Causes of bad breath

There are a number of possible causes of bad breath (halitosis) .

Poor oral hygiene

The most common cause of bad breath is poor oral hygiene. Bacteria that build up on your teethparticularly between themas well as your tongue and gums, can produce unpleasant-smelling gases. These bacteria are also responsible for Gingivitis and periodontitis and tooth decay .

If you don't floss and brush your teeth regularly, any food trapped between your teethwill be broken down by the bacteria and may be responsible for bad breath.

Bacteriacan also liveon the rough surface ofyour tongue. As well as brushing your teeth, cleaning your tongue can also help control bad breath.

You should have regular dental check-ups to ensure any oral hygiene problemsare picked up and treated early. Your dentist will be able to advise you about how often you need a check-up.

Food and drink

Eating strongly flavoured foods, such as garlic, onions and spices,is likely tomakeyour breath smell. Strong-smelling drinks, such ascoffee and alcohol , can also cause bad breath.

Bad breath caused by food and drink is usually temporary. Itcan be avoided by not eating or drinkingthese types of food and drink too often. Good dental hygiene will also help.

Smoking

Smoking is another cause of bad breath. As well as making your breath smell, smoking stains your teeth,irritates your gums, and reduces your sense of taste.

Itcan alsosignificantly affect thedevelopment of gum disease, another major cause of bad breath. Stopping smoking will lower your risk of gum disease and help prevent bad breath.

Crash dieting

Crash dieting, fasting, and low-carbohydrate diets are another possible cause of bad breath. They cause the body to break down fat, which produces chemicals called ketones that can be smelled on your breath.

Medication

Some types of medication can also cause bad breath. These include:

• nitratesthese are sometimes used to treat angina , chest pain caused by a restriction in the blood supply to the heart
• some chemotherapy medication
• tranquillisers (phenothiazines)

If the medicationyou're taking is causing bad breath, your GP may be able to recommend an alternative.

Medical conditions

In rare cases, bad breath can be caused by certain medical conditions. In dry mouth (xerostomia) , the flow and composition of saliva may be affected.

A lack of saliva can cause morebacteria than normal to build up in your mouth, as well as a change in the types of bacteria. A build-up of these in the mouth may lead to bad breath.

Dry mouth can sometimes be caused by a problem in the salivary glandsor by breathing throughyour mouth instead ofyour nose.

In some cases, gastrointestinal conditions can also cause bad breath. For example, a bacterial infection of the stomach lining and small intestine (H. pylori infection) and gastro-oesophageal reflux disease (GORD) have been linkedto bad breath.

If agastrointestinal conditionis thought to be causing your bad breath, you may need to have an endoscopy . This is a procedure where a piece of equipment calledan endoscope is usedto examine an area inside thebody, such as your airways or abdomen.

Other medical conditions that can cause bad breath include diabetes and lung, throat, or noseinfections for example, bronchiectasis , bronchitis , tonsillitis , and sinusitis .