If you consistently have bad breath or a bad taste in your mouth, it may be a sign of periodontal (gum) disease. This occurs when plaque (the sticky, bacteria-filled film that coats your teeth) builds up and hardens, leading the gums to become inflamed. About half of Americans over age 30, including 70 percent of those over 65, have some form of periodontal disease, according to the CDC, though many if not most don’t know it.
Also called xerostomia, dry mouth happens when your mouth fails to produce enough saliva. Because saliva helps to wash food and bacteria away, too little of it can allow bacteria to congregate inside the mouth, creating a breeding ground for bad breath. Dry mouth can also be a side effect of certain medications (including antihistamines, antidepressants, and high blood pressure drugs) or a result of breathing through your mouth instead of your nose.
Besides directly causing bad breath (as anyone who’s kissed a smoker knows), tobacco is also a common cause of periodontal disease, since chemicals in cigarette smoke (or liquid from chewing tobacco) harm the gums and teeth.
When the lower esophageal sphincter relaxes, allowing stomach acid to wash up towards the throat, it allows intestinal gas and stomach contents to reflux upwards as well. In one German study, people with halitosis were significantly more likely to have acid reflux, also known as GERD (gastro-esophageal reflux disease), than people who didn’t have halitosis.
You might be surprised that cutting carbohydrates from your diet could affect your breath. But when people slash their carb intake (or otherwise cut their overall calorie intake extremely low), it forces the body into a state of ketosis, which means the body is burning fat instead of glucose for energy. This causes acidic chemicals called ketones to build up in the bloodstream. One of those chemicals, acetone, lends a sweet, fruity odor to breath.
If a person’s diabetes is untreated or improperly controlled, a dangerous condition called diabetic ketoacidosis can occur. Symptoms include frequent urination, nausea, and loss of appetite. As the condition worsens, the individual’s breath may start to give off a slightly sweet or fruity scent, almost like nail polish remover. As with very calorie-restricted diets (see previous slide), this is due to the build-up of ketones, particularly acetone.
Proper oral hygiene will usually put bad breath in its place. That means brushing your teeth twice daily, flossing once a day, and regularly brushing your tongue to remove malodorous bacteria. Twice-yearly teeth cleanings also help stave off bad breath. If good oral hygiene doesn’t resolve the problem, it might be time to see your dentist, who can assess your breath and refer you to a physician if another condition is suspected.
If you know you suffer from dry mouth, keep sugarless mints, chewing gum or candy on hand to stimulate saliva; your doctor may also prescribe an artificial saliva replacement and tell you to increase your fluid intake. And if you smoke, consider the constant smoker’s breath one more reason to finally quit.