Bad breath: common causes and what can help

Bad breath, also called halitosis, is common. It may follow a meal or be more noticeable when you wake up, but a persistent problem deserves attention. It is not proof of poor personal hygiene, and masking the smell does not identify its cause.

Where can the smell come from?

Problems within the mouth, including plaque, gum disease, decay and infection, can contribute. Food trapped around teeth or dental appliances can also be difficult to clean away. Strong-smelling foods, smoking, dry mouth and some conditions such as tonsillitis or acid reflux are other possibilities.

If brushing does not solve the problem, that does not establish that it comes from your stomach. A dental examination is a useful first step. The NHS guide to bad breath outlines common causes and when to seek help.

Dry mouth and morning breath

A dry mouth can make breath less pleasant. Mouth breathing at night and some medicines can cause dryness. Mention persistent dryness to your dentist or GP, particularly if it affects eating or speaking. Do not stop a prescribed medicine on your own.

Regular sips of water may help with dryness. A pharmacist can advise on suitable products, such as gels or sprays; not every product suits everyone. See the NHS dry mouth advice. Morning breath may improve with your usual oral care, but recurring symptoms should not simply be dismissed.

A daily routine that can help

• Brush your teeth and gums gently twice a day with fluoride toothpaste.
• Clean between teeth daily and gently clean your tongue.
• Spit after brushing rather than rinsing the toothpaste away.
• Clean dentures and remove them at night, unless your dental team has given different instructions.

If you wear braces or have dental work that makes cleaning awkward, ask for a demonstration using suitable brushes or floss. Do not scrub until your gums or tongue bleed. A dentist or hygienist can help you choose an appropriate mouthwash if needed; it does not replace cleaning or treatment of an underlying problem.

Sugar-free gum or mints can help after strong-smelling food, but they are temporary measures. There is no fixed two-hour guarantee and no reason to eat extra meals to cover the smell. Garlic and onions can leave a lingering odour without indicating dental disease.

When to arrange an assessment

See a dentist if bad breath continues after a few weeks of self-care, or sooner if you have toothache, sore or bleeding gums, loose adult teeth or problems with dentures. Explain what you have tried and bring a list of medicines.

The next step depends on the findings. You may need help with cleaning, dental treatment or assessment of a possible medical cause. If no dental explanation is found, your dentist may suggest speaking to your GP. Healthy-looking teeth alone do not mean that persistent symptoms are your fault.

Contact the practice to arrange an appointment. If you already have a treatment plan from another practice, bring it for discussion; any recommendations and costs will depend on the examination. Our current finance information explains payment options if treatment is proposed.