How to prevent bad breath when wearing braces

Halitosis caused by braces is a common problem during orthodontic treatment. Braces can trap food debris and allow oral bacteria to build up around the brackets and wires, which increases the risk of bad breath.

The good news is that halitosis is not an inevitable consequence of orthodontic treatment. Proper oral hygiene, the use of cleaning aids and regular professional clean-ups significantly reduce the risk of this problem occurring.

In this article, you’ll find out what causes halitosis in people wearing braces, how it can be prevented, and when treatment for halitosis is necessary.

With a proper oral hygiene routine and regular check-ups with your orthodontist, the risk of halitosis can be significantly reduced. 

Halitosis is the presence of an unpleasant odour in exhaled air, commonly known as bad breath. In most cases, this is caused by the activity of oral bacteria which break down food debris and produce volatile sulphur compounds, substances responsible for the unpleasant odour.

In over 80 per cent of cases, the source of halitosis is located within the oral cavity and is associated with the build-up of dental plaque, gum disease or poor oral hygiene.

There are three main forms of halitosis:

• True halitosis – the unpleasant odour is present and can be detected by those around the person;
• Pseudo-halitosis – the patient believes they have bad breath, but this cannot be clinically confirmed;
• Halitophobia – the persistent belief that there is a problem even after the actual causes have been ruled out.

Braces can contribute to halitosis through the build-up of bacteria and difficulties with oral hygiene, especially if they are not cleaned properly.

• food debris
• bacterial plaque
• difficulties with cleaning, incorrect cleaning
• gum inflammation
• xerostomia (dry mouth) 

Food debris trapped between the components of the braces

Food particles left around the dental appliance are a constant source of nourishment for oral bacteria. As these bacteria break down the food debris, they release compounds responsible for causing bad breath.

Accumulation of bacterial plaque

Bacterial plaque is a biofilm consisting of bacteria and food debris that adheres to the surface of the teeth. When not removed effectively, it promotes the growth of oral bacteria involved in the development of halitosis.

Difficulties with cleaning and incorrect oral hygiene

The presence of braces makes certain areas more difficult to clean. For this reason, patients need to spend more time brushing and use additional hygiene aids.

For detailed recommendations on oral hygiene during orthodontic treatment, see also the article on scaling in patients with braces.

Gum inflammation

When bacterial plaque builds up around braces, the gums can become inflamed. The bacteria and the toxins they produce contribute both to the onset of gingivitis and to the development of bad breath.

Xerostomia (dry mouth)

Saliva plays a vital role in maintaining oral health. It neutralises acids, removes food debris and helps to control oral bacteria.

When saliva flow is reduced, bacteria multiply more easily and the risk of halitosis increases. 

The most common causes of halitosis during orthodontic treatment are:

• inadequate or incorrect brushing;
• ineffective cleaning between the teeth;
• gingivitis and gum inflammation;
• tartar build-up;
• excessive growth of oral bacteria;
• frequent consumption of foods high in sugar;
• low water intake;
• failure to attend regular professional dental hygiene appointments.

Preventing halitosis starts with a proper oral hygiene routine and following your orthodontist’s advice. In most cases, bad breath can be prevented by controlling bacterial plaque and maintaining gum health.

Proper oral hygiene

Thorough oral hygiene is the most effective way to prevent halitosis during orthodontic treatment.

It is recommended that you:

• brushing after every meal;
• using an electric or orthodontic toothbrush;
• using a mouthwash;
• using special dental floss designed for braces;
• using interdental brushes;
• cleaning your tongue daily;
• using an alcohol-free antibacterial mouthwash.

Ideally, the oral irrigator, dental floss and interdental brushes should be used before brushing to remove food debris from hard-to-reach areas. In certain situations, the dentist may also recommend oral probiotics to support the balance of the oral microbiome.

At DENT ESTET, prevention begins before braces are fitted, through an assessment of gum health, guidance on brushing technique and personalised hygiene recommendations.

Healthy habits

In addition to oral hygiene, certain habits help reduce the risk of halitosis:

• staying properly hydrated;
• a balanced diet and limiting sugar intake;
• avoiding strongly odoured foods;
• regular orthodontic check-ups;
• professional dental cleaning appointments every 3–4 months.

Saliva helps to remove food debris and control oral bacteria, which is why staying hydrated is essential for preventing halitosis. 

Persistent bad breath may be the first sign of conditions that require treatment.

Gingivitis

Gingivitis is the most common complication associated with the build-up of bacterial plaque during orthodontic treatment.

Signs of gingivitis include:

• bleeding when brushing;
• tender gums;
• a change in the colour of the gums;
• swollen gums;
• bad breath.

If diagnosed in time, gingivitis is reversible.

Periodontitis

If left untreated, gingivitis can progress to periodontitis, a condition that affects the structures supporting the teeth.

As well as halitosis, symptoms may include gum recession, tooth mobility and discomfort when chewing. In some cases, orthodontic treatment must be temporarily suspended until periodontal health has stabilised.

Dental caries

Bacterial plaque that accumulates around the brackets promotes the development of demineralisation and dental caries. These can prolong orthodontic treatment and may require additional treatment. 

• Khounganian, R. M., Alasmari, O. N., Aldosari, M. M., & Alghanemi, N. M. (2023). Causes and Management of Halitosis: A Narrative Review. Cureus, 15(8), e43742.
• Musa, Hamsah et al. “Comparative Assessment of Halitosis and Oral Health-Related Quality of Life Among Children and Young Adults with Clear Aligners, Those with Lingual Orthodontics, and Non-Orthodontic Controls: A Cross-Sectional Study with Dietary Subgroup Analyses.” Journal of Clinical Medicine vol. 14,11 3995. 5 June 2025, doi:10.3390/jcm14113995
• Patel, N. (29 January 2024). The silent culprit: Unveiling the link between gum disease and halitosis. Pure Periodontics
• Mayo Clinic Staff. (7 September 2024). Bad breath. Mayo Clinic.
• Ramamurthy, Jaiganesh & Gopalasamy, Kirtana. (2020). Prevalence of gingivitis in patients aged 18–25 years undergoing orthodontic treatment: a retrospective study. International Journal of Dentistry and Oral Science. 1231–1235. 10.19070/2377-8075-20000243.