Bad breath after brushing? Look at what the brush misses

Brushing twice a day is useful, but the NHS also recommends gently cleaning the tongue and cleaning between the teeth daily. Food and plaque can remain in places a toothbrush does not reach. If you wear removable dentures, clean them and take them out at night as advised. Avoid scrubbing until your gums bleed; harder brushing is not a cure for bad breath.

Notice whether the smell follows a particular food and passes, or returns day after day. Check for bleeding or swollen gums, tooth pain, a loose adult tooth, or a denture that no longer fits well. The WHO notes that gum disease can come with bleeding, swelling and bad breath. These signs deserve a dental look, not another scented product.

Saliva helps wash food particles from the mouth. The US National Institute of Dental and Craniofacial Research lists persistent dry mouth and bad breath together; some medicines can reduce saliva. A sticky feeling, trouble swallowing dry food, or waking with a very dry mouth is worth mentioning to a dentist or doctor. Do not stop prescribed medicine because you suspect it is responsible.

If your mouth is dry, sip water regularly and ask a clinician or dentist what is suitable for you. Tobacco can also contribute to bad breath and gum problems. The point is not to guess a disease from one smell: several causes are possible, and a person may have more than one at once.

Try a few weeks of consistent care for your teeth, gums, tongue and spaces between teeth. If bad breath still does not go away, the NHS advises seeing a dentist. Arrange a visit sooner if your gums hurt, bleed or swell, or you have toothache, a loose adult tooth or a problem with dentures. A dentist can check the mouth rather than making you guess from the smell alone.

If a dentist finds no oral cause, ask whether a medical review is appropriate; the American Dental Association notes that conditions outside the mouth can sometimes play a part. Our six-question bad-breath guide can help you put the pattern and other symptoms into words before a non-urgent visit. It cannot identify the cause or replace an examination.