How can I get rid of bad breath?

By Misba (Makkah, Saudi Arabia)

Sir,

I am a 35-year-old man and I am not married. My health is now very poor, although I was healthy before. I cannot sleep well.

I also have very bad breath. I cannot speak comfortably with other people because of it. Every day I clean my teeth four or five times with aloe vera toothpaste.

The bad breath has lasted for one or two years. I do not have an insurance card for good-quality care. Doctor, please help me.

Answer

Hi Misba,

Persistent bad breath is called halitosis. It can be distressing, but in many cases the cause can be identified and treated. The American Dental Association explains that oral bacteria, dry mouth and gum disease are common causes. Stomach, liver or kidney disease should not be assumed before your mouth and teeth have been properly examined.

What May Be Causing It?

• Gum disease or dental problems: Plaque, cavities, trapped food, an abscess, loose teeth or bleeding gums can produce a persistent odor.


• Tongue coating: Odor-producing bacteria commonly collect toward the back of the tongue.


• Dry mouth: Low saliva allows bacteria to build up. Dehydration, smoking, some medicines and sleeping with the mouth open can contribute.


• Nose, sinus or throat problems: Postnasal drip, chronic sinus symptoms, tonsillitis or tonsil stones may cause odor.


• Acid reflux: Reflux can contribute, especially when bad breath occurs with heartburn, sour taste, belching or regurgitation. It is not the most common cause.


• Food, tobacco or fasting: Garlic, onions, smoking, prolonged fasting and crash diets may worsen breath.


• Diabetes or another illness: Diabetes can increase dry mouth, gum disease and oral infection risk. Less commonly, kidney or liver disease may change the breath, but testing should be guided by symptoms and an examination.

Your poor sleep also matters. Snoring, nasal blockage or sleeping with your mouth open may dry the mouth. If you snore loudly, wake gasping, have morning headaches or feel very sleepy during the day, tell a clinician because sleep apnea may need assessment.

A Practical Plan

1. See a dentist: Because the problem has lasted so long, arrange a dental examination and professional cleaning. Ask about gum disease, cavities, hidden infection, dry mouth and tongue coating. If cost is a barrier, ask local public clinics, teaching hospitals or dental schools whether they provide reduced-cost care.


2. Brush gently twice a day: Use fluoride toothpaste for two minutes. Brushing four or five times daily is usually unnecessary, and forceful brushing may injure gums or wear tooth enamel.


3. Clean between the teeth daily: Use floss or interdental brushes. Toothbrushing alone cannot clean these spaces.


4. Clean the tongue once daily: Use a tongue scraper or soft toothbrush gently, especially toward the back.


5. Support saliva: Drink water regularly. Sugar-free gum may help if it is safe for you. Avoid tobacco, excess alcohol and alcohol-containing mouthwash if it worsens dryness.


6. Review medicines and symptoms: A doctor or pharmacist can identify medicines that cause dry mouth. Mention heartburn, nasal blockage, tonsil stones, weight loss, thirst, frequent urination or changes in urine.

Mouthwash may temporarily reduce odor but does not cure gum disease, cavities or infection. Aloe vera toothpaste is not a substitute for fluoride toothpaste, flossing, tongue cleaning and dental treatment.

Should You Be Tested for Diabetes?

Bad breath alone does not diagnose diabetes. However, testing is reasonable if you also have excessive thirst, frequent urination, blurred vision, unexplained weight loss, repeated infections, slow healing or a family history of diabetes. A clinician may use fasting plasma glucose and HbA1c; see the guide to blood tests for diabetes.

If diabetes is present, improving blood glucose and treating gum disease can both support oral health. The CDC notes that high blood sugar can worsen dry mouth, gum inflammation and oral infections. Read more about bad breath and diabetes.

Do Not Self-Treat With Antibiotics or Stomach Medicines

If your dentist finds no oral cause, a primary-care clinician can evaluate reflux, sinus or throat disease, diabetes and—when symptoms suggest them—kidney or liver problems. Routine liver ultrasound is not necessary for every person with bad breath.

When to Seek Urgent Care

Related Questions

• Can garlic cause bad breath or other side effects?


• Why does blood sugar rise after brushing my teeth in the morning?


• What does HbA1c 6.6% mean when finger-prick readings are normal?

Related Resources

• Causes of bad breath in people with diabetes


• Blood tests used to diagnose diabetes


• Diabetes complications and warning signs


• Diabetes and kidney health

Medical References

• American Dental Association: Bad Breath


• NHS: Bad Breath—Causes and Self-Care


• CDC: Oral Health and Diabetes

Written by Dr. Albana Greca Sejdini, MD, MMedSc

Medically reviewed by Dr. Ruden Cakoni, MD, Endocrinologist

Last reviewed: July 2026

Educational only—not personal medical advice. This information does not replace an examination, diagnosis or treatment from a dentist or healthcare professional.