Bad breath (halitosis): causes and solutions that work

In short: around 90% of bad breath starts in the mouth itself, not in the stomach as is commonly believed. The most common causes are an uncleaned tongue, plaque between the teeth, tartar and inflamed gums. The good news is that it almost always has a solution once you find where it comes from.

Where does bad breath actually come from?

Most of the time, from the mouth. There are bacteria that live mainly on the back of the tongue and between the teeth, and as they break down food debris they release sulphur compounds that smell bad. That is why bad breath is usually stronger when you wake up: at night you produce less saliva and the bacteria run riot.

The most common oral causes are a dirty tongue (that whitish coating at the back), built-up plaque and tartar, inflamed gums that bleed, untreated decay or trapped food debris. Resolving that usually resolves the problem. An origin in the stomach, which many people take for granted, is in fact uncommon.

Why do I have bad breath if I brush every day?

Because brushing your teeth is not always cleaning your mouth properly. There are three spots many people skip:

• The tongue. It is the number one hiding place for bad-odour bacteria, and ordinary brushing does not touch it. Running a tongue cleaner or the brush itself gently over the tongue makes a big difference.
• Between the teeth. Debris stays there that the brush cannot reach and that ferments. Floss or interdental brushes daily.
• Tartar and gums. If there is tartar or gingivitis, the odour won’t go away no matter how much you brush, because the source is still there.

If you do these three things properly and your breath still does not improve, it is no longer a matter of technique: it is time to look at what is causing it.

What else can cause halitosis?

Beyond hygiene, there are factors that have an influence:

• Dry mouth. Less saliva, more odour. It happens during sleep, with certain medicines, when breathing through the mouth or with poor hydration.
• Tobacco and alcohol. They dry the mouth out and leave their own odour.
• Some foods (garlic, onion, coffee): this is temporary and normal.
• Untreated decay or diseased gums.
• In a minority of cases, causes outside the mouth (sinusitis, certain conditions). That is why, if the problem persists once an oral origin has been ruled out, it is worth consulting about it. (This is general information and does not replace a diagnosis at the clinic.)

What solutions actually work?

The ones that tackle the cause, not the ones that perfume it for a while:

1. Clean your tongue daily. The most underrated gesture and one of the most effective.
2. Clean between your teeth with floss or interdental brushes, every day.
3. Stay hydrated and cut down on tobacco and alcohol, which dry the mouth out.
4. Remove tartar with a professional dental cleaning. If there is tartar or the gums are inflamed, this is usually what really changes things.
5. Treat whatever is underneath: a cavity, a tooth in poor condition or a gum problem that requires periodontics. Until the source is treated, the odour comes back.

Mouthwashes and sugar-free gum help as a complement, but not as the sole solution: they mask without fixing.

When should you see a dentist about bad breath?

If the bad breath is persistent and does not improve with good hygiene, the sensible thing is a check-up. In most cases a specific oral cause is found (tartar, a cavity, gums) and, once it is treated, the problem disappears. It is a very common reason for consultation and nothing out of the ordinary, so don’t feel embarrassed.

If you are in Bilbao and you are worried about your breath, don’t stay in doubt or cover it up with mints. Your first check-up is free: book an appointment, we locate where it is coming from and put a solution in place.