How to choose tools for bad breath: tongue cleaners, interdental brushes, mouthwash

3 min read

In "Most bad breath comes from the mouth, not the stomach," we saw that the main sources of bad breath are the tongue, the gums, and saliva.

So among the tongue cleaners, floss, interdental brushes, and mouthwashes on the drugstore shelf, which should you choose? I'll separate what research has shown from what isn't known yet.

First: what to check before buying tools

If your gums bleed, your teeth feel loose, or strong bad breath persists, you may need treatment for gum disease or something else. Seeing a dentist is faster than collecting tools.

This article is a guide to choosing tools for daily care.

Tongue cleaners: a dedicated one beats a toothbrush

Many people use a toothbrush to clean the coating on their tongue. A review of two randomized controlled trials in adults with bad breath found that dedicated tongue cleaners and scrapers reduced the volatile sulfur compounds that cause bad breath slightly more than a toothbrush [1]. But there were only 40 participants in total, and the effect was confirmed only over a short period.

For how to use one, the method described on Japan's Ministry of Health, Labour and Welfare e-Health Net site is easy to follow: check the coating in a mirror, place the tongue cleaner lightly at the back, and pull it forward. Don't press too hard; once when you wake up is enough, and overdoing it can damage the tissue [2].

When choosing, pick one that's made for the tongue, soft, and shaped to reach the back. Avoid shapes that only work if you scrub hard.

Cleaning between teeth: floss or interdental brushes

A toothbrush alone has trouble reaching between the teeth. A Cochrane review of 35 studies (3,929 adults) found that adding floss or interdental brushes to toothbrushing may reduce gum inflammation (gingivitis). In comparison, interdental brushes did better than floss [3]. But the certainty of evidence was low for both.

• If the gaps between your teeth are tight: floss (including floss picks)
• If you have gaps: an interdental brush sized to fit them

An interdental brush that's too thick can damage your gums. Start with a thinner one, and if you can't tell what size fits, ask your dentist.

Mouthwash: use it as a supplement

A Cochrane review of 44 studies (1,809 people) on treatments for bad breath rated the certainty of evidence for mouthwash, tongue cleaning, toothpaste and other methods as low or very low, and couldn't conclude which method is best [4].

Mouthwash helps mask odor temporarily, but it doesn't remove the sources themselves: tongue coating and gum disease. Do the tongue cleaning and between-teeth cleaning first, and use mouthwash as a supplement.

Summary

If you choose by these guidelines