Slay the dragon (breath)

July 11, 2024 2:27 PM

I’ve been told I have bad breath. I want to stop having bad breath.

You are not my doctor, dentist, etc.

I am a male in my late-40s, in overall good health, height/weight proportional, exercise regularly, and have no other underlying health concerns as of my last annual check-up a month ago. Based on an old AskMe, I checked and I don't think I have tonsil stones.

But I can't seem to get handle on this problem. I can't smell it myself, but I've been told I have bad breath. It's embarrassing, and I'm sure it's negatively impacted otherwise positive interactions I've had with people.

I want to create a "stop having bad breath" regimen. So far, I’ve come up with:

1. Improve oral hygiene (brushing, flossing, waterpik, nonalcoholic mouthwash)
2. Drink more water to prevent dry mouth
3. Eat (to prevent ketosis)
4. Take an oral and/or gut probiotic
5. Chew gum or use breath mints

Looking for any other suggestions and best practices from your experience. Please chime in if you can speak to the efficacy of any of the above or other strategies not listed. I'm open to just about any solutions at this point.

If you have brands you swear by, please recommend them. I also have my 6-month dental check-up/cleaning soon, so if there are specific things I should mention at that visit, please feel free to suggest those as well.

posted by Apropos a pro's pose to Health & Fitness (29 answers total)

I really do think you've probably got tonsil stones.

When you open your mouth to do the aaaahh thing do you see your little tonsil pockets? You might not be able to see anything in there, but crud can hide. If you can see visible pockets, then you've probably got tonsil stones.

One thing you can do is take a qtip, put a couple drops of water on the swab, then saturate the swab in hydrogen peroxide (it dilutes just enough that way). Then swizzle it into those little pockets. The foaming reaction will help dislodge the crud.
posted by phunniemee at 2:40 PM on July 11 [6 favorites]

It would be really helpful to know your current brushing regimen. When do you brush your teeth now? If you eat or have some flavored drink, your breath is going to be not great a few hours later most likely. Drinking water may help a bit. But, brushing your teeth sometime after that meal would work best.

If you have just eaten, then your breath is probably fine, unless you ate something with, like, raw onions or garlic.

But, yeah, just get in the habit of brushing your teeth sometime after your meals, and before your next important social interactions, and I bet this problem will go away.

Let me put it another way: I am a person who really doesn't want to have bad breath. I generally brush my teeth before I leave the house (when I am working from home), and then after lunch if I'm at work, especially if I have someplace to go/people to interact with. If I'm going out after work, even if it's to dinner, I will brush my teeth before I go.
posted by bluedaisy at 2:42 PM on July 11

Floss, drink water regularly, brush regularly, ask your dentist about gum disease, cavities, etc.

If you get tonsil stones, you should be able to feel the big sacs at the back of your throat, and express them (push from the bottom up towards your head) to get them out. They have to be pretty big before they come out on their own. Do it like once a week or so. There is one on each side. Ask your dentist if you have the pockets phunniemee mentioned.
posted by The_Vegetables at 2:45 PM on July 11 [2 favorites]

To help you narrow down the possible causes, you may want to try a dry mouth toothpaste brand like Biotene. Biotene also makes a mouthwash and fresh breath gum that are specifically for dry mouth. Therabreath's mouth wash for dry mouth is decent, too.

As an aside, do you take ADHD medication like Adderall or Vyvanse, by chance? One of the potential side effects is dry mouth (ask me how I know). You could still have dry mouth due to other causes, including dehydration/an electrolyte imbalance, but it might be good to rule out a medication-related cause.
posted by nightrecordings at 2:47 PM on July 11

Tongue scrapper!! The long plastic strip with little ridges. Use it while brushing and like once in the afternoon or so.

https://a.co/d/0fG4a5GE

I’m surprised no one has mentioned this.
posted by Mr. Papagiorgio at 3:00 PM on July 11 [10 favorites]

I think people who drink a lot of fizzy drinks, especially sweetened ones (even if it’s with sweeteners instead of sugar) generally have bad breath. So maybe cut back on sodas if they’re part of your normal habits.

I used to have really bad breath and a regular flossing habit really helped.
posted by congen at 3:11 PM on July 11 [1 favorite]

Tongue scraper, or just brush your tongue.
posted by number9dream at 3:24 PM on July 11

FLOSS FLOSS FLOSS FLOSS
posted by Melismata at 3:27 PM on July 11 [4 favorites]

Dentist for a really intense cleaning
Tongue scraper, right to the very back of your tongue
Learn how to remove your tonsil stones
Check for acid reflux and address it
Swish your mouth with water after eating
Gargle with Therabreath- it’s the best mouthwash!
posted by nouvelle-personne at 3:30 PM on July 11 [1 favorite]

Don’t drink only coffee or tea for breakfast. Something about empty stomach after those drinks is just vile-smelling on some people.
posted by oxisos at 3:57 PM on July 11 [2 favorites]

I had two kids with shocking dragon breath, brushing didn't touch it. Turns out they were both mildly lactose intolerant. Eventually the lactose intolerance became less mild and started causing constipation, which is what ultimately led us to switch to non-dairy/lactose free. The sudden disappearing bad breath was an unexpected and welcome side effect.
posted by Ausamor at 4:08 PM on July 11

Surprised no one has suggested post-nasal drip! That’s an ongoing struggle for me, and actually a cause of my occasional tonsil stones. I have it even when my nose is not stuffy—my ENT insisted it must be GERD for that reason until he snaked my nose and found the chronic sinus infection I was sure I had! So I guess a low-grade chronic sinus thing AND GERD (especially after seeing Ausamor’s lactose mention) are both outside-the-box culprits you might think about.
posted by lovableiago at 4:19 PM on July 11 [5 favorites]

Seconding (fourthing?) flossing here. To really drive this home, floss your teeth right now and then sniff the floss. Smells gross, right?

Also - you didn't mention it, but if you smoke pot, you might want to brush/floss or at least swish some water in your mouth after doing so. People I know with otherwise normal breath tend to get poopy-smelling (not pot-smelling) breath if they don't do that.
posted by queensissy at 4:50 PM on July 11 [1 favorite]

Gargle with a generous swig of hydrogen peroxide for at least 30 seconds, then spit out, several times a day. Then brush, and be sure to brush your tongue. Floss. This regimen should eliminate significant colonies of smelly flora in your mouth. If it persists, it might originate elsewhere, such as the gut or sinuses.
posted by 2N2222 at 5:13 PM on July 11

Use therabreath and don’t skip gargling. Use Cocofloss — best floss brand on the market; I was so grossed out the first time I used it. Drink peppermint tea.
posted by meowmeowdream at 5:20 PM on July 11 [1 favorite]

a peroxide based mouthwash, either homemade or therabreath, neutralizes things really well.

also make sure you don't have sinus issues leading to post nasal drip.
posted by zippy at 6:12 PM on July 11

If GERD is potentially causing any your issues, peppermint can actually make it worse; it relaxes the sphincter at the top of the stomach.
posted by Blue Jello Elf at 6:13 PM on July 11

I hope you don't feel too bad about this. It's likely nothing that you're doing wrong. I would keep searching for the underlying issue and address the root of the problem. Can you talk to your GP? I'm not a doctor, but I know that diabetes and some liver/kidney issues can cause this.

Also, how's your sleep? If you have sleep apnoea, you might be sleeping with your mouth open, and that can cause halitosis. You're the perfect age, many men get diagnosed between 40 and 50. If you do have it, there are treatments that would improve your overall health, like reducing the risk of strokes and heart attacks. And rather than going to a sleep lab, you might be able to do a test with a device to take home.
posted by toucan at 7:00 PM on July 11 [5 favorites]

This style of disposable tongue scraper is super cheap, very effective, more comfortable than the serrated kind, and there is absolutely no reason to dispose of them; just rinse them off after use. I'm still using the first one from a packet I bought four years ago.

Open your mouth wide, stick your tongue right out and run each scrape from way way way at the back, as far back as you can go without gagging, all the way to the tip. Repeat until you've covered the whole top surface of your tongue. Do it right after brushing so that your tongue has been exposed to your toothpaste for a while before you start. If you've not used a tongue scraper before you'll probably be astonished at how gross the stuff that comes off it is. Gargle, rinse and spit to finish.
posted by flabdablet at 11:30 PM on July 11 [1 favorite]

Are you taking any medication that might cause a dry mouth? Antihistamines, for example.
posted by Bloxworth Snout at 2:35 AM on July 12

A lot of people are mentioning flossing, but I would recommend specifically flossing after anything you eat. I carry dental floss everywhere.
posted by wheatlets at 3:21 AM on July 12 [2 favorites]

If your teeth are jammed together as tight as mine are so that flossing is desperately uncomfortable, interdental brushes are a good alternative. They're basically teeny tiny bottle brushes. I rinse mine clean and dip it in toothpaste for each individual gap, working all the way around my mouth before starting my main brushing session.

Again, these things are sold as single-use disposables but there is absolutely no need to; with gentle use so as not to kink the central wire, and a thorough rinse before re-capping and putting back in the drawer, mine generally last about as long as my main toothbrush does.

Getting the right size for your mouth is important. You want the biggest ones that fit comfortably between your teeth without needing to be forced in, and you'll probably need several sizes to be able to cover your whole mouth.

If you've not been in the habit of using either these or floss then there will probably be a small amount of gum bleeding as the gingivitis that's been souring your breath gets scraped out, but if that persists for longer than a week or so, drop down a size even if the size you're using is already comfortable.
posted by flabdablet at 4:07 AM on July 12 [1 favorite]

if you smoke pot, you might want to brush/floss or at least swish some water in your mouth after doing so

Smoking anything will fuck up your breath until your whole mouth has been thoroughly cleaned, but pot will do it even if eaten instead of smoked because it brings on dry mouth in most people.
posted by flabdablet at 4:12 AM on July 12

You've been told you have bad breath but can't smell it yourself. Has more than 1 person told you this? Has your dentist or dental hygienist told you this?
posted by at at 6:50 AM on July 12

Response by poster: Thank you for all the suggestions!

I can rule out some factors: I don’t smoke (tobacco or weed). I am not taking any medication besides over-the-counter vitamins. My drinking habits average fewer than one drink per month. I also don’t drink coffee, tea, or soft drinks (I do like juices). I don’t think I have GERD/acid reflux, but I am probably mildly lactose intolerant. I don’t think I have a sinus infection.

I have had more than one person remark this, but it’s been many years in-between comments. I like to think we mostly live in a polite society, so people probably just don’t say anything, rather than risk offending or hurting my feelings. I have smelled other people’s bad breath before, and just not said anything, so…I kind of get it. :-\

I’m going to ask about the tonsil stones at my upcoming dental appointment. I always have good oral hygiene habits immediately following a cleaning (brushing twice a day minimum, flossing at night, waterpik at night, and mouthwash), but I usually fall off at some point. I need to stay committed to the new regimen.
posted by Apropos a pro's pose at 7:46 AM on July 12

a) Water flossers are really effective. b) If you have facial hair, make sure it isn't contributing to the problem.
posted by Iris Gambol at 9:43 AM on July 12

I usually fall off at some point
Yeah, if you're not brushing at least twice a day, I suspect that's the culprit. But really, if you're interacting with people several hours after a tooth brushing and after a meal or two, anyone is going to have not-great breath at that point.
posted by bluedaisy at 10:21 AM on July 12

I have had more than one person remark this, but it’s been many years in-between comments.

It may well be the case, then, that your breath is already inoffensive most of the time. Just about everybody's breath will smell bad when they get sick or dehydrated or both, and "morning breath" is notoriously normal. What are the chances that those very sparse complaints reflected temporary conditions and that you already do stop having bad breath on the regular?
posted by flabdablet at 10:33 AM on July 12

I was so convinced I had tonsil stones causing my bad breath (and chronic tonsillitis) that I had my tonsils removed last year. Imagine my dismay when it didn't improve my breath at all! I didn't figure out the cause until, in a span of one week, an unrelated CT scan indicated that I had quite bad acid reflux and my dentist remarked that my teeth were getting quite scarred by acid. I don't notice it at all, but Pepcid has solved the breath problems when literally nothing else would.
posted by restless_nomad at 1:30 PM on July 12 [2 favorites]