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We’ve all had that colleague, friend or teacher with the unbearable bad breath. It’s an unfortunate social faux-pas that is all too common and sometimes leads to obsessive use of mouthwash, mints and chewing gum.
Bad breath is a huge turnoff, whether in personal or businesses relationships. Even if someone appears outwardly attractive and healthy, if their mouth emits a foul odor, it’s a subconscious signal that they are not in an ideal state of well-being.
In medieval times, people would cover their noses with small bouquets of flowers or scented handkerchiefs because they believed that bad smells carried the black plague. While this wasn’t exactly accurate, the instinct to escape an unpleasant scent remains.
This makes social situations difficult for those of us who experience bad breath. There is even a defined disorder for the fear of having bad breath, called halitophobia. Sufferers misconstrue the actions or comments of others as being against their breath, and become obsessed with constant cleaning of their teeth and mouth.
Unfortunately, constant cover-ups don’t treat the root cause of bad breath. Mouthwashes usually contain alcohol and may actually dry out delicate mouth and sinus tissues, perpetuating the problem. Mints and chewing gums are frequently made with artificial flavors and chemical sweeteners, which come with their own range of potential side effects including digestive discomfort and headaches.
So how can we uncover and address the true reason for bad breath? There are actually many ways this problem can come about — some that are fairly obvious, and others that can be quite insidious and difficult to detect.
Sometimes bad breath actually does originate in the mouth
Most conventional sources hold that bad breath originates in the mouth, and that improved oral hygiene can remove the issue. Let’s first examine some of these more obvious cases.
Oral hygiene: Not brushing your teeth often enough can lead to the buildup of a film of bacteria called plaque. Got pink in the sink when you brush? This is due to gum irritation, which is referred to as gingivitis. The irritation is usually there because of bacteria living in the gaps between the teeth and gums.
The same may happen on the textured surface of the tongue, or on dentures that are not properly cleaned or sanitized. We recommend regular flossing, brushing with a gentle natural toothpaste, and the use of an ayurvedic tongue scraper to keep mouth bacteria in check. A holistic-minded dental practitioner can also advise on the best practices for good oral hygiene.
Certain foods: Consuming high-sulfur foods, such as onions and garlic, can change the smell of your body, not just directly from eating them, but also by altering your blood chemistry. However, they are also very helpful for a robust immune system, so we don’t recommend avoiding them. Instead, just ensure you are eating a wide variety of different vegetables, herbs and spices, rather than relying too heavily on any particular type.
Consuming citrus fruits, on the other hand, can help improve bad breath, since their essential oils have antibacterial abilities, helping to kill smelly bacteria and remove phlegm.
Dry mouth: Many medical conditions can cause mouth breathing or reduced saliva production, which can lead to a dry mouth. Saliva is very important for keeping tissues lubricated and moving food particles out from between the teeth and gums.
It also contains enzymes that are vital for digesting food. Without enough saliva, food and plaque can accumulate and result in unpleasant odors. Some examples of conditions causing dry mouth include hormonal imbalances, sleep apnea, and the use of a wide range of medications including those used for anxiety, allergies and epilepsy.
While some incidences of smelly breath may be solved with the easy fixes outlined above, the real cause commonly lies in less expected areas of the body, such as the throat and sinuses. Or, as we will discuss in a following section, further down the digestive tract.
Throat and sinus issues that can cause bad breath
The throat and sinuses have many areas that can collect mucus — this in turn harbors malodorous bacteria. It’s pretty unpleasant to think about, but that nasty smell might actually be coming from slime in the back of your throat.
Tonsil stones: The tonsils are sacs of lymphatic fluid that rest at the back of the throat and help protect against infections by invading disease-causing bacteria. They are not smooth, but rather have pits and crevices that serve as collection points for mucus, food, bacteria, and calcifications called tonsil stones.
Tonsil stones are not well understood, although studies have shown that up to six percent of the population may be harboring them. The stones can be removed using a simple salt water rinse at home, or by using an oral irrigation device. The surface of the tonsils can also be smoothed using a laser procedure, if the situation causes repeat issues. Regular gargling is likely a good preventative measure against tonsil stones.
Post-nasal drip: This condition is where the rear of the sinuses and the throat are consistently plagued by mucus. If you are always clearing your throat, a post-nasal drip could be the reason. Mucus can harbor bacteria that cause a bad odor. Some common causes of this uncomfortable chronic condition are breathing dry air, allergies and bacterial infections. Food intolerances can also cause a post-nasal drip, particularly issues with the consumption of dairy foods.
Sinus infection: Similar to post-nasal drip, chronic sinus infections can also cause bad breath. The nose and throat are intimately connected and have a common bacterial environment. If this is out of balance, unpleasant odors can result. Holistic remedies, such as using a neti pot or administering fire cider, can be helpful against a chronic sinus infection. However, seeing a knowledgeable practitioner is likely a good idea as well.
Is the problem further down?
So now we’ve seen where bad breath can start in the mouth and throat. For many people, however, the issue can start further down in the digestive tract. Similar to the smells that can be emitted with a belch, the goings-on in the digestive tract can contribute to bad breath.
Esophageal and digestive issues: Acid reflux happens when the sphincter between the esophagus and stomach is not functioning correctly. This can be due to eating too fast, food intolerances or low stomach acid. Poor digestion can cause food to putrefy in the stomach and can leak up through a poorly-functioning esophagus. It’s easy to see how bad breath could be a result. Although many people treat this condition with antacids, these can exacerbate the problem. Try improving your stomach acid production and digestion instead.
Small intestinal bacterial overgrowth (SIBO): This is a complex problem that can have many contributing causes and result in many symptoms. Essentially, any abnormal growth of bacteria within the small intestine, also referred to as the small bowel, can result in a pathogenic condition. The bacteria thriving here give off gases, which escape through your mouth and are interpreted as bad breath. It’s quite clear that brushing your teeth more will not be helping with this bad breath problem!
Your gut bacteria is a vital part of your digestive and immune systems, but when there is an imbalance, there can be many complications including food allergies, systemic inflammation, and autoimmune diseases. The lack of ability to digest properly can also lead to nutritional deficiencies. It is important to keep the gut biome in a healthy balance.
Risk factors for an imbalanced microbiome include frequent use of antibiotics, taking the birth control pill, and existing medical conditions such as diabetes and celiac disease. Some strategies that may be helpful include consuming a whole foods diet and fermented foods to support good bacteria, and using a botanical antimicrobial protocol as administered by a knowledgeable practitioner. Potent medicinal herbs, such as garlic, cinnamon and cardamom, can help discourage the growth of harmful gut bacteria.
Medications and diseases
Unfortunately, there are a number of pharmaceuticals and medical conditions that can cause a person to have persistent bad breath. This is another one that clearly cannot be defeated by repeated toothbrushing.
Studies have indicated that seven of the top 10 prescription medications in the United States can have dry mouth, bad breath or taste disorders as a side effect. In these cases, bad breath can be indirectly caused by a dry mouth, or the medication may break down in the body and release chemicals that are carried on the breath. Insulin shots, triamterene (Dyrenium), and paraldehyde are some common medications related to this issue.
You can see that bad breath may be a deeper issue requiring more than just a new toothpaste or stronger mouthwash. Learn more about how to balance your internal environment for better breath, stronger immunity, and improved overall health with this helpful article on healing your gut.