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Bad Breath

NHS Direct Online Health Encyclopaedia

Introduction
Causes
Diagnosis
Treatment
Prevention
References
Selected links

Introduction
Bad breath is a very common problem. The medical name for bad breath is halitosis. Other people generally notice bad breath before the individual does. It may be difficult to tell someone they have bad breath without causing them embarrassment, and many people worry about bad breath even if they do not have it.

Most of us have bad breath from time to time, particularly after eating strongly flavoured food such as garlic. Smoking and drinking a lot of alcohol can also cause your breath to smell unpleasant. Bad breath can usually be prevented by good dental hygiene.

Causes
There are a number of different causes of bad breath, but poor dental hygiene is the most common. Bacteria coating the teeth and tongue occur naturally in the mouth. They attack food particles trapped between the teeth. As the bacteria breakdown food, smelly gasses are released. In people with healthy teeth, the smell is usually confined to the back of the tongue.

Strongly flavoured foods such as garlic, onion and spices produce a smell long before bacterial action sets in. Strong smelling drinks, including alcohol and coffee, can also cause bad breath.

Many people find that their breath smells bad in the morning. This is because the flow of saliva that washes away food particles between the teeth slows down when we are asleep. The food residues stagnate in the mouth, and mouth bacteria rapidly break them down, releasing an unpleasant stale smell.

Bad breath is generally caused by a problem in the mouth, and poor dental hygiene can contribute to conditions such as gum disease and tooth decay. The catarrh produced with throat or tonsil infections can also cause bad breath.

Other causes of bad breath include:

Dry mouth (xerostomia). This is a condition that affects the flow of saliva. Bacteria build up in the mouth, leading to bad breath.
Infections of the throat nose and lungs
Sinusitis
Bronchitis
Diabetes
Liver or kidney problems
Gastritis and food reflux
Smoking
Low carbohydrate diets such as the Atkins diet.

Diagnosis
The easiest way to find out if you have bad breath is to ask a close and trusted friend or family member for their honest opinion.

Bad breath is usually caused by a problem in the mouth, so you need to visit your dentist for diagnosis. Do not try to mask the smell before visiting your dentist, as this can make it more difficult to find out what the problem is. If bad breath is being caused by food decay in the mouth, your dentist will normally treat this straightaway. They will also give you advice about how to keep your teeth and gums healthy, and recommend regular dental check ups to help spot signs of tooth and gum decay early on.

If bad breath is not caused by a problem in the mouth, you may be referred to a clinic specialising in breath odour, a dental hygienist, or your GP for further investigation.

Treatment
Treatment depends on what is causing bad breath. The simplest and most effective treatment is usually to improve your dental hygiene. To avoid bad breath, you need to keep your mouth and teeth clean.

Your dentist is likely to recommend that you brush your teeth and gums with a fluoride toothpaste twice a day. Choose a small to medium sized toothbrush, with soft, multi tufted, nylon bristles. Use a separate toothbrush or tongue scraper to lightly brush your tongue. Use dental floss to clean between your teeth and remove any trapped food that could cause tooth decay.

Your dentist may also suggest daily rinsing with an anti-bacterial or anti-odour mouthwash. This should not replace brushing your teeth, but should be incorporated into your complete oral hygiene routine. Avoid brushing your teeth for 30 minutes after an acidic drink such as fruit juice, or acidic fruit such as oranges, to prevent tooth erosion.

If you wear dentures, take them out at night to give your mouth chance to rest. Avoid cleaning them with toothpaste, which will scratch the surface and cause stains to build up. Clean them thoroughly with soap and lukewarm water, a denture cream or a denture-cleaning tablet. Use a separate toothbrush to clean your dentures.

Prevention
As well as maintaining a high level of oral and dental hygiene, there are a number of self-help measures that can help to prevent bad breath:

Try cutting down on strongly flavoured or spicy food that can make your breath smell. Reducing your alcohol intake and stopping smoking can also help.
Find out how much you'll save by kicking the habit Use a tongue cleaner and clean right to the back of the tongue.
Use a mouthwash recommended by your dentist or pharmacist. The best time to use it is just before sleeping.
Drink plenty of fluids and cut down on coffee, which is strong smelling and can make bad breath worse.
Clean your mouth after eating milk products, fish and meat.
Chew sugar-free gum after eating and if your mouth feels dry.
Avoid sugary snacks between meals, which increase bacteria in the mouth.
Visit your dentist regularly and have your teeth professionally cleaned as required.

© Queen's Printer and Controller of HMSO, 2005

Crown copyright material is reproduced with the permission of the controller of HMSO and the Queens Printer for Scotland.

 

 

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