We have all experienced the discomfort of a too-close conversation with a person whose breath reeks of their stinky lunch—or many lunches from days gone by. At times we’ve been the culprit, too. Despite having access to all kinds of oral hygiene products, from mouthwash to mints and toothpaste to whole teeth cleaning kits, sometimes our breath just isn’t fresh.
For a majority of people, battling bad breath takes no more than daily brushing and flossing, with an occasional mouthwash rinse. The everyday care should also be complemented with biannual visits to the dental office for a deep cleaning, which help hold down the bacteria that causes stinky breath. But for people with a medical condition that causes bad oral odor, it might take a little more effort to pass the smell test.
Brushing and flossing regularly isn’t new advice for keeping your breath fresh, but you might not know that a buildup of bacteria on the back of your tongue can also cause chronic halitosis—the technical term for bad breath. So you should include tongue cleaning in your routine.
“There can be an overpopulation of gas-producing elements that this bacteria is causing,” says Dr. Yosef Krespi, a board-certified otolaryngologist and a world-recognized expert in surgeries to relieve oral malodor. “(The elements) break down proteins we eat and as a result, you get volatile sulfur compounds in the oral cavity.”
According to the American Dental Association, halitosis and bad breath can be caused by food particles that remain in the mouth and collect bacteria; gum disease; dry mouth; smoking and tobacco; and medical conditions such as diabetes, sinus infections and bronchitis.
In addition to regularly cleaning your teeth, gums and tongue, staying well hydrated is another way to avoid bad breath. Fresh fruits and vegetables washed down with plenty of water can assist in fresher breath, as well as cutting down on foods and beverages that dehydrate, such as coffee, alcohol and heavily seasoned foods, Krespi says.
Using tongue brushes that are wider than toothbrushes can help keep the tongue clean, as can alcohol-free mouthwash. Since bacteria may be the cause of bad breath, Krespi also recommends taking a probiotic.
“Think of it as replacing the bad guys with the good guys,” he says.
For some people, everyday maintenance isn’t enough. To help these people, Krespi and a team of doctors and researchers pioneered a laser treatment to reduce troublesome bacteria that accumulate far too deeply to be reached by any brush.
“(The procedure) doesn’t burn, irritate or damage anything,” Krespi says. “You don’t need anesthetic. It creates a shockwave effect over the tongue to dig down to deeper biofilm. Whatever the smooth brush can’t do, the laser energy cleans up.”
The laser treatment, however, isn’t a one-time fix for bad breath. Krespi encourages patients to include the laser tongue cleaning in their schedules when also going in for regular dental cleanings.
“There isn’t a cure for halitosis, but we have a protocol for them to adhere to, and we manage the condition,” Krespi says.
Tonsils are another potential cause of chronic bad breath. They can accumulate calcified deposits of bacteria known as tonsil stones, which can be a recurring source of bad breath. A doctor can remove your tonsils to eliminate the chance of recurring tonsil stones. In some cases, only a portion of the tonsils need to be taken out.
