Dear Alice,

Like many people, I often have an embarrassing bad breath. Listerine and other mouthwashes won't be of any help for this chronic problem. There are lots of products available to get rid of "volatile sulfur compounds (VSC)" - that supposedly cause this — and I just don't know which one I should try. Also, what's your opinion on tongue-brushing?


Evil Breath

Dear Evil Breath,

As you’ve surmised, you’re in the same boat as about 40 million Americans who also deal with bad breath, which is also called halitosis. For this common problem, countless breath freshening products exist, such as mouthwash, toothbrushes, dental floss, and tongue scrapers. However, some of these may only temporarily mask odors instead of resolving the true cause of chronic bad breath. So, aside from mouthwash, what are other effective alternatives? The solution to your situation may depend on the source of your bad breath. Potential causes could include:

  • General dental hygiene affects the mouth's environment. The mouth offers a moist, dark, and warm place for bacteria to thrive. These bacteria are the source of the problem because they react with sulfur-containing proteins in the mouth. In turn, these proteins help generate the release of volatile sulfur compounds (VSCs), which are gases that smell like rotten eggs. A thorough dental hygiene routine can help get rid of these odor-causing bacteria.
  • Various foods, such as garlic and onions, are absorbed into the bloodstream and may be exhaled through the lungs as smelly breath odors. These are unlike odors from burps, as those come from the stomach and are usually fleeting. You can try experimenting with avoiding these foods to determine whether they’re the culprits behind your bad breath.
  • Tobacco use may result in short-term, foul mouth odors. Smoking not only causes your mouth to smell of tobacco and smoke, but it also can dry out the oral lining, causing stinky breath. If you’re a current smoker, quitting may improve your breath and overall health.
  • Dry mouth (xerostomia) may also contribute to the development of bad breath. Dry mouth can be caused by certain medications (i.e., antihistamines, decongestants), breathing predominantly through the mouth, salivary gland problems, or not drinking enough fluids.
  • Various dental conditions, such as advanced periodontal disease, gum disease, and cavities, may cause persistent bad breath. If any of these are an issue for you, consider asking your dentist for more information and treatment options.
  • Certain medical conditions, such as liver and kidney disorders, diabetes mellitus, postnasal drip, and respiratory and sinus infections may cause bad breath. If you think these could be a contributor to your situation, you might want to chat with a health care provider.

If you'd like to stick with mouthwash, it may be worthwhile to try gargling a few more types to see if any of them help. Aside from antibacterial and antiseptic mouthwashes, there are other options such as fluoride rinses or breath-freshening rinses. These don’t contain as much alcohol as classic antiseptic mouthwashes and may be gentler for your mouth.

Hopefully these tips can help you to stop holding your breath and breathe a little easier. However, if a new mouthwash or any of these tips don’t tame the oral odor, consulting a dental care provider may be your best bet. For more, check out the American Dental Association's Mouth Healthy information on bad breath and the National Institutes of Health's Dental Health resources.

Here's to staying fresh,


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