If you wake up and immediately want to gargle with mouthwash, you are far from alone. It’s estimated that about 30% of people experience bad breath (officially known as halitosis), and first thing in the morning is when it’s most likely to strike.
Morning breath can feel gross, it can be embarrassing, and if it’s something that’s been difficult for you to manage, you may be wondering what causes morning breath and what you can do to fix it. We reached out to medical experts to help us understand what morning breath is, what causes it, and, perhaps most importantly, how to effectively freshen up your breath and make morning breath a problem of yesterday.
What is morning breath?
Almost all of us are familiar with morning breath (halitosis), either because we have it or we’ve been near someone who has it (it’s kinda hard to miss!). In a nutshell, morning breath is a term used to describe unpleasant breath, typically experienced first thing in the morning. Not everyone experiences bad breath upon waking, but most of us experience it from time to time, and for some people, it can become a chronic issue.
What are the symptoms of morning breath?
For many of us, morning breath is experienced as a sour taste in our mouths, says Dr. Gary Liu, a pediatric dentist. “Most commonly, morning breath is experienced by others around you as a foul odor when you speak or open your mouth,” Liu describes. Often, we aren’t aware that we have morning breath until someone else informs us, he adds. (And no, that trick of puffing breath into your hand to smell doesn’t really work.)
Dr. Alex Rubinov, a general and cosmetic dentist in New York City, says that different people may experience morning breath in unique ways. “The severity really varies, based on your overall oral hygiene,” he explains.
Many people with foul-smelling morning breath have a yellow or whiteish coating on the tongue, Rubinov shares, especially toward the back of the tongue. They may also have plaque buildup on their teeth and a dry feeling in their mouth, especially at night. And of course, either they or someone else will detect that off-putting smell.
What causes morning breath?
Most of the time, morning breath is caused by poor dental hygiene, but sometimes, other medical issues contribute. Understanding the root cause of your bad breath is the first step to solving the problem.
Poor dental hygiene
People who don’t practice good, consistent dental hygiene are most likely to suffer from bad morning breath, says Liu. “Food and plaque that are not cleaned from the mouth create odors that others can smell,” says Liu. “Plaque that accumulates on the textured surfaces of our tongues can also produce a smell if left uncleaned.”
Dry mouth and bacterial overgrowth
Another frequent cause of morning breath is the combination of a dry mouth and bacterial overgrowth. While we are awake, saliva is produced — most often when we eat. “Saliva is stimulated when you consume food so that mucus can lubricate the food and proteins and enzymes can start breaking down the food,” Rubinov explains.
But while we are asleep, we produce less saliva, and our mouth becomes dry as a result, explains Rubinov. This dryness causes odor-producing bacteria to grow overnight, so that we wake up with that telltale funky breath.
Other causes of morning breath
Dr. Jyoti Matta, medical director of the Center for Sleep Disorders at Jersey City Medical Center, says that other commonly experienced conditions can contribute to morning breath. These include:
- Sinus issues
- Acid reflux and gastroesophageal reflux disease (GERD)
- Gingivitis (gum inflammation)
- Sleep apnea
Sleep apnea is a common contributor to dry mouth symptoms and creates a breeding ground for bacterial overgrowth. “With sleep apnea, in particular, people sleep with their mouths open to try and overcome breathing obstructions,” says Matta. “That can lead to drying secretions in the mouth, aggravating bad breath.”
Does morning breath ever indicate a serious health issue?
Occasionally, having chronic morning halitosis may indicate a more serious underlying health issue. For example, people who have liver or kidney disease might have poor-smelling breath because they are unable to filter toxins properly out of their bodies. In particular, people with chronic kidney failure may have breath that smells like ammonia. Finally, untreated diabetes can lead to a serious condition called ketoacidosis, which can produce unusual, sweet-smelling breath. Bad breath can also be a sign of throat or tonsil issues, as well as of tooth decay. In short, an ongoing issue with your breath should be a cue to check in with your doctor to make sure it’s not indicative of a larger health concern.
If your morning breath doesn’t resolve after addressing basic issues like oral hygiene, it’s important to see your health care provider to rule out any medical issues that may be causing your symptoms.
How to get rid of bad breath
Morning breath can be annoying, inconvenient, and, well, stinky. The good news is that most cases of morning breath can be minimized or even eliminated with some basic measures.
Good oral hygiene
Having an efficient and thorough dental routine is key. To ensure that your mouth is not a breeding ground for bacteria, you must brush and floss. “Regular brushing and flossing will eliminate plaque and food from the mouth,” says Liu. He also recommends investing in a good mouthwash and making sure to brush and use mouthwash before facing the world each morning. Sleep has given your mouth several hours to accumulate bacteria, so a good wakeup routine is critical for good oral hygiene.
Investing in a tongue scraper is a good idea, too, if you battle chronic bad breath, says Rubinov. “In the morning, I can't emphasize the importance of using a tongue scraper at the same time as brushing your teeth,” he suggests. “Your tongue harbors a lot of bacteria, and if that isn't cleaned daily, your morning breath has compounding effects.”
Regular dental check-ups
Going to the dentist for regular cleanings and check-ups is another important way to keep your mouth clean and manage morning breath. “Regular dental check-ups and cleanings can help catch and eliminate any problems before they become catastrophic,” says Liu. Your dentist can help identify any conditions that may be contributing to your morning breath, such as plaque buildup and gingivitis (inflammation of the gums) or periodontitis (severe gum infection).
Treating underlying causes
Sometimes, morning breath doesn’t go away, even after taking steps to address your oral hygiene. “If the issue persists even after taking these steps, it’s important to contact your doctor,” Matta advises. Diagnosing and treating any medical conditions that could be contributing to your bad morning breath, such as sinusitis, chronic dry mouth, sleep apnea, or acid reflux, is vital — not just for your breath, but for your overall health.
The bottom line about morning breath
Whatever you do, keep in mind that morning breath isn’t something you have to put up with. Morning breath isn’t just unpleasant: It can lower confidence and create social anxiety. It can also alert you to any issue with your overall state of wellness. Thankfully, it’s a solvable problem that can be an afterthought by the afternoon.
Wendy Wisner is a writer and lactation consultant (IBCLC) whose work has appeared in The Washington Post, Family Circle, ELLE, ABC News, Parents Magazine, Verywell Family, Healthline, Fit Pregnancy, Your Teen Magazine, and elsewhere. Find her at www.wendywisner.com.