What causes bad breath?

Question

Hi doctor,

I need help figuring out what is going on with my mouth.

I have been dealing with bad breath that would not go away, even though I am brushing two to three times a day, flossing, using mouthwash, and tongue scraping. I use Hello fluoride-free toothpaste and sometimes rinse with lemon water or saltwater. I have also been eating fruits like apples, strawberries, and blueberries to stay fresh. Nothing seems to help.

I had bad oral hygiene during quarantine due to mental health struggles, and I was not brushing consistently back then. My tongue stays white, even after scraping it daily. It even bled light pink when I scraped earlier. My mouth is always dry, even though I drink water regularly. It feels dry again seconds after drinking.

My lips stay moist, but my tongue and the inside of my mouth feel dry. My gums used to bleed a lot more; now they only bleed lightly or not at all. Floss sometimes gets stuck or pulls my gums in certain areas. I have anxiety, which might be part of the dry mouth issue.

But I am not sure; I just want to figure out what is causing this and how to fix it. Please help me figure out the cause and recommend what I should do next.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Bad breath can also be due to pockets in the gum (deep points within the gum that are deeper than their normal depth, which are normally easy to clean out naturally or by gargling). These deep points make it really difficult to clean to the full depth, creating a stinky smell. To exclude this, you need to visit your dentist and make periodical visits to maintain the situation and prevent it from getting worse.

Did you check for diabetes? This can also cause dry mouth and affect dental health. If so, diabetes should be controlled first before dental treatment.

Does your mouthwash contain alcohol? In turn, it causes dry mouth; if so, stop it and replace it with another alcohol-free mouthwash.

Gastric problems can also cause bad breath. If you have such problems, visit your physician for further investigation. Problems related to the ear, nose, and throat can also contribute to bad oral smell; if having any, visit an ear, nose, and throat physician for further investigations and treatment.

Also, I am wondering if you are taking any medication because of your previous mental struggles or for anxiety. Some drugs can cause dry mouth and then bad breath as a result.

In my opinion, if you do not have medical problems with your stomach or ear, nose, and throat and are not taking any new medication or regular drugs with dry mouth side effects, please visit your dentist for further checks of your dental health. You may have decayed teeth or cavities, poor previous dental treatments, or gum pockets. You may need a cleaning session to ensure no tartar deposits over the teeth or under the gum line, and a tooth filling.

Keep your oral hygiene as it is, be sure to always have a new medium toothbrush every three months, avoid a lot of ingestion of aromatic foods like onion, garlic, or curry, and drink a lot of water.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.