Halitosis: 10 reasons -- and remedies -- for your bad breath
Posted November 28, 2018 4:56 a.m. EST
(CNN) — Are you constantly failing the "sniff test," in which you surreptitiously blow into your cupped hands to check for stinky breath?
(Tip: If you can smell it, then your breath is flat-out noxious, as most of us can't tell on our own, dentists say.)
If your mouth funk rates as "stank-nasty," then you -- and all those around you -- are victims of halitosis, breath that smells so repulsive it could only be attractive to buzzards and flies.
You're not alone. Up to 80 million people have chronic bad breath, according to the Academy of General Dentistry.
Besides the obvious impact on your popularity, bad breath can be a sign of diseases and conditions, some serious.
While you race for a mint, it might help to know the top 10 reasons why your breath smells bad in the first place and what you can do about it.
1. You stink at brushing.
Yes, poor dental care is a leading cause of bad breath. When food is trapped between your teeth and under your gums, bacteria get busy breaking it down, leaving behind putrid gases that smell like rotten eggs or worse (even as bad as poop).
One way to tell if you have bad breath, dentists say, is to floss and then smell the thread. If there's a rank smell on the floss, you'll know for sure your breath is toxic.
The good news is that you can easily fix this type of bad breath by brushing your teeth with fluoride toothpaste twice a day and flossing regularly. While the brush is in there, don't forget your tongue and cheeks; studies show that brushing them can reduce bacteria load.
Cosmetic mouthwashes and gum only temporarily cover up the stink, dentists warn, because neither reduces bacteria.
2. You ate or drank something smelly.
Coffee. Garlic. Fish. Eggs. Onions. Spicy food. The foods we eat can easily cause bad breath.
Many of the foods that contribute to stinky breath do so by releasing sulfides. Sulfur, as you know, smells like rotten eggs.
A mint or stick of gum might mask the reek, but be warned: Odors from some of what you eat can stick around until the food works its way through your system -- even if you brush. According to the Academy of General Dentistry, the allyl methyl sulfide in coffee, onions and garlic can stay in your bloodstream and be expelled via your breath up to 72 hours after consumption.
Try fighting back with other foods, such as lemons, parsley and crisp fruits and veggies such as apples or carrots that stimulate saliva production, which your mouth relies on to wash away impurities. Drinking water helps too! Caffeine, on the other hand, slows the production of saliva.
3. You eat a lot of sweets.
Before you plop that next sugary candy, cake or cookie in your pie hole, listen closely. You might hear the chorus of cheers coming from the bacteria that live in your mouth. For them, sugar is a superfood, and boy, do they have a party gobbling it down, leaving a stink behind.
Dentists say sticky candies such as gummies and caramels are the worst offenders; if you must eat something sweet, they suggest (oh, joy!) plain chocolate. It has less sugar than many other candies and dissolves more quickly in the mouth.
4. You're on a low-carb diet.
Eating a lot of protein and few carbs forces your body into ketosis, when your system begins to burn fat cells for energy.
The process creates waste products called ketones. Too many of those aren't good, so your body has no choice but to make you a walking stank house, excreting ketones via your urine and your breath. It's a rank odor, which many compare to rotten fruit.
Try drinking extra water to flush ketones out of your body. If you use breath mints, candies or gum, be sure they are sugar-free.
5. You're a mouth breather.
At night, saliva production is decreased, which is why many of us wake up with a rotten taste (and smell) in our mouths, even after diligent brushing and flossing.
Mouth breathing or snoring, such as from sleep apnea, further dries out the mouth, making your breath even more foul. Called xerostomia, dry mouth is not only unpleasant but potentially harmful. You might develop a sore throat, hoarseness, difficulty speaking and swallowing, problems wearing dentures and even a change in your sense of taste.
The solution: Get to the bottom of your mouth breathing problems and fix them while drinking lots of water and keeping up your dental hygiene both morning and night.
Of course, dentists also suggest regular checkups. Don't be shy or embarrassed. If you tell your dentist about your persistent problem, he or she may be able to help pinpoint the cause.
6. Your medications are partly to blame.
Hundreds of commonly used medications can dry out your mouth, contributing to rank breath. Some of the most common culprits are meds that treat anxiety, depression, high blood pressure, pain and muscle tension.
Check the drug's list of side effects to see whether dry mouth is on it, and then talk to your doctor about switching to a medication that doesn't reduce saliva.
7. You've got a stuffy nose or allergies.
Do you have chronic sinus infections? Respiratory illnesses? As your nose gets stuffy, you're more likely to be breathing through your mouth, drying out tissues and reducing saliva flow.
If you have allergies, the struggle to stop the constant drip-drip-drip with an antihistamine can lead to bad breath, as well. Many of the prescription and over-the-counter meds used to combat colds, flu and allergies dry up more than just the nose.
And all that postnasal drip can cause a stink by ending up stuck on the back of your tongue, which is incredibly hard to reach with a toothbrush. Dentists recommend scraping the back of your tongue with a specially designed scraper and rinsing with a mouthwash containing chlorine dioxide.
8. You smoke or chew tobacco (or other things).
If you're a smoker, you probably have no idea how the odor of tobacco clings to your clothes and belongings and especially your breath. Breathing in hot fumes dulls your senses, diminishing your ability to smell and taste.
Obviously, hot air will also dry the mouth. The loss of saliva, combined with the odor of tobacco, creates the infamous "smoker's breath." Cottonmouth is also a typical side effect of smoking or ingesting weed, a growing scenario across the country as more states legalize cannabis.
Chawing tobacky? It's a no-brainer that your teeth will stain, your gums will suffer, and your breath will stink.
The solution? You know.
9. You drink alcohol.
Yup, we're still talking about things that dry out the mouth. That, my wine-loving, beer-drinking, cocktail-imbibing friends, includes alcohol. Not to mention wine contains sugar, as do many of the mixers used to create cocktails. Cue the cheering crowds of bacteria.
Fight back by sucking on sugar-free candies or chewing sugar-free gum, as both stimulate saliva production. Don't forget to drink water (it's also good in preventing hangovers) and brush and floss as soon as you can.
But here's an irony: A lot of mouthwashes and rinses contain alcohol. So if Hal. E. Tosis won't leave you alone, talk to your dentist about using a therapeutic mouthwash designed to reduce plaque instead.
10. You have an underlying medical condition.
Do you have heartburn, acid reflux or gastroesophageal reflux disease? Puking up a bit of food or acid into your mouth can easily create bad breath. Don't write that off as just gross; untreated GERD can easily develop into a serious illness, even cancer.
Bad breath can also be an early sign of an underlying disease that may not have outward symptoms.
One of the signs of diabetic ketoacidosis, a life-threatening condition that affects mostly people with Type 1 diabetes, is fruity-smelling breath. It occurs because people with no to little insulin cannot metabolize ketone acids, allowing them to build up to toxic levels in the blood.
Sweet-smelling breath in a person with Type 1 diabetes should trigger prompt medical action. In rare cases, people with Type 2 diabetes can also develop the condition.
People with severe, chronic kidney failure can have breath with an ammonia-like odor, which the US National Library of Medicine says can also be described as "urine-like or 'fishy."
A sign of liver disease is fetor hepaticus, a strong, sweet, musty odor on the breath. It occurs because a diseased liver cannot fully process limonene, chemical found in citrus peels and some plants. Scientists are trying to develop a breath test based on the smell that can alert doctors to early stage cirrhosis of the liver, thus triggering treatment.