When you realize that you have bad breath, your first reaction is probably to kick your oral hygiene into high gear and start using mouthwash more regularly. But what do you do when your bad breath persists, even when you're brushing, flossing and rinsing regularly? Chances are, your bad breath has a more sinister cause that you'll need to deal with. Here's a look at three possible causes.

Tooth Decay

Tooth decay is caused by oral bacteria. These bacteria release smelly odors as they breed and feed. Since they have worked their way below the surface of your tooth, they cannot be removed with simple brushing and flossing. Tooth decay does not always cause pain, and it cannot always be visualized. So, it's not wise to assume you don't have tooth decay just because bad breath is your only symptom. If improving your oral hygiene is not getting rid of your bad breath, visit your dentist to be checked for tooth decay. If it is caught early, you might just need a simple filling – but if you wait, you might need a root canal or extraction.

Dry Mouth

Saliva serves several functions. One of these is to constantly rinse oral bacteria away, so they don't become too prevalent in your mouth. When your mouth is too dry, this does not occur properly. Smelly oral bacteria are allowed to have a heyday. If your mouth frequently feels dry and sticky, or if you're experiencing symptoms like cracks in the corners of your mouth and a cotton-mouthed feeling, you probably have dry mouth.

Dry mouth has a number of possible causes. If you're a smoker, quitting smoking will help ease your dry mouth. Many medications, including antidepressants and allergy meds, cause dry mouth as a side effect. If you're taking a medication, talk to your doctor about switching to another one that won't have this effect. You can also try using a special rinse that increases saliva production. These are available over-the-counter in most drugstores. If dry mouth is to blame for your bad breath, you should notice an improvement within a few days.

Tonsil Stones

Bacteria, saliva, and pieces of food can become caught in the crypts of your tonsils, forming off-white stones. These stones are notorious for causing bad breath. If you look in the mirror and see what looks like white spots on your tonsils, chances are you have tonsil stones. You may also cough them up from time to time – they look like little whitish pebbles. An ear, nose and throat doctor can extract your tonsil stones, alleviating your bad breath. If they are persistent, you may need to have your tonsils removed.

 If your bad breath does not respond to an increase in brushing, flossing and mouthwash use, don't just ignore the problem. Dry mouth, tonsil stones, and tooth decay are common causes of bad breath, and all should be treated in a timely manner before they cause bigger problems. For more information, talk to an experienced dentist like Mannarino Gary Dr.