Bad breath is one of the more isolating dental complaints, partly because it is difficult to assess in yourself and awkward to ask about. It is also, in the large majority of cases, caused by something in the mouth that can be identified and dealt with.
Where the smell comes from
The odour is produced by bacteria breaking down proteins and releasing volatile sulphur compounds. Those bacteria thrive wherever there is a reservoir of protein and low oxygen: the back of the tongue, between the teeth, under the gum line, and inside the pockets that form when gum disease progresses.
Around nine in ten cases originate in the mouth. The persistent belief that bad breath comes from the stomach is, for most people, simply wrong.
The common dental causes
The tongue
The rough surface at the back of the tongue traps debris and bacteria and is the single largest contributor in many people. It is also the area most often missed entirely during brushing.
Gum disease
Inflamed gums and the pockets that develop around teeth create exactly the oxygen-poor environment those bacteria prefer. Bad breath accompanied by bleeding gums is a strong pointer. More in why gums bleed and when to act.
Food trapping
A gap between teeth, an overhanging filling margin, a poorly contoured crown or an area of decay will hold food for hours. This often produces a very localised problem and an obvious improvement once the site is repaired.
Dry mouth
Saliva continually washes the mouth and buffers acid. When flow drops, odour rises. This is why breath is worst on waking, and why medications that reduce saliva are such a common contributor. Covered separately in dry mouth: why it happens and why it matters.
Dentures and appliances
Dentures, retainers and splints accumulate a biofilm just as teeth do. They need cleaning daily and, for dentures, removal overnight unless your dentist has advised otherwise.
Untreated decay and infection
A decayed cavity or an abscess produces a distinct and persistent odour that will not respond to anything short of treatment.
What actually helps
- Clean the tongue. A tongue scraper, used gently from back to front, removes more than a toothbrush. Do this daily. For many people this alone makes the largest single difference.
- Clean between the teeth every day. Brushing reaches around three of the five surfaces of each tooth. The odour often comes from the two it misses. Smell the floss after use if you want to identify the site.
- Have the calculus removed professionally. No home routine removes hardened deposits, and they hold bacteria against the gum.
- Keep saliva moving. Water through the day, sugar-free gum after meals, and reducing alcohol and caffeine where practical.
- Have food traps repaired. A single overhanging margin can be responsible.
- Choose mouthwash carefully. Alcohol-based rinses dry the mouth and can worsen the problem after the initial freshness fades. Alcohol-free rinses containing zinc or chlorhexidine are more useful, and neither substitutes for mechanical cleaning.
When it is not dental
If the mouth is healthy, cleaning is thorough and the problem persists, it is worth looking further. Tonsil stones, chronic sinus infection and post-nasal drip are common non-dental sources. Reflux, poorly controlled diabetes, and some liver and kidney conditions can produce characteristic odours. Certain medications do too. A dentist can usually tell you whether the mouth is the source, which is the useful first step before seeing your doctor.
How to assess it yourself
You cannot smell your own breath reliably, because you adapt to it. Two rough tests: lick the inside of your wrist, let it dry for ten seconds and smell it; or scrape the back of the tongue with a clean spoon and smell the residue. Neither is precise, but both are more informative than cupping your hand over your mouth, which tells you almost nothing.
What assessment and treatment cost
Our new patient consultation and clean package starts from $219 and includes the examination, a full mouth OPG x-ray, photographs, the clean and mineral treatment. Where the cause turns out to be a food trap or decay, tooth-coloured fillings range from $209 to $450. Where gum pockets are involved, deeper cleaning may be recommended and is quoted before it proceeds. Current fees are on our price list, with more on check-ups and cleans at our Canberra practice.
Common questions
Does bad breath come from the stomach?
Rarely. The great majority of cases originate in the mouth. Reflux is the main gastric exception and has other symptoms alongside it.
Will mouthwash fix it?
It masks odour temporarily. Where the cause is a coated tongue, gum inflammation or trapped food, only removing the cause resolves it.
Why is it worse in the morning?
Saliva flow drops substantially during sleep, so bacteria are less disturbed overnight. Morning breath is normal; breath that stays bad through the day is not.
Can I ask my dentist about this directly?
Yes, and it is worth doing. It is a common reason for attending and the examination is the same one that identifies the cause.
Booking an appointment in Canberra City
Civic Gentle Dental Care is at Suite 8, Level 3/161 London Circuit, Canberra City, a short walk from the Canberra Centre. To arrange an appointment, call (02) 6247 0224 or send us a message through our contact page.
This article is general information only and is not a substitute for individual dental advice. Whether a treatment is suitable for you, and what it will involve, can only be determined after an examination by a dentist. Any prices mentioned are estimates drawn from our current price guide and are not a quote.