Morning breath is a surprisingly common complaint. It has been claimed that the vast majority of adults experience “socially unacceptable” bad breath on waking in the morning(1), though in most cases the odour disappears over time.
All the same, waking up with questionable breath is pleasant neither for you nor your partner. Fortunately, there are ways to reduce or even get rid of morning breath.
What is Morning Breath?
Over recent years it has become increasingly popular to link bad breath with poor oral hygiene routines. However this isn’t necessarily the case, especially when discussing morning breath(2). In reality, even individuals with otherwise faultless breath may find themselves waking up to a dry mouth, furry tongue and an unpleasant odour.
Quite simply morning breath is most commonly a result of large numbers of oral bacteria which, having been left unchecked overnight, have proliferated. In doing so, they have produced volatile sulphur compounds (VSCs) which have a characteristically unpleasant smell(3).
Thus the cause of morning breath are these sulphur compounds being exhaled on the breath.
What Causes Morning Breath?
While the cause of morning breath sounds quite simple at first glance, it turns out that there is quite a bit more to this story than initially meets the eye.
After all, how do the bacteria get into your mouth, why are they worse at night, and what can we do to reduce their impact?
It’s fair to say that all of us have a culture of bacteria in our mouths. Very little can be done to entirely rid our mouths of such things. However the numbers of bacteria can be kept under control, and fewer bacteria means less bad breath.
The problem is that many of the actions which help to control microbial load in our mouths decline or cease altogether while we are asleep.
Saliva production has been shown to be positively correlated with fresh breath, yet at night our salivary flow declines. Eating food can also stimulate saliva production, so unless you’re snacking at night then this too can have an impact.
While we’re awake, beverage consumption can flush away food particles that otherwise serve as fuel for bacterial action.
However possibly most interesting impact of sleep on breath is that through a combination of reduced salivary flow and beverage consumption, exfoliated oral epithelial cells remain in the mouth for longer.
This is most prevalent on the tongue, and serves as an ideal source of fuel for the bacteria causing bad breath. As the bacteria go about their work, breaking down these sloughed cells from the mouth, so VSCs are produced, leading to the all-too-familiar sensation of “morning breath”.
Is Morning Breath “Natural”?
As should be clear by now, while long-term bad breath which lasts throughout the day may be a cause for concern, suggesting potential oral care issues, morning breath is a quite normal part of everyday for many people.
To quote another study: “a large proportion of individuals with oral malodour are periodontally healthy”.
It is interesting to mention a study of morning breath which confirmed that VSC levels tend to be highest first thing in the morning(4), but that that morning breath can vary in severity over time. If you’ve recently discovered a problem, this therefore doesn’t necessarily represent a major problem, assuming that good oral hygiene procedures and dental check-ups have been maintained.
How to Get Rid of Morning Breath
One of the problems with stopping morning breath is that many of the most obvious cures simply aren’t possible while we sleep. Fortunately there are a number of strategies that can be employed by those concerned.
Use a Mouth Rinse
Many people think of mouthwashes as minty-flavoured liquids to gargle with.
However while they might leave your mouth feeling fresh and zingy, the impact on morning breath can be minimal because many washes simply mask the problem.
Good quality oral rinses are rather different, and serve two distinct benefits.
Firstly, an anti-biotic mouth rinse will help to significantly reduce the bacterial load in your mouth. It follows that the fewer bacteria are present, the more pleasant your breath will be on waking.
The other critical element when assessing mouth rinses is to avoid any which contain alcohol (which is the vast majority, incidentally). The reason is simple: alcohol can dry out your mouth while you sleep, worsening your morning breath.
Aim for a good quality antibacterial mouth rinse that is free from alcohol such as UltraDEX Oral Rinse and you could experience quite an improvement. Indeed, a study from Belgium(5) stated that “morning halitosis can be successfully reduced via daily use of mouth rinses”.
Scrub Your Tongue
Perhaps surprisingly, tests have found that the greatest number of sulphur-producing bacteria are typically found on the tongue(6), rather than anywhere else. So while many people proudly brush and floss each night, if bad breath is a concern then cleaning your tongue properly twice a day should be considered just as important.
If you happen to wake up at all during the night, consider keeping a glass of water by your bed. This way, when you stir you can help to lubricate your mouth by taking a few sips of water.
Breathe Through Your Nose
Just as using alcohol-containing mouth wash can dry out your mouth, and worsen morning breath, so too can breathing through your mouth. Heavy snorers can be particularly prone to morning breath.
If you can, try to sleep on your side or your front, rather than your back, where your mouth will be more likely to remain closed while you’re asleep.
Use Proper Oral Hygiene
It goes without saying that an effective oral hygiene routine will also help to keep the bacteria at bay. This means brushing and flossing interdentally at least twice a day, and for the prescribed period of time advised by your dentist. Never be tempted to skip your evening routine, no matter how tired you may feel, or your breath could be noticeably worse in the morning.
If All Else Fails
Lastly if you’ve tried all the advice above but are still concerned about your breath in the morning, consider keeping a fresh breath spray next to your bed. In this way you can quickly freshen up in advance of some snuggling, without having to get out of that cosy warm bed!
- (1) Sanz, M et al. 2001. Fundamentals of breath malodour. Journal of Contemporary Dental Practice 2(4), pp 001-017. Available at: www.ekulf.com
- (2) Bosy, A et al. 1994. Relationship of oral malodour to periodontitis: evidence of independence in discrete subpopulations. Journal of Periodontology 65(1), pp 37-46. Available at: www.joponline.org
- (3) Scully, C and Greenmam, J. 2008. Halitosis (breath odour). Periodontology 2000 48(1), pp 66-75. Available at: www.onlinelibrary.wiley.com
- (4) Snel, J et al. 2011. Volatile sulphur compounds in morning breath of human volunteers. Oral Biology 56(1), pp 29-34. Available at: www.sciencedirect.com
- (5) Van Steenberghe et al. 2001. Effect of different mouthrinses on morning breath. Journal of Periodontology 72(9), pp 1183-1191. Available at: www.joponline.org
- (6) Pedrazzi, V et al. 2004. Tongue-cleaning methods: a comparative clinical trial employing a toothbrush and a tongue scraper. Journal of Periodontology 75(7), pp 1009-1012. Available at: www.joponline.org