Publication date Sep 06, 2007
Bad breath is a common problem. It can be embarrassing, but there are treatments that can help.
Everyone gets bad-smelling breath occasionally. It’s common first thing in the morning, and after eating strong-smelling foods. It usually goes away when you clean your teeth.
This information is about bad breath that lasts through the day. It’s sometimes called halitosis. It’s usually caused by gum disease or bacteria on your tongue.
Gum disease is caused by plaque. Plaque coats your teeth. It’s mainly made of bacteria, which can infect your gums. Early, mild gum disease is called gingivitis. Advanced gum disease is called periodontitis.
Bacteria growing on your tongue give off bad-smelling gasses. You’re more likely to get this if you smoke, don't brush your teeth regularly, or don't produce enough saliva. Saliva helps keep your mouth clean.
Some people worry that they have bad breath when they don't. They continue to worry even after they've been examined and reassured. This can be very upsetting.
People may notice an unpleasant smell when you talk or breathe out. It's possible to have bad breath without knowing. That's because you get used to the smell of your own body. If you worry you may have bad breath, you could ask a trusted friend, or visit your dentist.
You can get a rough idea of what your breath smells like. You lick your wrist, wait a minute for it to dry, then smell your wrist. That tells you how your tongue smells.
Your dentist can probably give you all the help you need with bad breath. As well as testing your breath, your dentist should check your teeth, gums and tongue. If your dentist can’t find any problems, but agrees your breath smells bad, he or she may suggest you see your doctor. Bad breath is sometimes caused by a problem somewhere else in your body.
The treatment you need depends on what is causing your bad breath. This information is about treatments for bad breath caused in the mouth. It doesn't look at treating bad breath caused by illness elsewhere in your body.
There are several things you can do to keep your mouth clean. These can reduce the number of bacteria in your mouth, which may make your breath fresher. There’s no good research on these things, but your dentist may suggest:
Many people try things to cure bad breath themselves. We didn’t find any good research to show if they help. But you may want to try:
Research shows your breath is likely to improve if you use an anti-bacterial mouthwash twice a day. A mouthwash that doesn't kill bacteria is unlikely to help. Antibacterial mouthwash starts working straight away, but the benefits wear off. You’ll need to use it for two to four weeks to see a lasting improvement.
You can buy lots of different brands of mouthwash from the chemist. Look for the active ingredients. These kill the bacteria.
Some brands (with their active ingredients) are:
Some types of mouthwash might make your tongue discolour. If you get a sore mouth while using mouthwash, you could try diluting it half and half with water.
There are other treatments meant to get rid of bad breath caused by bacteria, but there’s no good research to say if they work. These include: tongue cleaners to scrape your tongue, toothpastes containing zinc, and artificial saliva, which comes as a lozenge, a spray or a gel.
If you have mild gum disease (gingivitis) your dentist will advise you to clean and floss your teeth thoroughly every day. He or she may also scrape the plaque from your teeth. This is called scaling.
If your gum disease is more advanced (periodontitis) you may need more complicated treatments, like scaling below the gum, root planing or flap surgery. These remove plaque from the parts of your teeth covered by the gums. You’ll have a local anaesthetic to numb your gums first.
Some medicines can be used to treat gum disease. They're normally used after scaling and root planing. You may need to use a mouthwash containing chlorhexidine. It helps to kill bacteria. Your dentist may suggest a low dose of an antibiotic called doxycycline (brand name Vibramycin).
If you have really bad breath that doesn't improve with treatment, your dentist may prescribe an antibiotic called metronidazole (Flagyl). You mustn’t drink alcohol when taking metronidazole, because using the two together can make you vomit.
Most people can cure bad breath themselves by keeping their mouth clean. But if your breath doesn't get any better, your dentist will probably be able to help.
If your dentist can't find any sign of bad breath, he or she will reassure you that your breath is perfectly acceptable.
If you're still worried about having bad breath, even after you've been reassured by your dentist, you may have a condition called halitophobia. This is a strong fear of having bad breath, even though your breath actually smells fine. As with any kind of phobia, a psychologist or psychiatrist will be able to help you.
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice.
If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.