Make the Most of Your Mouth

Fighting Bad Breath: Ask the Dentist

Dentist Steven E. Roth, DMD answers your questions about how to fight bad breath and halitosis.

Question:

How can my teeth be so clean and white, while my breath smells so bad?

Answer:

Bad breath comes from either plaque on your teeth -- below and/or above the gum line -- bacterial plaque on your tongue, tooth decay, sinus problems, stomach problems, or as a reaction to certain medications. Having clean-looking, white teeth does not guarantee that you won't have bad breath.

Question:

How can I get rid of halitosis? I have healthy teeth, I brush every day, and I go to the dentist every 6 months.

Answer:

The first step is to discuss the problem with your dentist. Your halitosis could be caused by bacterial plaque on your tongue, sinus problems, stomach issues, or as a reaction to certain medications. Also, make sure to floss every day to be sure no food particles remain in your mouth, which could also cause bad breath.

Question:

Do antiseptic mouth washes help fight bad breath better than other kinds of mouthwash?

Answer:

Yes, they can work better by attacking bacteria that may cause halitosis. Of course, the cause of your halitosis may not always be bacterial. So you may need an accurate diagnosis of what's causing your bad breath first.

Question:

When I use mouth rinse, sometimes my mouth feels numb afterward. Why is this?

Answer:

It is most likely the included mint that is causing a tingle on your tongue. Some mouthwashes have a high alcohol content that can also “numb” your oral tissues.

Question:

My 9-year-old granddaughter brushes, flosses, and uses mouthwash multiple times a day. But she still has horrible-smelling breath. She visits the dentists regularly, and at the last visit they found no cavities. If I can smell her awful breath, I know her peers can. I'm worried that she may be teased about it. What can we do?

Answer:

Take her to her pediatrician for an evaluation. There are numerous possible causes of bad breath, including plaque on the teeth -- below and/or above the gum line -- bacterial plaque on the tongue, tooth decay, sinus problems, stomach problems, or as a reaction to certain medications.

Question:

I brush, floss, and use mouth rinse on a regular basis. But 30 minutes after I'm done, I develop a slimy smelly liquid around my gums. What is this and how can I get rid of it?

Answer:

It is hard to say without an actual evaluation. It sounds like it is time for you to see the dentist. You could have an infection that is leaking pus and not even realize it. 

Question:

A bad smell comes from my mouth when I floss between my molars. What could be the cause?

Answer:

If there is tooth decay or a cavity between the molars, flossing can cause a bad taste or smell. Periodontal (gum) disease can also cause bad breath that doesn’t go away after brushing or mouthwash. Gum disease is caused by the buildup of plaque, the layer of bacteria that forms on teeth. You should see your dentist as soon as possible to avoid a more serious problem.

Question:

Every time I brush my teeth my gums bleed. Could this be related to the problems I have with my breath?

Answer:

Bleeding gums are a sign of gum disease that could lead to the loss of your teeth. It is your body’s way of telling you that something is wrong. See your dentist for a diagnosis as soon as you can.

Question:

How can I tell if I have periodontal disease?

Answer:

The best way to tell is to have your dentist diagnose it. Periodontal disease is a silent disease. It doesn’t usually hurt, but it can cause you to lose your teeth, develop infections, and have bad breath.

Question:

My daughter has had braces for nearly a year. How can she get rid of that metallic smell on her breath?

Answer:

The metallic smell may be from a metabolic condition other than the braces. It is really important to see the dentist, orthodontist, or physician to rule out all the possible causes of disease.

Question:

I had a root canal 1 year ago. Now there's a black ring forming near my crown and it smells bad. I'm also bleeding a lot after flossing. What could be wrong?

Answer:

The possibilities include a gum infection, a bone infection of the root canal, or it could simply be the metal of the old crown showing. Either way, you should see your dentist to get an examination and diagnosis.

Question:

I had a tooth pulled a few weeks ago. Suddenly the area aches and smells bad. What could this mean?

Answer:

There are numerous possible causes, including a dry socket, an infection, or something as simple as old food stuck in the extraction site. An infection where a tooth was extracted can be very dangerous. Please see your dentist immediately.

Question:

My 13-year-old daughter had 6 baby teeth extracted 3 days ago. She is still in pain and she has a funny smell to her breath. Is this normal? She wants to get back to school and to playing sports.

Answer:

Odds are your daughter is just fine, but she is healing. However, to play it safe you should see the dentist that removed the teeth for a follow-up visit, just in case there are any areas of infection.

Question:

Three days ago I had a molar extracted. Today, while I was eating, a foul-tasting liquid gathered in my mouth, and now my breath smells terrible. Also, when I blew my nose I noticed air coming from a tiny hole where the tooth was extracted. What can I do?

Answer:

It sounds like you may have a perforation between your sinus and your mouth. Although this can happen occasionally when an upper tooth is extracted, it still must be seen by the surgeon. Do not blow your nose or spit until you see the surgeon that removed the tooth.

Question:

I had my front teeth capped recently. The cosmetic improvement is great. But despite regular brushing and rinsing I now have constant bad breath. Is this normal right after getting caps. What should I do?

Answer:

Bad breath comes from either plaque on your teeth -- below and/or above the gum line -- bacterial plaque on your tongue, tooth decay, sinus problems, stomach problems, or as a reaction to certain medications. Nice-looking teeth are only a small part of good oral health.

Question:

I had root planing about 7 years ago. Ever since, I've had chronic bad breath. My current periodontist recommends that I have deep cleanings every 3 months. But my halitosis still persists. I floss daily, brush at least three times a day, and use a water pick. Using mouth wash doesn't help; it just gives me dry mouth. What can I do?

Answer:

Halitosis, or bad breath, comes from either plaque on your teeth -- below and/or above the gum line -- bacterial plaque on your tongue, tooth decay, sinus problems, stomach problems, or as a reaction to certain medications. Sometimes it is necessary to have a general dental exam in order to get an exact diagnosis.

Question:

Sometimes I can see white things on my tonsils. It leaves an awful taste in my mouth and a weird feeling in my throat. Could this be the cause of my bad breath?

Answer:

Tonsil stones are foul-smelling globules of whitish-yellow pus that hide in the crypts of the tonsil. You need to see your physician or an ENT specialist for a tonsil evaluation.

Question:

I have a complete set of dentures in place of my top row. So I get thrush every so often. When it develops, I can see the cottage cheese-like substance at the back of my throat and smell my own bad breath. Is there an herbal supplement or some kind of OTC medication that I can take to get rid of it?

Answer:

Oral thrush, or Candidiasis, is a fungal infection of the palate and throat. Whenever it appears, a prescription antifungal medication is needed. Loss of your sense of taste, bleeding, and irritation can occur if not treated properly.

Question:

I have a painful dark spot on the back of my gums, where the wisdom teeth are supposed to be. It smells really bad, too. What could this be?

Answer:

This could be an infection of a tooth, an infection of the gum, the result of a traumatic injury, or -- in rare instances -- a tumor. You need to see a dentist right away.

Question:

I'm 49 years old and I've suffered from severe dry mouth for many years. I use mouth rinse every day and night. But it doesn't seem to help. I wake up in the middle of the night and my mouth is so dry that I'm scared my teeth are going to fall out. I get regular dental checkups and use an electric toothbrush. Is there anything else I can do? It's beginning to ruin my sleep and my social life.

Answer:

Dry mouth, or xerostomia, is caused by a lack of saliva. The lack of saliva is caused by diseases, medications, radiation and chemotherapy, smoking, and alcohol use. Patients who have dry mouths tend to have bad breath, high decay rates, and gum inflammation. Some of the worst cases of dry mouth are seen in methamphetamine users. Without saliva, the protective qualities that are in silica cannot bathe and protect the teeth. See your dentist and have him/her recommend you to a salivary gland specialist or an oral surgeon if one is not available.

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