Bad breath

Diagnosis

Your dentist will likely smell both the breath from your mouth and the breath from your nose and rate the odor on a scale. Because the back of the tongue is most often the source of the smell, your dentist may also scrape it and rate its odor.

There are sophisticated detectors that can identify the chemicals responsible for bad breath, though these aren't always available.

Treatment

To reduce bad breath, help avoid cavities and lower your risk of gum disease, consistently practice good oral hygiene. Further treatment for bad breath can vary, depending on the cause. If your bad breath is thought to be caused by an underlying health condition, your dentist will likely refer you to your primary care provider.

For causes related to oral health, your dentist will work with you to help you better control that condition. Dental measures may include:

• Mouth rinses and toothpastes. If your bad breath is due to a buildup of bacteria (plaque) on your teeth, your dentist may recommend a mouth rinse that kills the bacteria. Your dentist may also recommend a toothpaste that contains an antibacterial agent to kill the bacteria that cause plaque buildup.
• Treatment of dental disease. If you have gum disease, you may be referred to a gum specialist (periodontist). Gum disease can cause gums to pull away from your teeth, leaving deep pockets that fill with odor-causing bacteria. Sometimes only professional cleaning removes these bacteria. Your dentist might also recommend replacing faulty tooth restorations, a breeding ground for bacteria.

Lifestyle and home remedies

To reduce or prevent bad breath:

• Brush your teeth after you eat. Keep a toothbrush at work to use after eating. Brush using a fluoride-containing toothpaste at least twice a day, especially after meals. Toothpaste with antibacterial properties has been shown to reduce bad breath odors.
• Floss at least once a day. Proper flossing removes food particles and plaque from between your teeth, helping to control bad breath.
• Brush your tongue. Your tongue harbors bacteria, so carefully brushing it may reduce odors. People who have a coated tongue from a significant overgrowth of bacteria (from smoking or dry mouth, for example) may benefit from using a tongue scraper. Or use a toothbrush that has a built-in tongue cleaner.
• Clean dentures or dental appliances. If you wear a bridge or a denture, clean it thoroughly at least once a day or as directed by your dentist. If you have a dental retainer or mouth guard, clean it each time before you put it in your mouth. Your dentist can recommend the best cleaning product.
• Avoid dry mouth. To keep your mouth moist, avoid tobacco and drink plenty of water — not coffee, soft drinks or alcohol, which can lead to a drier mouth. Chew gum or suck on candy (preferably sugarless) to stimulate saliva. For chronic dry mouth, your dentist or physician may prescribe an artificial saliva preparation or an oral medication that stimulates the flow of saliva.
• Adjust your diet. Avoid foods such as onions and garlic that can cause bad breath. Eating a lot of sugary foods is also linked with bad breath.
• Regularly get a new toothbrush. Change your toothbrush when it becomes frayed, about every three to four months, and choose a soft-bristled toothbrush.
• Schedule regular dental checkups. See your dentist on a regular basis — generally twice a year — to have your teeth or dentures examined and cleaned.

Preparing for your appointment

If you're going to have your bad breath evaluated by your dentist, these tips can help:

• Dentists generally prefer morning appointments for testing bad breath to reduce the chances that foods you eat during the day will hinder the exam.
• Don't wear perfume, scented lotions, or scented lipstick or lip gloss to your appointment, as these products could mask any odors.
• If you've taken antibiotics within the last month, check with your dentist to see if your appointment needs to be rescheduled.

What to expect from your dentist

Your dentist will likely start with an evaluation of your medical history, asking questions such as:

• When did you first begin to experience bad breath?
• Is your bad breath occasional or continuous?
• How often do you brush your teeth or clean your dentures?
• How often do you floss?
• What kinds of foods do you eat most often?
• What medications and supplements do you take?
• What health conditions do you have?
• Do you breathe through your mouth?
• Do you snore?
• Do you have allergies or sinus problems?
• What do you suspect might be causing your bad breath?
• Have other people noticed and commented on your bad breath?

Be ready to answer these questions so that you can make the most of your appointment time.