Bad breath or halitosis is extremely common. Everyone develops bad breath sometimes, but chronic or frequent bouts of bad breath can have negative effects on self-esteem and daily life. It can cause anxiety in social situations or even lead to avoiding them entirely.

Mouthwash, sprays, gum, mints, and other products are advertised as solutions to freshen breath, but these are all temporary measures. The only way to relieve bad breath permanently is to address the underlying cause.

Gum Disease

Debris from food can accumulate between the teeth and gums. Bacteria feed on that debris and form plaque buildup. Eventually, bacteria can cause gum disease and tooth decay. Gum disease makes this worse. Infection causes inflammation, and gum tissue pulls away from the teeth and forms pockets. More food particles and bacteria build up within those pockets and produce gases with an unpleasant odor.


Tobacco Products

Cigarettes, chewing tobacco, and other tobacco products can cause bad breath. The smell of smoke and tobacco lingers, and all tobacco products cause dry mouth. Saliva helps wash bacteria and food particles out of the mouth, so less saliva gives debris a chance to accumulate.

Chewing tobacco and smoking can also increase the risk of gum disease and oral cancers.


Low-Carb Diets

Sometimes low-carb and ketogenic diets cause bad breath. Keto breath is different from most cases of bad breath. It has a sweet, slightly fruity odor that may be similar to the smell of nail polish remover. A low-carb diet forces the body to burn fat for energy instead of carbohydrates. Ketone bodies are a normal result of that process, and these bodies are responsible for the unusual smell. This cause of bad breath usually goes away once the body gets used to being in ketosis.



Although heartburn may not seem to be associated with bad breath, it can be. The burning sensation comes from stomach acid and food particles traveling back up the esophagus. Not only do the acid and bits of food produce a foul odor, but the acid can also erode tooth enamel and contribute to decay.



Foods with a strong odor, such as garlic, cheese, onions, and spices, are a common cause of bad breath. Coffee and tea are also regular culprits. Both beverages may cause bad breath and even stain the teeth.

Although the presence of such foods inside the mouth is a direct source of bad breath, these foods also contain compounds that enter the bloodstream. Simply brushing your teeth may not get rid of lingering odors because certain compounds stay in the blood for a short time after eating. However, bad breath caused by foods and beverages only lasts until those compounds are gone.


Oral Hygiene

Oral hygiene is the most effective deterrent of bad breath. Food particles building up on or between teeth have to be removed with a good toothbrush and dental floss.

Braces, dentures, and other dental fixtures can become harbors for old food particles, bacteria, and even fungus. The tongue is a frequent source of bad breath as well because many people don't always remember to clean the white coating off their tongues.



Medications cause bad breath in several ways. Some medications reduce saliva production, which leads to dry mouth. Other types cause bad breath because they break down into molecules that have an unpleasant odor.

Medications that may cause bad breath include nitrates used for chest pain, sedatives, certain drugs for drug or alcohol treatment, and some epilepsy medications.


Kidney Disease

The kidneys filter blood to remove toxins and keep fluid levels balanced. Medical professionals frequently monitor concentrations of urea and uric acid in the blood to assess kidney function. If kidneys aren't functioning well, these substances can build up in the blood and saliva. Urea and uric acid produce the acrid odor of urine, and they can produce the same odor in breath.


Post-Nasal Drip

The mouth is connected to the nasal cavity. Post-nasal drip occurs when fluids in the nasal cavity drain into the back of the throat. Most cases of post-nasal drip are related to respiratory conditions such as allergies, a sinus infection, or a simple cold.

Sometimes bad breath comes from thick, foul-smelling mucus draining into the mouth, especially from bacterial or viral sinus infections.



Dehydration is a cause of bad breath because it reduces saliva production and leads to dry mouth. "Morning breath" occurs because saliva production drops significantly during sleep. The lack of saliva lets bacteria grow and multiply in the mouth. Drinking alcohol the night before can make morning breath worse because alcoholic beverages cause dehydration.


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