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Bad breath (halitosis in doctorspeak) is not a topic for polite conversation. In fact even your dentist or best friend may not bring up the subject of dragon breath. Many people are painfully aware of their breath problem. They chew gum, suck on mints, gargle regularly and ask health professionals for help. They frequently feel frustrated because no one can can come up with either the causes or the cures for bad breath.
There Can Be Many Reasons for Halitosis:
Determining the cause behind bad breath can be challenging. There are so many contributing factors that it can take Sherlock Holmes-type sleuthing to discover what is really going on. That’s partly because there is no one medical specialty that is responsible for figuring out what is causing halitosis or coming up with the “best” solution.
Gastroenterologists, family dentists, periodontists and otolaryngologists (ear, nose and throat specialists, aka ENTs) can all diagnose and try to come up with cures for bad breath. How successful someone is depends a lot on experience and the capability of the individual practitioner.
Food As A Culprit (Lactose Intolerance):
Food is an obvious source of odor. It’s not just garlic and onions that can cause bad breath. Readers of this column have shared some fascinating stories about milk and dairy products:
“I have a problem with terrible bad breath after eating anything with dairy in it, and also anything with sugar. I have had this problem since my early twenties and am now in my sixties. My husband says it is so bad that he can sometimes smell it from his side of our king-size bed. This is right after brushing, flossing and rinsing with mouthwash before bedtime.
“If I stay away from sugar and dairy, the smell goes away completely after four or five days. It starts again within 30 to 45 minutes of eating the offending foods.”
Another reader shared this:
“I suffer from severe lactose intolerance. Even after taking Lactaid enzyme pills I would have body odor when I ate dairy products. Once I eliminated dairy from my diet, the odor went away.”
We have heard from a great many people who report that dairy products contribute to their bad breath. To read how they came up with cures for bad breath check out this link.
Probiotics As Cures for Bad Breath:
This reader says her husband’s halitosis disappears thanks to probiotics:
“You have written about bad breath that might be caused by an infection with H. pylori. May I suggest an approach that helps my husband?
“When his breath turns bad, he takes acidophilus for a few days. That seems to settle his stomach as well as eliminate the bad breath. This probiotic pill does not require a prescription.
A. Thank you for the suggestion. Lactobacillus acidophilus is the name for beneficial bacteria that normally live in the mouth and digestive tract. Probiotics containing this bacterial strain are widely available over the counter.
We checked the medical literature for research on bad breath (halitosis) and probiotics. A recent meta-analysis found only four randomized controlled trials testing whether probiotics can reduce bad breath (Frontiers in Nutrition, Jan. 21, 2022). The authors concluded:
“Despite the limitations of this meta-analysis, we believe that some probiotics have a beneficial effect on halitosis, although more clinical trials are needed to establish real evidence on this aspect.”
H. Pylori As A Cause of Bad Breath:
You are right that stomach infections with Helicobacter pylori bacteria are associated with bad breath. Sometimes bad breath originates in the stomach. Decades ago we spoke with Nobel Prize laureate Barry Marshall, MD. He discovered that the bacterium Helicobacter pylori could cause stomach ulcers. He told us that these germs are behind some cases of hard-to-treat bad breath.
Other symptoms include abdominal pain, nausea, bloating, loss of appetite and weight loss. Eliminating H. pylori can produce long-lasting relief from halitosis (Journal of Gastroenterology and Hepatology, March 24, 2022).
This is not a do-it-yourself process, however. It will require a physician who is up on the latest treatment approaches to get rid of this bad actor of a bacteria. Many gastroenterologists prescribe “triple therapy.” It includes a proton pump inhitor (PPI), and antibiotics such as amoxicillin and clarithromycin. There is even a product that contains all three called Prevpac.
But some infections have become resistant to clarithromycin, so it is critical to determine the best combination for any given patient. There is even quadruple therapy that involves bismuth, the same ingredient found in Pepto-Bismol. And once H. pylori is gone, it can come back. Follow-up is essential!
One radio listener told us that after years of suffering with heartburn and ulcers he was treated for Helicobacter pylori. After successful treatment with antibiotics, our listener was astonished to find that his long-standing bad breath had disappeared. His girlfriend used to complain bitterly and even his dog would retreat. He was thrilled about the unexpected bonus in curing his ulcers–his dog and his girlfriend no longer backed off.
Cures for Bad Breath Depend Upon the Cause:
Other causes of bad breath may include gum disease, tooth abscess, bacterial overgrowth on the tongue, tonsil troubles, sinusitis, bronchitis, diabetes or liver disease. A specialist should do a complete workup to discover the source of the odor.
Here is an example:
“My 11-year-old daughter had terrible breath. The dentist said that it wasn’t coming from her teeth and referred us to an ear, nose and throat specialist. The ENT said that he suspected that the small sinus cavities on each side of her nose had fungal infections in them. He prescribed a special nose spray to get rid of the infection. Within two days her bad breath was gone. Now whenever her breath starts to get bad we just have her start using the nose spray mixture and it disappears.”
Imaginary Bad Breath:
Some people may imagine that they have bad breath. Doctors have a term for this condition. It is called halitophobia or delusional halitosis. No matter how much they are reassured that their breath smells fine, such people are convinced they could knock out a horse with each breath. There are no cures for bad breath that originates in the mind.
Diagnosing the cause of bad breath and coming up with cures for bad breath can be challenging. Once the origin is identified, however, halitosis can frequently be remedied. Please share your own story in the comment section below. We are especially interested in cures for bad breath if you have been successful.
Joy
My husband, who had always had sweet breath, had several months of bad breath which could not be helped by improved brushing or flossing. We brought it to the attention of both our doctor and our dentist, but neither had an explanation. To our surprise, it resolved completely after his gallbladder was removed.
Janie
Hiatal hernia is also a source of very bad breath, as the gases from digestion in the stomach are leaking back into the mouth.
Lynn
I suffered with ‘tonsil stones’ for years, which caused me to have terrible breath. Doctors said there was nothing I could do to prevent them. But I found that gargling with antiseptic mouthwash once a day eliminated the problem. I also have noticed that people with terrible breath also do not floss their teeth regularly.
Jackie
Also tonsilloliths (stones), cavities in the tonsils can harbor bacteria. They make the mouth very difficult to clean. Constant gargling may help to dislodge this usually white or cream debris that gets ‘stuck’.
Sharon
I had a terrible taste in my mouth causing bad breath and saw an ENT who determined I needed to have my tonsils removed, at age 29. I went for a second opinion, and this ENT told me I had tonsil stones. He removed them with a long Qtip and told me to use a baby’s ear syringe to squirt warm salt water up my nose, and bring it out my mouth. It helped but the stones came back. I decided to use my waterpik on the lowest setting to remove them. It works but it caused gagging. Just a warning. Eventually the stones disappeared but I do continue to use the salt water treatment daily.
Mark
Anybody try a tongue scraper? The further back on your tongue you can get, without gagging, the better. You’ll be amazed what lurks on that thing. For me, after slowly starting in the middle of tongue and progressively working my way back, the gagging is pretty much eliminated. It took a couple of weeks to get back there without wanting to gag. I get a three pack of scrapers from online for $7-9, and each one lasts about three months.
Vanessa
Also consider TONSIL STONES. Just check out “Tonsil Stone Man” on YouTube. Who knew?!?
Toby
You need to add tonsilloliths to the causes of bad breath.
Kathleen
Closys rinse before brushing, listerine and ACT floride rinses after brushing have eliminated all traces of bad breath in my household and improved oral health overall.
This is the advice given by Ellie Phillips DDS, author of Kiss Your Dentist Goodbye. Hopefully you will have her as a guest on your show one day.
Sonja
I had off and on bad breath that I couldn’t smell, but others smelled sometimes from across a small room. It was that bad. Sinus medicine that dried up the sinuses was the only thing that took away the smell. I had sinus surgery and the doctor said that I had 2 holes in the sinuses where there should be only one hole. There was mucus wrapping between the holes. She had never seen that before. So she snipped the area between the holes to make one large hole instead of two smaller ones. That was over 15 years ago and I have never had that same bad breath again.
Mary J
The first line of defense starts with good oral hygiene. I have an arsenal of tools: unwaxed floss, go-between brushes of varying sizes, rubber-tipped instrument, and toothbrushes of varying types.
When flossing it’s important to get under the gum. The rubber-tipped instrument can help with that as well. If this causes bleeding, it means that there is bacteria. Good oral hygiene can eliminate that. Inclining the toothbrush at an angle and vibrating it gently should be standard technique.
Rotadent is a great toothbrush; toothpaste is really of very little value.
It’s important to find a preventive dentist, one who is true to the etymology of “doctor,” which means teacher. The hygienist is of equal, or more, importance than the dentist.
Makayla
Palm Beach, FL
Please someone help. I have been suffering for this problem for years with no solution. I have seen the ENT and GI doctor. I’m diagnosis with Hplori and have taken the medication 3 times but it keeps coming back. I don’t know what else to do, this is a nightmare
Abdul Aziz
quetta
i also had bad breath for many years and people could smell from far it. i used diluted hydrogen per oxide to gargle so as to kill bacteria, then i would use baking soda either in my toothpaste or i mix it with water and i used apple cider vinegar i no longer have bad breath.some doctor said that i have stomach problems, i,taken some medicine like metrozin etc but does not any effect on bad breath.after that i visited an other doctor they said i have sinus they advised me to nasal spry but the problem remain exist.
i requesting to kindly resolve my problem.
mono.
Kenya, Africa
l also had bad breath for many years and people could smell it from far. l used diluted hydrogen peroxide to gargle so as to kill bacteria, then l would use baking soda either in my tooth paste or l mix it with water. l no longer have bad breath. Read how to use hydrogen peroxide and baking soda on internet to stop bad breath.
l had white patches on my tongue which were as a result of vitamin and mineral deficiency. l take vitamin C every day from fruits not supplements an Apple, various green vegetables and various animal proteins and fruits. l eat variety of foods as a daily intake of balanced diet. Read from internet so as to get the super foods to always include in the diet, how to prepare them and their side effects. l also do take green tea in the morning, but for it to be effective you do not take it when taking your protein and foods rich in iron. read the side effects and drug interaction to be able to programme yourself. best taken with lemon. l do take wheatgrass and there are others like barley grass chollera spirulina that are regarded as superfoods.
Note that the first step is to see a doctor to rule out any infection like candida, liver and kidney problems and also ulcers and constipation. wheatgrass helped my constipation. One can also try toothpaste that contain tea tree oil or any natural products.
Mess
Ethiopia
I have the same bad breath problem since I was in high school. I am now in thirties.
I really don’t what exactly cause my bad breath. I visited a dentist he assured me it’s not from my teeth. Drinking a beer or soda most of the time caused the problem. Even right after I brush, the bad smell occurs. As people barely tells me when I have the bad breath, it makes it difficult to know when & how I have it. But people start complaining about the bad breath when I am around, and this happen even when I did not have those things I identified causing my bad breath. An internist to whom I visited gave me several tests and found nothing. It is so becoming embarrassing and it really affected my r/ship with people. Specially my love life. I also believe bad breath comes out of my nose because of experience. I wonder if there is aany medicine that cures. Or any diagnosis to find out the cause. I live in Ethiopia making it difficult to get some of the medicines mentioned here. Does gatritus could be my problem?
Thank you
Kay
Columbia
I read the article and it says to get checked out by a specialist. Which specialist? I’ve been to so many people I just need someone to tell me who exactly can do a full body check and pinpoint the cause of the problem.
The People's Pharmacy
It makes sense to start with the dentist; if that is not productive, the ENT (ear-nose-throat) specialist is the next most likely to be helpful.
Bernadette
Pyramid
I have heard a story of a girl sufering from fungal infection in her sinusses, gave her a bad breath only after the doctor gave her a perscribed nose spray, it went away.
jitendra
Varanasi
I’m suffering from bed breath for 12 Years. Some doctors said that I have stomach problems and I’m taken some medicine like metrozole but does not take any effect on my bad breath. After that I visited another doctor they said I have sinus they advised me to spray nasal spray but the problem remain exist.
I’m requesting to kindly resolve my prolem.
thanks
Anonymous
East Coast
It seems I have the same problem as the woman who’s had bb since she was in her 20’s and is now in her 60’s. Except I am in my 30’s and the bb just started in the last 6-9 months. The first time I noticed it was when someone close to me said I should brush my teeth and I just had. It has been so bad that anyone sitting next to me in a public/indoor environment, starts commenting on the smell and looking around to see where it’s coming from.
Honestly, this might sound strange but it smells exactly like my cat’s poop. Almost immediately after I eat anything with dairy or processed sugar the bb comes back. And it also usually takes about 4-5 days to go away (while not eating dairy and processed sugar items). I’m so new at this and I’ve been eating dairy and processed sugar products for 30+ years that I’m not sure how or when I’ll be able to make that complete life change.
It’s very hard to be around anyone with this kind of bb, but I have to do something. I guess I’m learning that I may have a lactose intolerance. That’s a start. Thank you so much for the thread. I have been searching the internet for months, going to the dentist (who just clumped me into a bb category and gave me a tongue scraper and sent me home-twice!!), and gargling mouthwash containing zinc(which does work for about 30 minutes long in an emergency) like a champ. Good luck to anyone else who may read this. It has been such a relief this week knowing that I am not alone, and that there may be an explanation! I read this post about a week ago and had to come back and write, just in case it can help someone.
LE
I realise CC left the comment requesting how H.pylori was cured quite some time ago, but for anyone else reading this: A one-week course of two antibiotics plus an acid-suppressing medicine will usually clear the H. pylori infection. This should prevent the return of a duodenal or stomach ulcer that had been caused by this infection.
CC
this article is very interesting and noted that once the bacteria was found the problem cured, however, the article fails to name the magic drug. Please share with me the name of the drug she took. Thank you.
PD
Scraping the tongue with a spoon cleans off the white coating. Stopped my bad breath.
CAH
Halitosis can originate in the throat as well–an unusual but possible cause is a Zenker’s Diverticulum–a pouch in the throat where food collects until it fills, causing coughing, and regurgitation. Appropriate diagnosis can be made by an ENT physician following swallowing studies and symptom evaluation.