Symptoms A-Z

Chronically Bad Breath Symptoms, Causes & Common Questions

Understand your chronically bad breath symptoms, including 8 causes and common questions.

An image depicting a person suffering from chronically bad breath symptoms

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  1. 8 Possible Chronically Bad Breath Causes
  2. Questions Your Doctor May Ask
  3. Statistics

8 Possible Chronically Bad Breath Causes

The list below shows results from the use of our quiz by Buoy users who experienced chronically bad breath. This list does not constitute medical advice and may not accurately represent what you have.

Dental cavity

A dental cavity (caries) is an infection of the tooth, which is the result of long-term acid production by bacteria that sit on your teeth. This can result in pain and the spread of infection into the tooth pulp, and, if untreated, into your jaw bone or bloodstream. The development of a cavity is highly dependent on your lifestyle and is largely a preventable disease. Poor dental hygiene, a diet high in sugar, and the presence of aggressive bacteria in your mouth increase the risk of development of cavities. Once you have a cavity, it is important to see a dentist and have the cavity filled and improve oral hygiene at the recommendation of a dentist. Filing a cavity can protect against the spread of infection and improve your symptoms. Failure to fill a cavity may result in removal of the tooth (extraction) or cleaning/drilling into your jaw (root canal).

Rarity: Common

Top Symptoms: dry mouth, toothache, tooth pain that makes chewing difficult, pain in the top row of teeth, tooth pain that gets worse with hot, cold, or sweet beverages

Symptoms that never occur with dental cavity: spontanenous tooth pain

Urgency: Primary care doctor


Gingivitis is the inflammation of the gums. It is typically caused by poor dental hygiene and the buildup of bacteria. Its hallmark symptoms are swollen, discolored, bleeding gums. The main risk factors for the development of the disease are increasing age, smoking, and dry mouth. It is both treatable and preventable by engaging in recommended dental hygiene practices. A dentist can also treat the disease by cleaning plaque off your teeth, giving you a special mouthwash, and flossing your teeth. If gingivitis is not treated, it can progress to a more aggressive disease, called periodontitis, or can cause an infection of the gums, including the formation of an abscess.

Rarity: Uncommon

Top Symptoms: bleeding gums, gum pain, gum swelling, gum redness

Urgency: Primary care doctor

Strep throat requiring throat swab

Strep throat, or "strep," is a sore throat specifically caused by the bacteria Streptococcus pyogenes, also called group A streptococcus.

The illness spreads when an infected person coughs or sneezes and then someone else inhales the airborne bacteria, or touches a surface where it has landed and then touches their own face.

Children are most susceptible but anyone can be infected.

Symptoms include sudden throat pain, fever, headache, rash, body aches, and red, swollen tonsils. These symptoms can be caused by other illnesses, so a sample is taken by gently rubbing a sterile cotton-tipped swab over the back of the throat.

Testing will identify the organism responsible so that treatment with the appropriate antibiotic can begin. Be sure to finish all of the medication as directed, even after feeling better.

Untreated strep throat can lead to ear infections, kidney disease, scarlet fever, and rheumatic fever. These are serious illnesses. If strep throat is suspected, the person should see a doctor as soon as possible.

Rarity: Common

Top Symptoms: fatigue, nausea, sore throat, fever, rash

Symptoms that always occur with strep throat requiring throat swab: sore throat

Symptoms that never occur with strep throat requiring throat swab: general weakness

Urgency: Primary care doctor

Chronic sinusitis

Chronic sinusitis is also called chronic rhinosinusitis. It is an inflammation of the sinuses, or open spaces of the skull, above and below the eyes. "Chronic," in this case, means the condition has persisted for weeks in spite of treatment and has probably followed several cases of acute sinusitis.

The condition may start with a viral, bacterial, or fungal upper respiratory tract infection; asthma; allergies; or nasal polyps.

Symptoms include facial pain, swelling, and nasal congestion. There is often fatigue; greenish or yellowish nasal discharge; loss of sense of smell; ear pain; cough; and sore throat.

Chronic sinusitis should be seen by a medical provider, especially if symptoms worsen. The condition interferes with quality of life and the ongoing infection can become serious.

Diagnosis is made through patient history; physical examination; sinus cultures; skin tests for allergies; CT scan of the head; and nasal endoscopy (rhinoscopy.)

Treatment may involve saline nasal irrigation; nasal spray corticosteroids; oral corticosteroids; antibiotics for bacterial infection; immunotherapy for allergies; and, in some cases, surgery to remove polyps or other obstructions.

Rarity: Common

Top Symptoms: fatigue, headache, trouble sleeping, congestion, runny nose

Symptoms that always occur with chronic sinusitis: chronic sinusitis symptoms

Urgency: Primary care doctor

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Acid reflux disease (gerd)

Acid reflux disease, also known as GERD, occurs when the acidic contents of the stomach come back up into the esophagus. The most common symptoms are heartburn and regurgitation.

Rarity: Common

Top Symptoms: nausea, sore throat, pain below the ribs, cough with dry or watery sputum, deep chest pain, behind the breast bone

Urgency: Primary care doctor

Acute necrotizing ulcerative gingivitis (anug)

Acute necrotizing ulcerative gingivitis (ANUG) is a relatively rare infection of the gums. It's also known as "trench mouth", as it was discovered in a large number of soldiers in WWI that were stuck in trenches. The pain caused by ANUG is what makes it different from chronic periodontitis, and it requires treatment by professionals.

Rarity: Rare

Top Symptoms: bleeding gums, gum pain, chronically bad breath, severe mouth pain, gum swelling

Urgency: In-person visit

Ludwig's angina

Ludwig's angina is a rare but serious infection of the space below the jaw and the floor of the mouth, under the tongue. This illness is not to be confused with "angina" which refers to cardiac pain due to coronary artery disease. The infection usually starts in the floor of the mouth then quickly spreads to the area around the jaw on both sides of the face. Ludwig's angina is considered a medical emergency due to risks of impaired breathing.

Symptoms include fever and chills, mouth pain, a swollen tongue, a stiff neck, drooling and trouble swallowing, a muffled voice or trouble speaking and breathing.

Treatments include antibiotics, surgery to remove infection, and the installation of a tube to assist with breathing in severe cases.

Rarity: Rare

Top Symptoms: shortness of breath, fever, being severely ill, trouble swallowing, neck pain

Urgency: Hospital emergency room

Dry socket (postextraction alveolar osteitis)

Dry socket (or postextraction alveolar osteitis) is a common cause of severe pain after a dental extraction (tooth pull). It's known to be related to how the extraction was done, menstrual cycle, tobacco smoking, age, sex, and whether you have had an extraction before.

Rarity: Ultra rare

Top Symptoms: constant mouth pain, chronically bad breath, changed sense of taste, severe mouth pain, mouth pain at the site of a dental procedure

Symptoms that always occur with dry socket (postextraction alveolar osteitis): mouth pain at the site of a dental procedure, constant mouth pain

Urgency: Hospital emergency room

Questions Your Doctor May Ask About Chronically Bad Breath

To diagnose this condition, your doctor would likely ask the following questions:

  • Do you currently smoke?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Do you have a cough?
  • Do you have a runny nose?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

Take a quiz to find out why you're having chronically bad breath

Chronically Bad Breath Symptom Checker Statistics

People who have experienced chronically bad breath have also experienced:

  • 4% Fatigue
  • 3% Nausea
  • 3% Abdominal Pain (Stomach Ache)

People who have experienced chronically bad breath were most often matched with:

  • 36% Dental Cavity
  • 36% Strep Throat Requiring Throat Swab
  • 27% Gingivitis

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Chronically Bad Breath Symptom Checker

Take a quiz to find out why you're having chronically bad breath