The most common causes of bad breath – and how to fix it.
By Naomi Mead
Halitosis – or bad breath as it is more commonly known – can be an embarrassing social problem. For some, it’s nothing more than unfounded worry, and in severe cases this has been given the name of halitophobia – the fear of having bad breath when you actually don’t.
However, it’s thought that 25 per cent of the population really are suffering from this unpleasant complaint on a regular basis. So what are the common causes of bad breath, and how can you minimise it? Dietician Amanda Kruse looks at the most common causes of bad breath, and how to fix it:
How can you tell you have bad breath?
A simple lick and sniff test can help you to determine whether or not you have halitosis. Lick the back of your hand and let it dry. If you detect an unpleasant smell, this tells you there is a strong chance your breath also smells bad.
A tongue with a white furry coating is also a sign. For a more accurate diagnosis (and if you’d rather not ask a friend), there is a clinical test that can be carried out at the dentist using a halimeter – an instrument for measuring halitosis.
What causes bad breath?
There are seven factors that can contribute to bad breath. These include the following:
- Poor oral hygiene
This is probably the most common cause of bad breath, which stems from the excess build-up of bacteria in the mouth. These bacteria break down trapped food particles, producing foul-smelling sulphur compounds, often compared to the smell of rotten eggs.
✅ What to do: Be diligent with your oral hygiene. Brush and floss twice a day, and ensure you scrupulously clean your tongue, right to the very back, as this is where much of the bacteria is commonly found. Dentures that aren’t cleaned regularly, or don’t fit properly, can also harbour bacteria and food in the mouth. Visit the dentist and hygienist for regular six monthly check-ups.
- Odorous foods
Garlic famously causes bad breath, and it’s not just because it’s remnants accumulate in your mouth. After it’s been digested, chemicals from the garlic are taken up by blood, expelled through your lungs, and exhaled as what we refer to as ‘garlic breath.’ Onions, chives and leeks (all part of the allium family of vegetables) are other common culprits.
Avoid odour-forming foods, or choose carefully when you are going to eat them.
✅ What to do: Avoid odour-forming foods, or choose carefully when you are going to eat them i.e. not before an interview or a date! Mouthwash and teeth brushing can help to mask the odour, but the smell won’t fully subside until the food has passed through your body. Dietician Amanda Kruse recommends that you can also try drinking a tall glass of milk, which can neutralise the compounds found in these allium vegetables.
- Dry mouth
Saliva is your body’s built-in remedy for eliminating bacteria and helping to keep your mouth clean. Dry mouth naturally occurs when you sleep, due to reduced saliva production during the night, leading to ‘morning breath’. This is usually worse for those who sleep with their mouths open, and has been found to be more prevalent in women than men, although it is not understood why. A dry mouth can also be the side effect of certain medications.
✅ What to do: Drinking plenty of water to keep the mouth well hydrated is essential for keeping it clean. So too is chewing on foods like raw vegetables and fruit that can enhance saliva production, and rinsing your mouth between meals. If you are using a mouthwash, ensure that it is alcohol-free, as alcohol will dry out your mouth and could make your breath even worse.
- Acid reflux
For individuals suffering with reflux, where the contents of the stomach flow back into the oesophagus, bad breath can be a common symptom. ‘While the scientific link between bad breath and GI (gastrointestinal) disorders isn’t definitive, it certainly seems common for those suffering from those disorders,’ Kruse explains. ‘When stomach acid moves into the oesophagus, many individuals experience belching or metallic/sour tastes in their mouth, accompanied with an odour on the breath.’
For individuals suffering with reflux, bad breath can be a common symptom.
✅ What to do: Controlling acid reflux is an important strategy in preventing the bad breath it can cause. Many people find that their symptoms improve when they avoid common triggers such as coffee, carbonated drinks, chocolate, tomatoes, citrus, alcohol, and heavy meals especially close to bedtime.
- Highly restrictive low-carbohydrate diets
‘Individuals following restrictive low-carbohydrate diets may find that their breath becomes acetone-smelling (often described as the smell like rotten fruit), as their bodies create ketones,’ says Kruse. ‘These ketones are formed when the body starts to burn fat to fuel body processes, when it doesn’t have enough carbohydrates to do so.’
✅ What to do: ‘While there are some health conditions that may benefit from a low-carbohydrate diet, in general most people should consume around 55 per cent of their daily intake from carbohydrates,’ says Kruse. She advises always seeking professional advice before undertaking any sort of restrictive diet.
- Excess consumption of alcohol
When you drink, alcohol is absorbed into your blood and gets released when the blood reaches the lungs and you exhale – this is what a breathalyser is testing for. As a result, simply brushing your teeth or using mouthwash will not mask the smell of booze on your breath, even the next day. Drinking excess alcohol will also dry out your mouth, which can further contribute to bad breath.
Drinking excess alcohol will also dry out your mouth, which can further contribute to bad breath.
✅ What to do: Avoid drinking on an empty stomach, and drink alongside food to slow the absorption of alcohol into the blood. Dehydration can further add to bad breath, so ensure that you alternate each alcoholic drink with a glass of water.
- Nasal problems
If you have allergic rhinitis or find that you are suffering from excess phlegm or nasal discharge, this can sometimes cause unpleasant odours in the mouth.
✅ What to do: Treating the underlying problem usually reduces the bad breath symptoms. Kruse also advises ‘regularly drinking water to ‘thin out’ the post-nasal drip, and avoiding phlegm producing foods such as milk and other dairy products.’
Tips to get rid of bad breath
Try these lifestyle tips to minimise bad breath and feel fresh as a daisy:
✔️ Chew on fresh parsley or mint which release oils that can help to neutralise bad breath and act as a deodoriser.
✔️ Eat at least 5 portions of fruit and vegetables every day. Crunchy fruit and vegetables can help to increase the production of bacteria-fighting saliva in the mouth.
✔️ The British Dental Health Foundation recommends chewing on sugar-free chewing gum to increase saliva production.
✔️ If your bad breath is accompanied by ongoing digestive symptoms such as bloating, wind and constipation, it could be that a bacterial imbalance in your gut, rather than your mouth, is the underlying cause. If this is the case, focusing on optimising digestive health, and taking a good quality multi-strain probiotic supplement is recommended.