Bad breath is a common concern that brings many patients to the dentist. A periodontist explains the main reasons behind this phenomenon, helping people understand what causes the odor and how to address it.
Short-lived bad breath happens to almost everyone and is usually easy to manage with consistent, thorough oral care. Yet when the odor is strong and persistent, it may signal a problem beyond routine hygiene, particularly in the mouth.
Inflammation of the oral mucosa, known as stomatitis, can cause swelling and pain during meals and tooth brushing. These conditions can produce lingering odor and often accompany gum inflammation such as gingivitis or periodontitis.
Extensive tooth decay creates cavities where food particles can become trapped, fueling a sour or foul scent as decay progresses. This decay is a pathological process that damages hard tooth structures and traps food.
Worn or jagged edges on old fillings or crowns can injure gum tissue and the inner cheek lining, providing a breeding ground for odor-causing bacteria.
Ill-fitting or aging dentures need regular maintenance to prevent odor development. A dry mouth, or xerostomia, is another common factor and can be influenced by medications that reduce saliva.
Beyond the mouth, digestive conditions can play a role. Gastritis, Helicobacter pylori infection, and gastroesophageal reflux disease may push stomach acids and digestive enzymes toward the esophagus and sometimes into the mouth, producing odor. Treating the root illness is essential in these cases.
Fasting or very low carbohydrate regimens can trigger ketone production, including acetone, which carries a sweet, fruity scent. That breath can be surprisingly strong.
Not every mouth bacterium fuels odor. A healthy oral microbiome is key to fresh breath. Certain bacteria living on the tongue and gums contribute to the smell, while others support balance in the mouth’s ecosystem.
Good oral hygiene stands as the main defense against bad breath. Brush at least twice daily, floss to remove debris between teeth, and use a tongue scraper to reduce surface bacteria. For those with crowns, prostheses, braces, or plates, regular mouthwash and targeted rinses for hard-to-reach areas help lower bacterial load.
Regular dental visits, ideally twice a year, support plaque and tartar removal and enable early detection of potential oral problems.
Chewing sugar-free gum can assist by stimulating saliva flow, which helps neutralize acids and ease occasional heartburn.