You have probably found yourself in a conversation with someone whose breath is so bad, you’re forced to breathe through your mouth or even hold your own breath. During the pandemic, that uncomfortable situation was replaced with another even more sinister one: 

Maskbreath!

Maskbreath is one of the many things we dealt with (and some of us are still dealing with) as a result of the pandemic. Because when you are wearing your mask, the malodorous air you exhale from your mouth shoots directly into your nose. Your poor olfactory organs are assaulted by noxious and fetid-smelling air that’s coming from your own mouth!

Your halitosis (the medical term for bad breath) wasn’t bothering the people around you because they were likely wearing masks, too, and social-distancing. But, it was undoubtedly bothering you. And now that most of us aren’t masked-up anymore, it can make you wonder if your halitosis is causing your co-workers and friends to hold their breaths and they are too polite to tell you!

All that aside, let’s talk about the causes of bad breath and what you can do about it. 

Bad breath (medically known as halitosis), especially when it’s chronic, can be very humbling. It’s estimated that by 2026, people will be investing over $23 billion worldwide to avoid it. That includes mouthwash, breath mints, breath spray, gum, and more. All to prevent mouth odor.  

Tens of millions of bacteria exist in the mouth. Some are “good bacteria” and others are “bad bacteria”. The bad guys are called anaerobic bacteria, and they’re the culprits in bad breath. Anaerobic bacteria (the “baddies”) thrive in the nooks and crannies of your mouth, particularly between your teeth, under your gum line, and in the crevices of your tongue. When not systematically removed, they emit smelly and sulfurous compounds. (Yuck).

The 5 Main Causes Of Bad Breath

1. Poor Oral Hygiene

   Bad breath is often due to a failure to practice proper oral hygiene. But it is the easiest to treat. Bacteria overgrowth occurs in your mouth when dental plaque is allowed to accumulate on your teeth and under your gums. Food particles get lodged between teeth and under dental bridgework, and they’re a plentiful source of nourishment for dental bacteria.

   Bacteria have a veritable feeding frenzy when they find food particles in your mouth. They produce acids that cause tooth decay and gum inflammation. A mouth full of bacteria emits a putrid scent and malodorous gases, which are by-products of bacterial digestion of the food left behind.

   To help reduce halitosis, brush your teeth more frequently (after each meal is a good habit), floss daily, and brush your tongue with a couple of swipes of your toothbrush or with a tongue scraper.

2. A Reduction In Saliva

   Saliva is a natural lubricant and prevents food from sticking to surfaces of your mouth, including teeth, gums, and tongue. As we age, our bodies produce less saliva, which enables food particles to adhere to our teeth and gums. It’s the perfect environment for anaerobic bacteria to thrive. Saliva helps neutralize bacterial acids that can cause bad breath and, eventually, tooth damage. 

   A reduction in saliva production can also be caused by medications. According to the Mayo Clinic, hundreds of drugs cite dry mouth as documented side effects. Among the likely culprits are certain anti-depressants, high blood pressure medication, and anxiety drugs. Some antihistamines, decongestants, muscle relaxants, and pain medications can also cause saliva levels to decrease.

   Some medical conditions can lead to dry mouth, too. They include certain auto-immune diseases such as Sjogren’s Syndrome and poorly-controlled diabetes. When diabetes is not properly controlled, ketoacidosis can occur. Ketoacidosis is a metabolic state that can often be detected by a distinct and unpleasant odor.

   If your mouth is often dry, try to drink plenty of water throughout the day. After meals, brush your teeth, too. If brushing isn’t possible, swish water around your mouth to help flush out any loose debris.

3. Digestive Issues

   GERD and acid reflux are often the causes of halitosis. Stomach acids and associated gases can back up into your oral cavity, and they smell horrible.

   Antacids can offer a short-term remedy, but chronic GERD and acid reflux needs to be evaluated and treated by a physician to avoid serious health issues.

4. Old Or Broken Dental Work

   Most people have at least one filling. And many have crowns, a bridge, or dentures. If these restorations are not checked about every six months for breakage and fit, cracks and leaks can occur where food gets lodged in. Bad bacteria absolutely love it in there. (Gross!)

5. Sinus Problems

   Chronic sinusitis and sinus infections accompanied by postnasal drip are a significant cause of bad breath, too. Postnasal drip contains bacteria that can make for a malodorous mouth.

   Even without postnasal drip, sinus infections can be responsible for foul, stinky breath and potentially lead to serious health risks.

   If your sinuses are an issue, see your doctor and get evaluated immediately.

Now That You Know What’s Causing Your Bad Breath, Here’s What You Can Do About It

• Go To The Dentist

  The best way to avoid bad breath is to keep up with your dental checkups. A simple cleaning is usually all that’s needed to prevent a build-up of bad bacteria. Your dentist will also check on the condition of your dental work and repair or replace it if needed. Cleanings will reduce the conditions that cause bad breath – and may even save you from aggravation and expense in the future.

• Address Your Sinus Problems

  If you suffer from chronic sinusitis or experience frequent sinus infections, seek the care of an ENT (Ear, Nose, and Throat doctor). An ENT will determine the cause and help you feel better.

  Sometimes, acute or chronic infections in an upper molar can cause a sinus infection because your upper back teeth roots are close to, or actually extend into, your sinuses. So, that means an abscessed tooth can cause the maxillary sinus to fill with bacteria and spread infection. 

• Use a Tongue Scraper

  Tongue scrapers are handy tools that help reduce the number of bacteria in your mouth. Just use it to brush your tongue after you brush your teeth. If you don’t have a scraper, one or two good swipes with your toothbrush will do the trick. (Be sure to rinse thoroughly afterward.)

• Use Mouthwash

  If your diet is causing halitosis, one good swish with a strong mouthwash can be helpful. But, if your bad breath is due to a dry mouth, please avoid brands that contain alcohol – they will make your mouth even dryer.

  Note: mouthwash covers up bad breath, but it won’t replace good oral hygiene.  

• Try Non-Alcoholic Mouth Rinse

  For my older patients complaining of dry mouth, I frequently recommend mouth rinses such as Biotene®. These non-alcoholic rinses are as effective at killing bad bacteria as the alcohol-based ones.  They are much gentler to gums and mouth tissue and won’t cause dry mouth.

In Conclusion

After experiencing your own maskbreath, it is a good idea to figure out what is causing your halitosis.

If you haven’t been in a while, there should be a visit to the dentist on your calendar. If your bad breath is not dentally-related, he or she will provide you with guidance about what to do next.

Luckily, most of us don’t have to worry about smelling our own maskbreath anymore. Of course, my staff and I will be wearing our masks at the office…forever!

If you have questions or would like to make a comment, please enter it in the space below.

For more information on the foods that can cause bad breath, link here.

Michael Sinkin practices cosmetic, implant, and restorative dentistry in New York City. He is known for superior dental care and his wicked sense of humor! To contact Dr. Sinkin, click here.