We’ve all been there: we realize our breath stinks and there’s not a bottle of mouthwash near. You might think, “What on earth? I brushed, flossed, and used mouthwash this morning! Why does my breath still stink?”
More than 50 percent of the general population has halitosis, or chronic bad breath, and it can cause significant worry, stress, and anxiety in many people.
There are many well-known causes of bad breath, including:
• Foods: The breakdown of food particles in and around the teeth can increase bacteria in the mouth. Certain foods, like garlic, onions, and dairy products can also cause bad breath.
• Bacteria on the tongue: The tongue has many crevices, which is the perfect spot for bacteria to grow, produce odors, and cause bad breath.
• Plaque: Plaque is a colorless, sticky film of bacteria that forms on the teeth. When it’s not brushed away, it can irritate the gums and lead to periodontitis.
• The common cold and postnasal drip: A stuffy nose can lead to mouth breathing, which dries out the mouth and harbors bacteria, in addition to an excessive secretion of mucus in the throat, can lead to bad breath.
• Cracked teeth and/or fillings: Food particles can become trapped in cracked teeth and/or fillings, causing cavities, gum disease, and bad breath.
But did you know that there are other — quite surprising — causes of bad breath, too?
1. Alcohol: Alcohol can dry out the mouth, which causes the body to not form as much saliva as normal — which encourages the bacteria that causes halitosis.
2. Diet: Caffeinated beverages, spicy food, garlic, and alcohol can all dry out your mouth and lead to bad breath, but did you know that the popular Ketogenic (Keto) diet can also cause halitosis? The Keto diet limits carbs and pushes higher protein and healthy fats. When carbs are limited or cut out altogether and the amount of protein is increased, the body begins to burn fat for energy — a process called ketosis, in which fatty acids are converted into ketones. Those ketones are comprised of acetone, acetoacetate, and beta hydroxybutyrate and are released from the body through urination and exhalation. The excessive amount of ketones in the body while on the Keto diet can contribute to bad breath.
3. Smoking: The chemicals in cigarettes stick to the teeth and gums and encourage certain bacteria in the mouth, while other chemicals kill the mouth’s essential bacteria. Smoking also causes dry mouth, which, in turn, is the recipe for bad breath.
4. GERD (Gastroesophageal Reflux Disease): This is a digestive disorder that affects the ring of muscle between the esophagus and stomach, causing acid reflux and heartburn. When the stomach acid is irritating the esophagus — or even undigested food is coming back up — it can cause postnasal drip and, in turn, bad breath.
5. Certain medicines: More than 400 over-the-counter and prescription medicines (such as Xanax, Valium, and Prozac) can reduce the amount of saliva the body produces, and some can also alter the mouth’s pH level, which causes dry mouth and harbor bacteria and, you guessed it: bad breath.
6. Stomach ulcers: A bacteria that causes stomach ulcers (Helicobacter pylori) can lead to bad breath, as the bacteria also carries one of the major periodontal bacteria, Prevotella intermedia.
How can you combat bad breath? Here are some helpful ways:
1. Change your toothbrush head every few months.
2. Use a tongue scraper to remove bacteria on the tongue — the leading cause of bad breath. (But be sure to clean it regularly!)
3. Drink water! Keeping your mouth moist and staying hydrated allows your body to produce saliva, which helps wash away food and bacteria in your mouth.
4. Brush twice daily and floss once a day. If you’re able, brush and floss after each meal and/or snack.
5. Clean dental appliances and dentures daily.
6. Avoid food and beverages high in sugar content, and limit caffeinated beverages.
7. Chew sugar-free gum or suck on sugar-free candy to stimulate the mouth’s saliva production.
8. Schedule regular dental checkups (twice a year — every six months is recommended).
Sources: Mayo Clinic, Johnson & Johnson, Northwestern Medicine, National Library of Medicine