While we may all be curious about the best plunger or probiotic tampon or cold-sore remedy, it can be difficult to discuss these more personal items. That’s why we’re tackling Things We Don’t Talk About, a series in which we track down the best hygiene-, sex-, and bodily function–related things we all need but might be too embarrassed to ask about. In this installment, we consult experts on the best treatments for bad breath.
There is morning breath and then there’s bad breath — that persistent, noxious smell even mouthwash can’t kill. Most of us want to avoid both. “Socially and in the workplace, bad breath is a really bad thing, like body odor,” says halitosis expert Steven Fox, D.D.S., of Fox Fresh Breath Dental. And while eating garlic or anchovies would be an obvious culprit, “80 percent of bad breath usually comes from the dental environment (like gingivitis or bad dental hygiene), and 20 percent from things like indigestion, tonsils, or sinuses,” says Scott Froum, a periodontist who often treats cases of bad breath. At the root of bad breath is the build up of bad bacteria, which “naturally live in your mouth,” according to Dr. Ben El Chami, the co-founder and chief dental officer at dntl bar. “The bacteria feed on the leftover food material in your mouth and cause a foul smell as a byproduct.”
Extreme cases of halitosis, the medical term for chronic bad breath, afflict about a quarter of the population. If no amount of mints, mouthwash, or toothpaste have helped you so far, something is likely causing the bacteria to produce the scent — and that kind of bad breath needs to be investigated by the dentist. For run-of-the-mill bad breath that plagues most people, though, periodontist Mike Breault says that good oral hygiene — brushing and flossing, plus regular cleanings with your dentist — is most important. To find more immediate, specific treatments, we asked the experts for their best over-the-counter recommendations.
Tooth and tongue brushes
All the experts we spoke to recommend regular trips to the dentist and properly cleaning your teeth at home as the best way to beat bad breath. According to Dr. Sharon Huang, the founder of Les Belles NYC, a holistic dentistry practice in Manhattan, “mechanical removal is the most effective route of removing bacteria. [That means] flossing daily and brushing twice a day, not just the teeth but also the gum area and the tongue.” Her favorite manual toothbrush is this supersoft one from Nimbus. “It’s actually the most gentle toothbrush I’ve ever used,” Dr. Huang says. “ A common misconception is that you want to brush your teeth really hard to remove the debris, but that is actually not the case. You want to use a really soft bristle to gently remove the bacteria without stripping the enamel.”
If you think you can still brush gently with an electric toothbrush, Dr. Huang uses Burst’s sonic toothbrush. “I’ve tried many electric brushes on the market, and most of them, I feel, are a little too aggressive,” she says. This one, however, is a “gentle ultrasonic toothbrush.” It has soft, charcoal-infused bristles and a sensitive mode, if you think you might be brushing too hard.
Dr. Huang says you can clean your tongue with your normal toothbrush, but there are also special tools designed for it. This is one of Dr. Marie Jackson of Stellar Smile Center’s favorites. “It’s nice because it’s got these soft but firm nylon brushes, they’re a little bit different than toothbrush versions, their shape is a little more broad so It allows you to kind of clean your tongue without being too aggressive.” Both Dr. Jackson and Dr. Elisa Mello of NYC Smile Design prefer a plastic tongue cleaner like this to something metal, as those can be more aggressive and even hurt or cause cuts. No matter what tool you use, you should use it gently, but don’t be afraid to get a really good clean. “The tongue is not smooth, it’s actually like a shaggy carpet, and at the bottom of the little shaggy pieces is where bacteria hang out, and if you have a coating on your tongue, it could actually take anywhere from two to three weeks to actually remove it,” says Dr. Mello. “I personally tell my patients to brush first, because all the liquid and the toothpaste will sort of loosen up that stuff that’s on your tongue, and then very gently scrape down and scrape it off.” She adds that most patients don’t go far back enough, which can be uncomfortable, so once you get used to it, you can try and go back a little further each time. Dr. Mello says, “You’ll find over time the good bacteria will start to outnumber the bad bacteria that were on your tongue.”
Metal tongue scrapers do have one advantage over the plastic ones: They don’t harbor bacteria. If you think you can use it gently, this medical-grade tongue scraper comes highly recommended by writer Or Gotham as a solution for morning breath. After using this he says, “You’ll realize, as I did, that the amount of gunk not removed by simple brushing is … alarming.”
You should also be paying attention to toothpastes. Dr. Mello uses this all-natural toothpaste in her office. “It really maintains a nice balance because it’s natural,” she says. “ It doesn’t upset the bacteria count, and it really helps to keep everything pH balanced. When the pH is balanced, good bacteria can proliferate, as opposed to the bad bacteria.”
Dr. El Chami likes the Colgate Total line of products as he says they have “the right ingredients to improve the health of the gums and teeth.” One of those ingredients is fluoride, which can help remineralize the teeth and protect you from cavities. If you keep your teeth and gums healthy you can avoid things like gum disease, which can contribute to that bad bacteria build up.
Foul breath often goes hand in hand with a dry mouth, since saliva does the work of washing away dead cells and bacteria in your mouth. And whether your dry mouth means you’re a coffee fiend or have something chronic like an autoimmune disease, the first thing that Breault and Froum suggest as a solution is nonalcoholic mouthwash that kills bacteria without drying out your mouth. “In terms of mouth rinses, anything nonalcoholic is good because the alcohol will dry up oral mucosa (or, the mucous membrane lining the inside of the mouth) and actually contribute to bad breath,” says Froum. This alcohol-free Listerine is one of Dr. El Chami’s favorites. He says, “It is good for temporary relief of bad breath but mouthwash alone will not get rid of it for more than a temporary basis.”
Dr. Jackson is partial to Listerine’s antiseptic line. It does contain alcohol as an inactive ingredient, but she says this antiseptic mouthwash does the job by killing all the germs that would cause bad breath.