Clearing Up Bad Breath
Where the smell actually comes from, the habits that sort out most cases, what our hygienist can do that you can't, and the rarer causes that need your GP.
What Causes Bad Breath, and How Do I Stop It?
Almost always, the smell is made by bacteria in your own mouth, living on the back of the tongue, in the gaps between teeth and under inflamed gums. Clean between your teeth every day, clean your tongue, keep your mouth moist and get any gum problem treated, and most people notice a real change within two or three weeks. If it hangs on, a hygiene visit in Hamilton with Simra Ashraf, our hygienist, from £70, finds and removes what home care misses.
Where the Smell Comes From
The smell has a chemical source. Bacteria in the mouth feed on tiny scraps of food, shed skin cells and the proteins in saliva, and as they break them down they give off sulphur gases. Those gases are what other people notice: something between rotten eggs and boiled cabbage.
The bacteria that make most of it like places with little oxygen and little disturbance. That means the rough coating on the back third of the tongue, the tight contacts between back teeth, the edge of an old filling or crown, and the pockets that open up when gums are inflamed. Saliva keeps their numbers down by constantly washing over everything. When it slows, overnight or when you're short of fluids, they multiply, which is why breath is at its worst when you wake.
Do I Actually Have Bad Breath?
You are a poor judge of your own breath, because your nose gets used to it. Breathing into a cupped hand tells you very little. Better tests:
- Lick the inside of your wrist, let it dry for ten seconds, then smell it
- Run a clean teaspoon gently over the back of your tongue and smell what comes off
- Pass floss between two back teeth and sniff the floss
- Ask a partner, a close friend or a teenager in the house. They'll tell you straight
A persistent bad taste, a white or yellow film on the tongue, or gums that bleed when you clean them all point the same way. Some people worry about their breath when there's nothing wrong. If we check and find a healthy mouth, we'll tell you so.
Breath Still Not Right?
Book a hygiene visit with Simra Ashraf, our hygienist.
The Common Causes, and the Clue for Each
| Cause | The clue | What usually sorts it |
|---|---|---|
| Coated tongue | White or yellow film at the back of the tongue | Scraping or brushing the tongue daily |
| Plaque between teeth | Floss smells when you pull it out | Interdental brushes or floss once a day |
| Gum disease | Bleeding when you brush, a lingering bad taste | A hygiene visit, then gum treatment if needed |
| Dry mouth | Worse on waking, with mouth breathing or certain tablets | Water through the day, sugar-free gum, a medicine review |
| Food trapping | The smell or taste comes from one spot | Repairing the broken filling, crown or cavity |
| Dentures, retainers, aligners | The appliance itself smells | Cleaning it daily; dentures out overnight |
| Smoking or vaping | Constant, with a dry mouth | Stopping, which also protects your gums |
| Garlic, onion, spice, coffee | Comes and goes with meals | Time: it passes within a day |
| Fasting or very low-carb diets | A sweet, fruity or nail-varnish smell | Regular meals, as it isn't a cleaning problem |
A Daily Routine That Clears Most Cases
- Clean between your teeth first. Once a day, ideally at night, use interdental brushes in the gaps that take them and floss where they don't. If you add only one habit, make it this.
- Brush for two full minutes, morning and night, with a fluoride toothpaste, tilting the bristles into the gum line rather than scrubbing across the teeth.
- Clean your tongue. Reach as far back as is comfortable with a scraper or your brush and draw it forward a few times. A scraper copes better with the back of the tongue, and you'll see what comes off.
- Spit out the toothpaste and leave it, without rinsing, so the fluoride stays on the teeth.
- Keep your mouth wet. Sip water through the day, chew sugar-free gum after meals, and eat breakfast, which gets saliva going.
- Clean anything you wear. Dentures, retainers, aligners and gum shields pick up the same film as teeth. Brush them every day in cool water, and let your gums rest from dentures overnight.
Give it two or three weeks before you decide whether it's working. If nothing has changed by then, the source is probably out of reach, such as tartar below the gum line or a cavity, and that's the time to come and see us.
When the Gums Are Behind It
Of everything we find when breath won't improve, inflamed gums top the list. Plaque left along the gum line hardens into tartar within days, the gum swells and loosens its seal on the tooth, and a small pocket opens. The bacteria that settle in that pocket are exactly the sulphur-producing kind, and no toothbrush gets near them.
Look out for gums that bleed when you brush or floss, gums that look red, puffy or shiny, teeth that seem longer than they used to, and a bad taste that's back within an hour of brushing. Caught early, as gingivitis, it settles with a professional clean and better cleaning at home. If bone has started to go (periodontitis), Simra treats it with deep cleaning below the gum line in stages, at £100 a stage. 1 Our gum disease guide covers the signs and treatment.
What a Hygiene Visit Adds
A standard appointment with Simra Ashraf, our hygienist, is 30 minutes. She measures your gums, removes tartar from above and below the gum line, and uses Airflow (a jet of warm water, air and fine powder) to strip the film and staining from around every tooth, implant and brace bracket. Then she shows you, in your own mouth, where the bacteria are collecting and which brush sizes fit your gaps.
A hygiene visit costs £70, or £100 with Airflow. Where there's heavy build-up, a 60-minute deep clean at £130 gets it all done in one sitting. 1 Hygiene visits are part of both of our dental plans, so members pay nothing on the day. Usually one appointment, plus the changes Simra suggests for home, is all it takes.
If Your Mouth Checks Out Healthy
Now and again the smell isn't coming from the mouth at all. Other sources include:
- Nose and sinuses: post-nasal drip and sinus infections, often worse during a cold
- Tonsils: small, pale tonsil stones that form in the crevices of the tonsils
- Stomach: acid reflux, especially if you also get heartburn
- Medicines: many everyday tablets, including some for blood pressure, low mood, hay fever and bladder control, cut saliva flow
- Blood sugar: a sweet or pear-drop smell can be a sign of poorly controlled diabetes and should be checked promptly
If we've examined your teeth and gums and they're healthy, see your GP and mention that your dentist has already ruled out the mouth. It saves time and points them in the right direction.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.