This Is Why You Have Bad Breath—And Here’s What to Do

Whether it’s morning breath or a nasty mix of a garlic-heavy lunch coupled with an afternoon coffee, most people have regular bouts with bad breath. But some struggle with a particularly potent and consistent version of this socially challenging condition: chronic halitosis. For them, bad breath can be difficult to manage—and a source of embarrassment. “Many patients [with halitosis] don’t like even going to the dentist,” says Dr. Anuradha Prakki, an associate professor in the faculty of dentistry at the University of Toronto. “They are super shy and don’t want to talk about it.”

(Related: 12 Teeth-Cleaning Mistakes That Make Dentists Cringe)

What causes it?

Halitosis is generally caused by two main factors: poor oral hygiene, such as cavities or gum disease, or a health issue such as indigestion, gastric reflux (when stomach acid goes back into the throat), or gastritis, an inflammation of the lining of the stomach, says Prakki. Some people with diabetes also get a condition called ketoacidosis, in which a lack of insulin in your body causes your breath to smell like nail polish.

Other factors that can lead to halitosis are infections such as tonsillitis or sinusitis or autoimmune conditions like Sjogren’s Syndrome, which reduces the amount of saliva in the mouth, says Prakki. Some medications that dry out your mouth can also lead to halitosis, as they can prevent saliva from washing away odour-causing bacteria.

Why does it smell so awful?

“There are compounds that can be produced in the mouth called volatile sulfur compounds—that’s the bad breath smell,” says Prakki. She says these compounds, caused by bacteria, mix with acid that’s already present in the mouth, and this creates the odour associated with halitosis.

(Related: Do You Have Good Dental Etiquette?)

Who can smell it?

If you’re someone who has spent years sitting next to a coworker with halitosis, you’re well-aware of how bad the smell can be. But people with halitosis aren’t always aware of the severity of their condition is, says Prakki. “Some people don’t notice—or they get used to it,” she says. Others go through phases where they are aware of the condition and act on it, only to forget to manage it later on. Others can be obsessed with how their breath smells, even if their case isn’t severe. If you’re unclear on the state of your breath, ask trusted friends and family what they think.

(Related: 35 Secrets Your Dentist Won’t Tell You)

How to manage halitosis

Handling halitosis means keeping your mouth as clean as possible, says Prakki. “Brush your teeth and maintain gum health,” she says, and don’t forget to clean your tongue –whether that’s using a toothbrush or tongue cleaner sold in drug stores. Using a mouthwash or zinc-based toothpaste can also keep bacteria at bay. During the day, Prakki advises chewing sugar-free chewing gum to ensure saliva is generated which can keep your mouth clean. For people with dry mouth, she recommends using artificial saliva for lubrication.

“If you’ve got halitosis, the important thing is to get help,” says Prakki. “Talk openly about the problem,” she says, and seek assistance from a dentist or hygienist. Staying on top of oral hygiene is the best weapon in the fight against bad breath.

“It’s better than hiding,” she says.

Next: How To Get Rid of Bad Breath, Once and For All