Dear Dr. Manny,

Why do I have bad breath all the time? I keep brushing my teeth and it's not getting rid of the smell. How do I fix it?

Thanks for your question.

Everybody gets bad breath, either in the morning or after a garlicky meal. It’s normal. But if it doesn’t go away, then it may be chronic. Chronic halitosis might be an indication of something more serious.

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Bad breath might mean you have a bad respiratory infection, either in your sinus or in your throat. You’ll know if you have trouble breathing, buildups of mucus and a fever.

Diabetes might be another cause. Doctors linked an acidic odor to something called ketoacidosis, where the body excretes offensive smelling ketones. This is caused by a lack of insulin and can lead to death.

If you’re overweight, you might also have bad breath. Diets high in dairy and protein can lead to excessive amino acids, which can lead to bacteria growth.

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Dry mouth can also cause bad breath. One of the causes of dry mouth is a heavy drinking habit. Alcohol dehydrates you and makes your mouth susceptible to bacteria. Sleep apnea, or snoring, is another cause. This impedes the production of saliva.

Acid reflux and GERD can cause foods to begin decaying in the gut, which brings a bad odor along with it.

Stomach ulcers are caused by the same bacteria that cause chronic halitosis.

A fishy smell in your breath can come from a kidney or renal disease. If the kidneys are not properly removing toxins from your body, the smell might get into your breath.

Lung cancer might also be the cause. In fact, doctors rely on bad breath to help them diagnose lung cancer. Breath samples can also diagnose heart conditions.

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Aside from brushing and flossing more often, consider changing your diet in order to help combat bad breath. Scrape your tongue, use mouthwash, keep your gums healthy. Don’t eat candy to stop the bad breath, but chew gum. Stop your bad habits. Stop smoking. You might not make enough saliva, so make sure you keep your mouth moist to encourage better production of saliva.