up in the mouth, leading to bad breath. It affects one in five older people, often a side effect of medication.

Dry mouth can also be caused by salivary gland problems or continually breathing through your mouth instead of your nose.

Other medical conditions causing bad breath include lung, throat or nose infections such as bronchitis, sinusitis, diabetes and gastritis (inflammation of the lining of the stomach), and acid reflux .

When to see your GP

See your GP if you still have bad breath after improving your dental hygiene – as discussed above, it may be due to a medical problem or a drug side effect. Bad breath caused by mouth infections can be treated with antibiotics and a course of treatment to eliminate H. pylori bacteria can help if acid reflux is the cause.

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