When you’ve just finished off a garlicky meal or downed a beer (or three) after a long day, it’s expected that your breath is going to smell, well, off. But sometimes the cause of your bad breath (a.k.a. halitosis in doctor-speak) isn’t so clearly defined, and can leave you feeling self-conscious—maybe even embarrassed.
You’re not alone, though: Roughly half of adults have had bad breath at some point in their lives, according to the American Dental Association. “Generally, halitosis is a multifactorial diagnosis, as it’s caused by a wide range of issues,” says double board-certified cosmetic dentist Rhonda Kalasho, D.D.S.
If your breath still smells wonky, even after cutting back on funky-smelling foods (and enforcing the suggested lifestyle changes below), something more serious may be going on. A visit to your dentist can rule out gum disease and untreated cavities, says Dr. Kalasho, and if it turns out your mouth isn’t to blame, a consult with your primary care physician can help you get to the bottom of your bad breath.
Curious as to what might be going on? Below, experts reveal the top reasons why your breath smells awful, and exactly what to do about them.
1. Your oral hygiene habits aren’t that great.
Among the top reasons why your breath might smell bad is poor oral hygiene. When undigested food particles hang out in and around your teeth, they eventually get broken down by bacteria in the mouth and produce the smell of gum disease, says Dr. Kalasho.
Lifestyle changes, such as brushing your teeth and tongue twice a day (yes, for the full two minutes), flossing daily, staying hydrated, and seeing your dentist for regular checkups, are the best first steps toward better breath.
2. Dehydration could be a factor.
Saliva is important for breaking down food particles while keeping the tissues in the mouth spic and span—but saliva output can take a nosedive when you’re dehydrated. The plaque and tarter that sticks around during this drought period can contribute to bad breath.
“Drinking enough water each day will ensure proper hydration and saliva production,” says New York-based dentist Inna Chern, D.D.S. “The water bathes the teeth as well, along with creating good salivary output.”
3. It’s a side effect of your low-carb diet.
“When limiting carbs (think: the keto diet), the body will eventually go into a state called ketosis,” says Allison Baylis, D.D.S., clinical assistant professor of dental medicine at Touro College of Dental Medicine in New York. “Acetone builds up in the body, and breath can take on a fruity smell.”
If you’re certain the keto diet is right for you, then bad breath is an unfortunate side effect that’s best masked by being meticulous with your oral hygiene, staying hydrated, and chewing sugar-free gum.
4. ...or your medication.
Antidepressants, as well as cholesterol and diabetes medications, are a few of the many prescription drugs that can cause dry mouth as a side effect. The result? “Carbs and starches stick to the surfaces of the teeth and tissue, and without saliva to wash them away, it’s an all-you-can-eat buffet for bacteria,” says Dr. Kalasho
You can keep the effects of dry mouth to a minimum by staying hydrated and on top of your oral care routine. (Sugar-free lozenges are also helpful in promoting salivation, especially sour flavors, says Dr. Baylis.) OTC moisturizing gels, rinses, or sprays, like Biotene and Cloys, are another handy option to boost salivary flow.
5. You’re a sucker for sticky desserts.
“Sticky sweets don’t break down as easily as something like chocolate,” says Dr. Baylis. “They settle into the deep grooves of the biting surfaces of the teeth and provide ‘food’ for bacteria.” The more bacteria that’s present, the worse your breath will be.
Limiting your sugar intake and brushing after the occasional sticky treat can help you to avoid tooth decay—and the bad breath that comes with it.
6. And your coffee habit isn’t doing you any favors.
Coffee is both acidic and dehydrating, contributing to poor salivary flow and creating the ultimate environment for bacterial growth in the mouth. “Saliva is a great lubricant so that bad bacteria doesn’t stick to the teeth,” says Dr. Kalasho. “It also carries enzymes that neutralize the mouth and reduce the chances of gum disease and cavities.”
Drinking water after each cup of coffee—or staying hydrated in general—can help decrease coffee-related dehydration and keep your breath on the fresher side of the spectrum
7. Your blood sugar needs work.
One of the pesky side effects of diabetes is dry mouth—the ultimate breeding ground for bacteria to thrive and cause bad breath, says Dr. Chern. To top it off, if you don’t have your sugar levels under control, this can contribute to gum disease due to poor healing. (Recession of the gums leads to more areas where food debris gets caught and causes a foul odor.)
“It’s important to see your doctor to get the diabetes under control, and in the meantime, stay hydrated,” says Dr. Chern. Once your blood sugar is back on track, breath issues should improve. Meanwhile, your dentist might recommend treatment by a periodontist that can help maintain bone and gum tissue health.
8. Out-of-whack digestion may be the culprit.
Digestive disorders, such as acid reflux or GERD, causes stomach contents to regurgitate into the mouth—and since the contents are acidic, this can cause the mouth to become super-dry and bacteria to multiply. (Cue stinky breath.) “It can also thin enamel by giving an acid wash to the teeth all day, making them more prone to decay,” says Dr. Kalasho.
Eliminating trigger foods, chewing xylitol gum, and gargling with a non-alcohol-based mouthwash can help to alleviate the odor, says Dr. Chern, but it’s also important to see your doctor to treat the underlying cause before it causes too much damage to your teeth and oral tissues.
9. You’re drinking too much.
The dehydration caused by alcohol can contribute to poor salivary flow and excess plaque, which acts as a stomping ground for bacteria to accumulate, triggering bad breath, says Dr. Chern.
Where possible, try to limit yourself to one to two drinks per occasion, and drink water with every cocktail to decrease the potential for booze-related dehydration.
10. You're battling an illness.
When you’re feeling stuffy from a cold or sinus infection, you tend to breathe through our mouth. “Mouth-breathing dries out the mouth and causes less salivary flow,” says Dr. Chern. “The decreased salivary flow increases plaque and tarter buildup around the teeth, and the bacteria in the plaque contributes to bad breath.” (To top if off, some cold and sinus medications cause dry mouth as a side effect.)
Using nasal decongestion sprays or a neti pot can alleviate the stuffy nose, says Dr. Chern. Amping up your water intake can also help reinstate nasal breathing by re-hydrating the mouth, while keeping mucus from getting stuck in the back of your throat and causing a stink (ick).
11. Snoring could be making things worse.
Similar to when you have a cold, snoring causes mouth-breathing, which dries out the mouth, halts production of saliva, and allows bacteria to have a field day, says Dr. Baylis.
Getting in touch with your dentist or an ENT specialist (ears, nose, throat) may be helpful in getting to the root cause of the issue. In the meantime, staying hydrated and running a humidifier while you snooze can keep your mouth from drying out—and bacteria from setting up shop.
12. You smoke cigarettes (or marijuana).
Smoking generates heat in the mouth, which dries it out and gives bacteria the ultimate locale to thrive. This can make you more susceptible to gum disease and cavities.
Ultimately, smoking cessation is key to your long-term oral health, says Dr. Baylis, but being diligent about your oral care routine, staying hydrated, and popping sugar-free gum or mints can help in the meantime.
13. You’ve been skipping meals.
Saliva starts to flow as soon as we smell or sense food is coming (or fall victim to those slow-mo restaurant commercials). “Missed meals cause the salivary glands to go into hibernation mode and not give off as much saliva, leading to a dry mouth and bad breath,” says Dr. Chern.
The simplest fix is to eat on the regular—and for those who are into the whole intermittent fasting thing, staying hydrated with water can help remove the sensation of bad breath.
14. You’re experiencing tonsil drama.
Inflamed tonsils or tonsillitis can also cause bad breath. “Larger tonsils mean they hold more particulates of food when you swallow, as they get stuck on the irregular surface of the tonsils,” says Dr. Kalasho.
If your tonsils are giving you 'tude, make sure to gargle and use a mouth rinse as part of your daily oral care regimen (say, a salt water rinse of one teaspoon of salt mixed in one cup of warm water). If home remedies aren’t cutting it, your dentist can offer up some prescription-grade products to help control halitosis caused by inflamed tonsils.
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