It’s not only unpleasant for those around you. Bad breath, clinically known as halitosis, is just not healthy.

    “Halitosis can be caused by many issues. As a dentist, I do my best to run through a checklist of oral conditions that can be causing it, and then move on to systemic conditions,” says Dr. Justin Short of “Bad breath can be caused by poor hygiene, diet, medications, dry mouth, reflux and other systemic conditions, such as diabetes.”

    The first step in combating chronic bad breath is to realize that you have a problem and talk to your dentist or primary-care physician. “It is a very common problem, but few people like to discuss it. There should be no reason to feel embarrassed,” Short says.

    Individuals who wear braces or other types of oral appliances may find bad breath is a problem because braces can trap food particles, and rotting food in the mouth is one of the most common causes of bad breath. Not only do leftovers in the mouth cause halitosis, they also are the breeding grounds for bacteria that cause gum disease and other potentially serious medical conditions.

    Not surprisingly, the first piece of advice is usually to pay more attention to regular, thorough brushing and flossing. “Often bad breath is caused by odor-causing compounds on the tongue or in and around the teeth or gums,” Short notes. “Patients need to understand that brushing their tongue is just as important as brushing their teeth, but this is often overlooked.” He adds that even those with good oral hygiene have odor-causing compounds that can build up in the mouth and often can only be removed by a professional cleaning.

    Saliva is the mouth’s built-in cleaning system, says Dr. Robert Shapiro of Orthodontic Specialists of St. Louis. “I recommend that my patients chew sugarless gum to help stimulate saliva, which is the number one hedge against tooth decay and bad breath,” he says.

    Given that saliva is helpful, medications that cause dry mouth can be among the biggest culprits causing halitosis. Drinking plenty of water is another good way to keep the mouth moist and rinse away bits of trapped food. Smoking or chewing tobacco, drinking alcoholic beverages, or consuming pungent foods and spices, such as garlic, also may cause bad breath.

    Although there are many products available that claim to counteract bad breath, Shapiro is not a fan of mouthwash. “Overuse of mouthwash can disrupt the pH balance of the mouth,” he says. Similarly, Short relies primarily on improving oral hygiene, rather than specific rinses or mouthwashes for his patients with chronic halitosis.

    If bad breath persists despite good oral hygiene habits, it may be wise to see your primary-care physician to determine if the problem is related to a sinus infection, lung condition, liver or kidney disease, or diabetes.  LN