Where’s my mouthwash? If that’s your first thought upon waking, you’re not alone.

Just because you fear funky oral fumes doesn’t mean you emit them. Up to three-fifths of people who complain of bad breath expel no odor, as measured by the human nose, says Donna Warren-Morris, RDH, MEd, professor of periodontics and dental hygiene at The University of Texas Health Science Center at Houston (UTHealth) School of Dentistry.

Still, chronic bad breath—one of the most embarrassing pratfalls of personal hygiene—can cause isolation, “from you avoiding people you’re afraid of offending, or people not wanting to be close to you,” Warren-Morris says. 

How do I know? 

Unless folks turn their head each time you talk, it’s challenging to know if you need help. 

Breathing into your cupped hands only lets you smell your hand cream. “The best way is to blow out air and have a confidant smell it,” says Robin Weltman, DDS, MS, periodontist and acting chair of the Department of Periodontics and Dental Hygiene at UTHealth School of Dentistry. “You also can take a spoon, suck on it or scrape it along your tongue and smell it.” 

But that’s subjective. Only your dentist can definitively diagnose chronic bad breath, known as halitosis, derived from Latin halitus for “breath” and the suffix -osis, meaning “condition” or “disease.” 

Dentists measure stench via gas chromatographies known as Halimeters or BreathAlerts. “The meter gives you a score of the quantity of volatile sulfur gases you exhale,” Warren-Morris says. “It’s the most objective way.” 

Skip bad-breath kiosks at malls: Rarely do they have educated specialists, Warren-Morris advises. “They often suggest bleaching as a remedy or unproven remedies they sell. Bleaching can be harmful if you have decay. It should only be recommended by a dentist following a dental exam.” 

Soon you can rely on your smartphone to help recognize bad breath. Adamant Technologies of San Francisco has created a computer chip with 2,000 sensors to sniff out chemicals. That makes it as efficient as a dog’s sniffer and five times more than a human’s nose. Within two years, there will be a device for phones to diagnose bad breath causes.

The cause: your mouth

Nine out of 10 times your mouth is the root of rude aromas. Cavities, gum disease pockets and coated tongues can harbor bacteria that release volatile sulfur compounds (VSC). 

“The legend is that Clark Gable’s breath was so bad, leading ladies did not want to kiss the handsome actor,” Warren-Morris says. “These gasses (VSC) can smell like rotten eggs, corpses, decaying meat, smelly feet or fecal matter.” 

Morning breath—halitosis’ non-kissing cousin—results from a dry mouth, as you don’t swallow or drink during the night. “Saliva purges debris from your mouth, neutralizes acids and keeps bacteria at manageable levels,” Warren-Morris says. “At night, very little saliva is produced.” 

Tongue grooves also can trap food, and common drugs including some antihistamines, antidepressants and blood-pressure drugs may dry your mouth. If your tongue is coated, it is probably because you’re not cleaning it well enough. Plaque builds up on your tongue, just like on your teeth. 

Mouthwash and chewing gum are brief cover-ups, Weltman says. “In fact, mouthwash containing alcohol dries your mouth, making the problem worse.” 

You need to brush your teeth thoroughly twice daily—from all angles—and floss. Your dentist may suggest brushing with a chlorohexidine– or triclosan–containing gel and using a mouth rinse with zinc chloride or sewage-plant neutralizer chlorine dioxide to slay odious germs. “And it’s not about getting out a popcorn kernel,” Weltman says. “You need to floss underneath the gums to break up plaque that toothbrushes can’t reach.” 

Brush your tongue and inner cheeks with a soft bristle toothbrush, from back to front once daily. “If you’ve got many grooves, you might want to get a tongue scraper,” Weltman says. 

Also, get at least twice-yearly check-ups and dental cleanings, or more if you’re diagnosed with gum disease. 

Too much trouble? Not really, if you consider that “gum disease and tooth decay are infections that have bacteria also linked to diabetes, heart disease and stroke,” Warren-Morris says. 

The cause: lifestyle 

Other villains can be found in your kitchen: alcohol, garlic, onions, curry and other pungent flavors. Even sacrifice can be smelly. “If you’re fasting or on a low-carbohydrate diet, your body may burn stored fat for needed fuel, and that process gives off ketones,” Warren-Morris says. “It smells like nail polish remover.” So can an off-kilter metabolism due to diabetes. 

Changing your lifestyle, while challenging at times, can be easy. Hit the bread basket, bypass garlic and curry and get your blood sugar levels checked. 

Or consider that “a bad taste in your mouth may simply be that,” Weltman says. “We can get so emotional, but in fact it’s not bad breath, just bad taste.” 

The cause: your body 

Stopped up noses and sinuses are to blame for 5-10 percent of the bad smell, and infected tonsils for another 3-5 percent. “Bacteria can build up in sinuses and result in a bad odor,” Warren-Morris says. 

Gastrointestinal issues also may contribute. “You can actually smell it when someone’s sick or has gastrointestinal problems," she adds.

A gastrointestinal or nose, ear and throat specialist should be consulted for these issues. They may recommend treatment of an infection or recommend antibiotics and sinus sprays or neti pots (containers designed to rinse nasal cavities) to treat ailments, Warren-Morris says. 

Saline spray with Xylitol—the sweetener also found in chewing gum—reduces the chance of ear and sinus infections. It also is effective in preventing dental decay. Bacteria eat the sweetener and cannot produce the sticky plaque that helps them attach. 

As for alerting someone else, broach the subject carefully. Try to mention your own issues or inform the person about the adverse health effects associated with chronic bad breath. Or, you can join 109,000 tipsters who’ve sent virtual—and anonymous— “breath mints” via http://www.therabreath.com/tellafriend.asp.

This article, which has been updated, originally appeared on HealthLEADER, an online wellness magazine produced by The University of Texas Health Science Center at Houston (UTHealth). Visit HealthLEADER for more articles on a broad array of health and wellness topics.