It doesn’t help to turn on your TV. The commercials make halitosis seem epidemic. They warn darkly that without this or that mouthwash or breath-freshening gum, spray, or candy, you’re fated to suffer “morning mouth” or “dragon mouth” with horrendous consequences: lost lovers, missed promotions, and vicious gossip behind your back. Those commercials can’t possibly be for real, you tell yourself. But still, you wonder.

Halitosis (Bad Breath) Overview

Americans are so worried about our breath that we spend $1 billion a year on mouthwashes and other breath products in hopes of keeping it fresh.

Most people who worry about bad breath don’t have it, according to Walter Loesche, D.D.S., a professor of dentistry and microbiology at the University of Michigan School of Dentistry in Ann Arbor. Unfortunately, you never know.

In one study, Israeli dental researchers asked 52 people in Tel Aviv to self-test their breath using three age-old techniques: exhaling through their mouths into cupped hands and smelling it, licking their wrists and smelling it, and spitting into their hands and smelling it. Then the researchers smelled everyone’s breath. The result: The participants could not judge their breath by any self-test.

So how can you tell if you have bad breath. Dr. Loesche says: Ask a child. Children will tell you. Adults may not.

Most bad breath is caused by bacteria that live in the mouth, according to William Replogle, Ph.D., a professor of family medicine at the University of Mississippi Medical Center in Jackson. Two things keep these odor-causing bacteria in check—good oral hygiene (daily brushing and flossing) and salivation, which helps wash malodorous products of bacterial metabolism out of your mouth.

Bacteria in your mouth feed on food residues, and form plaque, the sticky deposits that cling to teeth and cause gum disease (gingivitis). If you don’t brush and floss it away regularly, the bacteria in your mouth produce foul-smelling compounds that give you bad breath. In addition, mouth bacteria also produce gum-irritating toxins that cause your gums to pull away from your teeth, opening up pockets that harbor even more bacteria, and lead to even worse halitosis.

Recently, Dr. Loesche and Michigan colleague Erika DeBoever, D.D.S., discovered the culprit in may cases of chronic halitosis—the tongue. The backs of some people’s tongues contain deep crevices where odor-causing bacteria thrive.

“Morning mouth,” the furry-tongued bad breath first thing in the morning, is a natural by-product of sleeping, Dr. Replogle explains. When you sleep, you stop salivating, and odor-causing compounds build up in your mouth. For the same reason, chronic dry mouth increases risk of bad breath. Many drugs can dry your mouth, among them: antihistamines, decongestants, pain relievers, antidepressants, diuretics, and cancer chemotherapeutics.

Finally, as you age, your breath generally gets worse. The reason is that the elderly produce less saliva than they used to.

Bad Breath Warnings

If persistent bad breath doesn’t clear up after a few weeks of aggressive home treatment and professional teeth cleaning, consult a physician. A number of potentially serious conditions can cause bad breath, among them: diabetes, kidney failure, lupus, hiatal hernia, liver and gallbladder disorders, and certain cancers.

Even exemplary oral hygiene can’t prevent bad breath that originates in the lungs. If you’re worried about your breath, avoid problem foods.

Your diet habits can go a long way to help you avoid bad breath.

• Meals heal.It’s important that you don’t skip meals. Chewing stimulates saliva flow, and keeping saliva production going helps keep bad breath away.
• The beef with meat. “Meat eaters are more likely to have halitosis than vegetarians,” Dr. Replogle says. Meats, especially pistrami, salami, and pepperoni contain sulfur and other compounds that get excreted through the lungs.
• Drink up. Drink plenty of water throughout the day, Dr. Brauer advises. It keeps your mouth tissue hydrated, and free of odor-causing food residues. Or drink citrus juices. In addition to the benefits of water, they also stimulate saliva flow.

Naturopathy for Bad Breath

• The digestion connection. Contrary to the mainstream medical view that bad breath originates in the mouth and, to a lesser extent, in the lungs, naturopath Joseph Pizzorno, N.D., president of Bastyr University, the naturopathic medical school near Seattle, contends that poor digestion also plays a role. His advice: A low-fat, high-fiber diet, with plenty of fruits, vegetables, and grains.

There are a number of things you can do at home to cure bad breath, from lifestyle choices to improving your hygiene habits.

Home Remedies for Bad Breath

• Don’t smoke. Tobacco causes bad breath.
• Rush to brush. Brush your teeth at least twice a day, and floss at least once, advises family practitioner Anne Simons, M.D., an assistant clinical professor of family and community medicine at the University of California’s San Francisco Medical Center. “Don’t just wave the brush around your mouth,” she says. “Brush thoroughly, especially around your gum lines. Floss thoroughly as well.”
• Target your tongue. Dr. DeBoever recruited 14 people with severe, chronic bad breath and taught them how to scrape the backs of their tongues. They also used a prescription antibacterial rinse (see below). After one week, their bad breath disappeared. Tongue scrapers are hard to come by. If you can’t find one, Alan Brauer, M.D., director of TotalCare Medical Center in Palo Alto, California, one of the nation’s oldest clinics to combine mainstream and complementary medicine, recommends using a toothbrush.

  Philadelphia periodontist John Richter, D.D.S., suggests using a cheap metal spoon bent to increase the angle between the handle and bowl. To be effective, you have to brush or scrape the very back of your tongue. Unfortunately, this may cause gagging. “But with a little practice,” Dr. Brauer says, “you can overcome your gag reflex.” Tongue scraping may be new to Western oral hygiene, but India’s Ayurvedic physicians have recommended it for centuries. “It’s very helpful,” Dr. Brauer says, “but few people do it.”

• Open wide. Have your teeth cleaned professionally at least annually.
• Disinfect dentures. If you wear removable dentures or any other dental appliance, clean it daily and soak it in a disinfectant overnight..
• Chew gum. It doesn’t have to be special breath-fresening gum, Dr. Simons says. Chewing any gum gets your saliva flowing, which helps eliminate bad breath.

• The chlorophyll cure. “Chlorophyll, the green pigment in plants, is a powerful breath freshener,” says Maryland botanist/herbalist James Duke, Ph.D., author of The Green Pharmacy. Ever wonder why restaurants often garnish meals with a sprig of parsely? It’s a modern echo of the ancient Roman practice of chewing parsley after meals as a breath-freshener. Parsely is rich in chlorophyll. So are basil and cilantro. “Refrigerate sprigs of fresh parsley, basil, and cilantro in a glass of water,” Dr. Duke suggests. “Nibble them throughout the day.” (Chlorophyll is the “Clor” in Clorettes breath mints, and one of the active ingredients in Certs.)
• Good ol’ cineole. Cineole is a powerful antibacterial antiseptic found in several medicinal herbs. “The richest source is cardamom,” Dr. Duke says, “but eucalyptus, spearmint, peppermint, rosemary, sweet annie, ginger, and tansy are also good sources. Munch them, or brew them in tea.”
• Take time for thyme. Thyme is another notable antibacterial herb, thanks to the thymol in its oil. Chew some leaves, or brew up a tea. Or rinse your mouth the Listerine, whose active ingredient is thymol. In one study, participants rinsed their mouths twice a day with either Listerine or a placebo mouthwash. The Listerine group wound up with 43 percent less plaque. The downside of Listerine and most commercial mouthwashes is that they contain alcohol, which can dry your mouth, and promote bad breath. But in Listerine, the antibacterial action of the thymol more than makes up for the alcohol.
• Be sanguine about your breath. In addition to Listerine, Dr. Brauer also recommends Viadent, an over-the-counter mouthwash that contains and extract of the medicinal herb sanguinaria (blood root). “Sanguinaria is a powerful antiseptic,” he explains. “It kills bacteria in the mouth and under the gums that contribute to bad breath.”