A dental check-up is the first priority. The British Dental Association suggests that you explain in advance that you will be asking for advice about bad breath. Tell the receptionist when you make an appointment and ask that it is noted down and that the dentist is told. Ask the dentist for a thorough scale and polish and ask if there are any defects where plaque and food debris might be building up.
Clean your teeth properly. A dental hygienist (make an appointment via your dentist) will show you how to clean your teeth properly, and how to use floss to clean between the teeth. Give your teeth a thorough cleaning for 3 minutes twice a day to remove the plaque and use floss (see also below). Use disclosing tablets (which you can buy from pharmacies); these dye the plaque on your teeth, showing the areas you have not been cleaning properly. Use a toothpick after meals to remove large food particles from between the teeth and, if possible, rinse your mouth out after meals.
How to clean your teeth
- Use a brush with a small head, about the size of a 20p or 5c coin.
- Use only a pea-sized blob of toothpaste. Toothpaste is abrasive and too much can cause wear of the teeth.
- The British Dental Association recommends the gentle scrub method. Place the brush at the neck of the tooth where it meets the gum and use very short horizontal movements, at a 45-degree angle, to dislodge the plaque. The brush can be held in a pen-like grip to avoid excessive force.
Buy a tongue cleaner. This is a curved plastic scraper like a small garden hoe. Stick out your tongue and place the cleaner onto the tongue as far back as possible. Then pull forward while gently pressing against the tongue surface. Do not scrape too much, because if you scratch the tongue, bacteria will get into the cracks and make the problem worse. You can buy tongue cleaners from most dentists and some pharmacies.
If you cannot obtain a tongue scraper, brushing the tongue with a soft toothbrush once a day may be helpful. The most important part to clean is the back of the tongue, if you can do this without gagging. Wet the brush with mouthwash, then stroke from the back of the tongue in an outwards motion. Do not overdo the brushing; the idea is to dislodge any bacteria and flush out stagnant saliva.
Don’t skip meals (especially breakfast). You need to eat regularly to keep the saliva flowing.
Drink black tea, that is tea without milk. Researchers at the University of Illinois, USA, found that chemicals in tea can stop the growth of the bacteria responsible for bad breath, and may suppress the bad-smelling chemicals they produce. However, to get the most benefit, the tea must be drunk without milk.
Chewing sugar-free gum can be helpful because it stimulates the flow of saliva and involves movements of the jaw and cheeks. Both these factors help to remove food debris and cleanse the mouth.
Stopping smoking will get rid of ‘smoker’s breath’.
Mouthwashes, deodorizing mouth sprays or tablets will mask bad breath temporarily – useful after eating onion or garlic. Modern mouthrinses also contain antibacterial chemicals so, in theory, they should improve mouth malodour related to gum disease. Before bedtime is the most effective time to use these mouthrinses. Gargle with the mouthrinse, sticking your tongue out at the same time, and then spit the mouthwash out. There are many different brands with different ingredients, so it is important to check the label to find one the most suited for you.
- There is some scientific evidence that mouthrinses containing chlorhexidine, cetylpyridinium chloride, chlorine dioxide or zinc lactate can reduce bad breath somewhat (Cochrane Database Systematic Review 2008;CD006701). Although chlorhexidine is one of the most effective antibacterial mouthrinse ingredients, it has a strong taste and can lead to teeth staining.
- Alcohol-containing mouthwashes may not be appropriate for patients with burning mouth syndrome or dry mouth as it can make these problems worse.
If you have dentures, remove them at night and soak them in a solution of hypochlorite or chlorhexidine. A pharmacist will be able to advise you.
First published on: embarrassingproblems.com
Reviewed and edited by: Dr Anna Cantlay
Last updated: October 2020