How can I get rid of stubborn bad breath?

Bad breath can definitely be distressing! I'm glad that you have taken your oral hygiene very seriously as having unhealthy gums or untreated open cavities can cause bad breath.

Bad breath may be caused by the presence of gum disease and tooth decay. These would normally be picked up by your dentist during a routine examination visit. Treatment of the underlying cause would normally eliminate the bad breath completely.

Bacteria living on the surfaces of our teeth and mouth break down proteins and produce strong smelling gases that mix with the air we exhale.

Other less common causes of bad breath include:

• A dry mouth
• Mouthbreathing
• A high protein diet
• Frequent caffeine consumption
• Post nasal drip (mucus leaking from the back of the nose down into the throat).

All these other issues have 2 things in common:

1) dryness of the mouth/lack of saliva, and

2) increased protein levels in saliva.

If you have been cleared of dental disease, then it may be worthwhile exploring the other causes for bad breath for a more lasting solution.

Many patients I see are chronic mouthbreathers with chronic nasal congestion from allergies or sinusitis. They report worse bad breath in the mornings after a night's sleep.

Other simple tips to optimize your mouth's natural defense mechanisms include:

• Avoiding foaming toothpastes
• Alcohol-containing mouthrinses as these strip the lining of the mouth and may worsen dryness
• Reducing caffeine consumption is helpful for preventing dry mouth caused by dehydration
• Switching to a high plant based diet rather than high protein diet may also be helpful

Probiotics are still relatively new in the management of bad breath. Conventional probiotics contain bacterial species found in a healthy gut, which may not correspond with the good bacteria species found in the mouth. There have been promising results with a new dental probiotic (BioGaia) for the treatment of bad breath.

As always, it is best to have a discussion in person with your dentist who can advise you on different strategies to tackle this problem.

Hope this helps.

I'm so sorry to hear about your frustrations with bad breath. I've had many patients seek treatment for bad breath at my practice and I know how distressing it can be, especially when you have tried "everything".

From my experience, for someone who has been cleared from any form of dental disease, the cause of the bad breath can be ENT-related.

I would advise you to seek an opinion from an ENT surgeon, and possibly a second opinion from another dentist just to be sure that your first dentist didn't miss anything.

Dr Marlene's article is very useful, and I also agree with Dr Jaclyn's pointers.

I wish you all the best in finding a solution to your problem!

Kind Regards,

Dr Gerald Tan

I totally agree with Dr Jaclyn Toh.

You might also want to check out this article I wrote a while back on the causes of bad breath, if you need more information.

Best,

Marlene