22M, 10+ years of chronic halitosis, dry mouth, gut issues, and cavities.
Posted: Sat Sep 05, 2026 9:56 pm
Long post, sorry. I've been dealing with this since I was around 10-11 and I've done a lot of testing, so I want to lay it all out rather than drip-feed details. Skip to the questions at the bottom if you want.
Background
Onset was around 4th-5th grade. I distinctly remember two things happening at the same time: a classmate told me I had bad breath, and I started noticing a lot of constant nasal congestion.
I'm 22 now, based in the US.
Symptoms
Chronic dry mouth (cotton mouth). Fluctuates day to day and even within a day, but basically always there. Drinking huge amounts of water does nothing for it.
Halitosis. My main complaint. Worse in the morning and worse at the end of the day. I honestly can't always tell whether the two are the same smell.
Bad-smelling mucus from the back of my nose. I can pull it down and spit it out. Strong odor, sometimes described as fishy, worst in the morning.
White coating on the back of my tongue that doesn't come off no matter how much I scrape.
Tonsil stones, frequently. Less often now that I gargle warm salt water twice a day.
Sudden cavities, more on this below, it's a big part of why I think something systemic is going on.
Things I've noticed myself (patterns)
These feel important and I'd love to know if others have the same:
It's dramatically worse when I'm exhausted or after an all-nighter, even if my oral care that day was perfect.
My breath an hour after brushing sometimes seems worse than when I wake up. Fresh for maybe 30 minutes, then it's back or worse.
Antibiotics makes it less bad temporarily. I've had a couple of courses (most recently after a sinus procedure) and both times the halitosis dropped off noticeably, the smell from my back teeth disappeared, and the nasal/throat smell went away. Comes back every time after I finish the course.
What I've had done / tested
Dental
Rigorous routine for years: tongue scraping, string floss, water floss, brushing 2x (Sonicare), interdental picks
Tried basically every mouthwash, Therabreath, CloSYS, SmartMouth Clinical DDS, ACT, chlorhexidine, hydrogen peroxide rinses. Some for weeks at a time. No durable effect from any of them.
Oral probiotics, 6+ weeks consistent, no change so far
Oil pulling one summer (seemed to actually help two cavities, did nothing for breath)
Periodontist exam at a Ivy league university dental school, gums reviewed by a professor, completely normal, no pockets, no gum disease
Hygienist at my last cleaning commented on how clean my teeth looked, despite me getting a bunch cavities all of sudden
Two saliva microbiome tests (Bristle)(I've attached the files in the link below), 2022 and 2026
2022: gum inflammation 9.2/10 (high risk), halitosis 8.8/10, gut impact 7.3/10
2026: gum inflammation 4.8/10 (average), halitosis 4.8/10 (average), gut impact 0.9/10 (optimal), beneficial bacteria 9.3/10
So the microbiome genuinely improved a lot over four years. Symptoms did not change at all, actually my halitosis might be worse now, which messes with me a lot.
One thing that went up: Solobacterium moorei, 66th → 89th percentile. From what I've read that's one of the species most linked to actual measurable halitosis, and it lives on the tongue dorsum.
ENT(multiple ENTs over the last four years)
Told at 18 that my adenoids were still present and shouldn't be at my age, plus nasal inflammation
Sinus CT(also attached in the link of results/notes below): mild mucosal thickening, septum deviated left, narrowed frontal recesses, and it also incidentally caught that one of my molars was carious
Balloon septoplasty + turbinate reduction ~4 months ago. Breathing improved drastically. Halitosis completely unchanged.
Multiple nasal endoscopies, just mentioned nasal inflation. My most recent one, two weeks ago, actually showed inflammation much lower, I guess that is a result of nasal sprays, rinses, and the procedure.
Sinuses still smell, and if I stop nasal rinses it goes bad again fast. I have this smell in the back of my throat, that comes back when I pause nasal rinses/sprays. Despite the nasal rinses ans sprays though, I can still smell something, especially at night, coming from the tonsils or even further back.
Allergy testing: strong reactions to dust mites and pollen. Currently in the early build-up phase of allergy shots.
Rheumatology (for Sjögren's)
Two consumer tests flagged possible Sjögren's-associated stuff, so I pursued it
Physical exam and antibody bloodwork both negative. Rheumatologist said it's probably not Sjögren's.
I have Evoxac (cevimeline) anyway. When I remember to take it I get noticeable saliva for maybe 30-60 minutes, then nothing.
GI
I used to get a lot of heartburn if I stood for long periods. This might still be true, I just don't stand for long periods anymore. The same isn't true for working out or walking, but it is true for simply standing still for long periods.
Upper endoscopy, nothing
Checked for Zenker's diverticulum, negative
H. pylori breath test (2023) and stool test (recent), both negative
trio-smart 3-gas breath test, H2, CH4, and H2S all normal. So no SIBO, no IMO, no hydrogen sulfide overproduction.
Full stool metagenomic test, basically unremarkable for my age. Borderline E. coli, lowish butyrate, nothing that explains breath.
Meds Adderall 20mg IR (started fairly recently), oral minoxidil 2.5mg, dutasteride 0.5mg. I know stimulants dry the mouth out, but my dry mouth predates the Adderall by about a decade.
The cavity thing
This is what worries me most beyond the smell. I had a couple of fillings at 16. Then two deep cavities on my upper molars needing root canals at 18. For reasons I regret, I didn't get them permanently sealed and capped for a long time, and they started to smell. I'm finally getting them done now: one is sealed, the second is happening in the next few weeks.
But I'm also getting new cavities faster than seems normal. My home dentist reversed his position on two teeth between last summer and this year. My university dentist basically shrugged and said maybe it's genetics. I don't buy genetics, especially because no one if my family has the same oral issues. I brush, floss, water floss and scrape more than anyone I know.
My working theory is that the dry mouth is the cause, no saliva means no remineralization and no buffering, so the decay just runs. Which would make the cavities and the halitosis the same problem wearing two hats.
I think my halitosis might have multiple sources, almost like a hydra. What i mean is, whatever the main source might be, creates sinus issues, creates dry mouth, which creates an oral environment for bacteria, etc. Because my I do get foul odors from even deeper than my mouth, and my tongue, as stated before it always white, especially the back half. I am trying to do another cleanse with Smart-mouth mouth rinse, and I am noticing a much stronger sulfur smell in my mouth now, something I never got before. Which is why I am worried that I might worsening or creating more halitosis.
Where my thinking is now
After going in circles for years chasing "one root cause," I think the actual shape of this might be:
Chronic nasal obstruction since childhood → mouth breathing at night (now with confirmed mild OSA) → mouth dries out overnight → anaerobes take over the back of the tongue and tonsil crypts → VSCs + tonsil stones + coating + accelerated decay. Plus the newly-added Adderall making the dryness worse on top. But I don't know why it also gets worse during the day. I am very persistent with making sure I am nose breathing, especially with some new found nasal relief from rinses, sprays, and the balloon septo.
The antibiotic response, the exhaustion pattern, and the "worse an hour after brushing" thing all fit a low-saliva picture rather than a bacterial-load picture, especially since my actual bacterial load tested fine.
But that ignores the deeper breath that exists at all times, the dry mouth during the day, nasal/sinus smelling fishy(not TMAU), and perhaps even gas issues I have, like incomplete emptying(last 2-3 years), flatulance(constant, about the same time as the halitosis, but it fluctuates a lot. There have been weeks where I get no flatulance, other times I fart like 20 times a day. When I was younger, I had chair breaking farts. Like it sounded like my fart was cracking the wooden shair I was sitting on.) I wonder if the main root could be nasal, throat, adenoids, tonsils, gut, etc, etc. I'm just so tired, especially because it felt like my halitosis is worse now more than ever. About four years ago, my halitosis, while still persistent, didn't seem like the social bother it is now. But it did still exist nonetheless, just not as strong.
What I still haven't done
Sialometry (unstimulated salivary flow rate). Nobody has ever actually measured how much saliva I make. I don't even know
Taking the sleep study back to ENT and asking about the adenoids specifically, given the mild OSA + persistent adenoids + perennial allergies combination. Might request adenoid removal, along with nasal deviation fix.
I just recently got permanent caps for one of my two root canals. Over the next few weeks I'll be getting permanent caps on the other one aswell.
More stomach things? I've done two upper endoscopies, one two years a go, and another just also month. Same with ultrasounds.
Gut Link????
Recently, whenever I standup, it smells like I farted? This is especially true if i was slouching. Sometimes, when i get in my friends car for example, after sitting down, it smells like I farted, even though I didn't feel any farts?
I really just want to fix my hygiene issues, especially given the time and energy I am pouring in.
Thanks for reading all of it. Ten years is a long time to think about the same thing every single day and I'm trying to be systematic instead of just buying the next product.
Link to all results and tests as mentioned: https://drive.google.com/drive/folders/ ... sp=sharing
Background
Onset was around 4th-5th grade. I distinctly remember two things happening at the same time: a classmate told me I had bad breath, and I started noticing a lot of constant nasal congestion.
I'm 22 now, based in the US.
Symptoms
Chronic dry mouth (cotton mouth). Fluctuates day to day and even within a day, but basically always there. Drinking huge amounts of water does nothing for it.
Halitosis. My main complaint. Worse in the morning and worse at the end of the day. I honestly can't always tell whether the two are the same smell.
Bad-smelling mucus from the back of my nose. I can pull it down and spit it out. Strong odor, sometimes described as fishy, worst in the morning.
White coating on the back of my tongue that doesn't come off no matter how much I scrape.
Tonsil stones, frequently. Less often now that I gargle warm salt water twice a day.
Sudden cavities, more on this below, it's a big part of why I think something systemic is going on.
Things I've noticed myself (patterns)
These feel important and I'd love to know if others have the same:
It's dramatically worse when I'm exhausted or after an all-nighter, even if my oral care that day was perfect.
My breath an hour after brushing sometimes seems worse than when I wake up. Fresh for maybe 30 minutes, then it's back or worse.
Antibiotics makes it less bad temporarily. I've had a couple of courses (most recently after a sinus procedure) and both times the halitosis dropped off noticeably, the smell from my back teeth disappeared, and the nasal/throat smell went away. Comes back every time after I finish the course.
What I've had done / tested
Dental
Rigorous routine for years: tongue scraping, string floss, water floss, brushing 2x (Sonicare), interdental picks
Tried basically every mouthwash, Therabreath, CloSYS, SmartMouth Clinical DDS, ACT, chlorhexidine, hydrogen peroxide rinses. Some for weeks at a time. No durable effect from any of them.
Oral probiotics, 6+ weeks consistent, no change so far
Oil pulling one summer (seemed to actually help two cavities, did nothing for breath)
Periodontist exam at a Ivy league university dental school, gums reviewed by a professor, completely normal, no pockets, no gum disease
Hygienist at my last cleaning commented on how clean my teeth looked, despite me getting a bunch cavities all of sudden
Two saliva microbiome tests (Bristle)(I've attached the files in the link below), 2022 and 2026
2022: gum inflammation 9.2/10 (high risk), halitosis 8.8/10, gut impact 7.3/10
2026: gum inflammation 4.8/10 (average), halitosis 4.8/10 (average), gut impact 0.9/10 (optimal), beneficial bacteria 9.3/10
So the microbiome genuinely improved a lot over four years. Symptoms did not change at all, actually my halitosis might be worse now, which messes with me a lot.
One thing that went up: Solobacterium moorei, 66th → 89th percentile. From what I've read that's one of the species most linked to actual measurable halitosis, and it lives on the tongue dorsum.
ENT(multiple ENTs over the last four years)
Told at 18 that my adenoids were still present and shouldn't be at my age, plus nasal inflammation
Sinus CT(also attached in the link of results/notes below): mild mucosal thickening, septum deviated left, narrowed frontal recesses, and it also incidentally caught that one of my molars was carious
Balloon septoplasty + turbinate reduction ~4 months ago. Breathing improved drastically. Halitosis completely unchanged.
Multiple nasal endoscopies, just mentioned nasal inflation. My most recent one, two weeks ago, actually showed inflammation much lower, I guess that is a result of nasal sprays, rinses, and the procedure.
Sinuses still smell, and if I stop nasal rinses it goes bad again fast. I have this smell in the back of my throat, that comes back when I pause nasal rinses/sprays. Despite the nasal rinses ans sprays though, I can still smell something, especially at night, coming from the tonsils or even further back.
Allergy testing: strong reactions to dust mites and pollen. Currently in the early build-up phase of allergy shots.
Rheumatology (for Sjögren's)
Two consumer tests flagged possible Sjögren's-associated stuff, so I pursued it
Physical exam and antibody bloodwork both negative. Rheumatologist said it's probably not Sjögren's.
I have Evoxac (cevimeline) anyway. When I remember to take it I get noticeable saliva for maybe 30-60 minutes, then nothing.
GI
I used to get a lot of heartburn if I stood for long periods. This might still be true, I just don't stand for long periods anymore. The same isn't true for working out or walking, but it is true for simply standing still for long periods.
Upper endoscopy, nothing
Checked for Zenker's diverticulum, negative
H. pylori breath test (2023) and stool test (recent), both negative
trio-smart 3-gas breath test, H2, CH4, and H2S all normal. So no SIBO, no IMO, no hydrogen sulfide overproduction.
Full stool metagenomic test, basically unremarkable for my age. Borderline E. coli, lowish butyrate, nothing that explains breath.
Meds Adderall 20mg IR (started fairly recently), oral minoxidil 2.5mg, dutasteride 0.5mg. I know stimulants dry the mouth out, but my dry mouth predates the Adderall by about a decade.
The cavity thing
This is what worries me most beyond the smell. I had a couple of fillings at 16. Then two deep cavities on my upper molars needing root canals at 18. For reasons I regret, I didn't get them permanently sealed and capped for a long time, and they started to smell. I'm finally getting them done now: one is sealed, the second is happening in the next few weeks.
But I'm also getting new cavities faster than seems normal. My home dentist reversed his position on two teeth between last summer and this year. My university dentist basically shrugged and said maybe it's genetics. I don't buy genetics, especially because no one if my family has the same oral issues. I brush, floss, water floss and scrape more than anyone I know.
My working theory is that the dry mouth is the cause, no saliva means no remineralization and no buffering, so the decay just runs. Which would make the cavities and the halitosis the same problem wearing two hats.
I think my halitosis might have multiple sources, almost like a hydra. What i mean is, whatever the main source might be, creates sinus issues, creates dry mouth, which creates an oral environment for bacteria, etc. Because my I do get foul odors from even deeper than my mouth, and my tongue, as stated before it always white, especially the back half. I am trying to do another cleanse with Smart-mouth mouth rinse, and I am noticing a much stronger sulfur smell in my mouth now, something I never got before. Which is why I am worried that I might worsening or creating more halitosis.
Where my thinking is now
After going in circles for years chasing "one root cause," I think the actual shape of this might be:
Chronic nasal obstruction since childhood → mouth breathing at night (now with confirmed mild OSA) → mouth dries out overnight → anaerobes take over the back of the tongue and tonsil crypts → VSCs + tonsil stones + coating + accelerated decay. Plus the newly-added Adderall making the dryness worse on top. But I don't know why it also gets worse during the day. I am very persistent with making sure I am nose breathing, especially with some new found nasal relief from rinses, sprays, and the balloon septo.
The antibiotic response, the exhaustion pattern, and the "worse an hour after brushing" thing all fit a low-saliva picture rather than a bacterial-load picture, especially since my actual bacterial load tested fine.
But that ignores the deeper breath that exists at all times, the dry mouth during the day, nasal/sinus smelling fishy(not TMAU), and perhaps even gas issues I have, like incomplete emptying(last 2-3 years), flatulance(constant, about the same time as the halitosis, but it fluctuates a lot. There have been weeks where I get no flatulance, other times I fart like 20 times a day. When I was younger, I had chair breaking farts. Like it sounded like my fart was cracking the wooden shair I was sitting on.) I wonder if the main root could be nasal, throat, adenoids, tonsils, gut, etc, etc. I'm just so tired, especially because it felt like my halitosis is worse now more than ever. About four years ago, my halitosis, while still persistent, didn't seem like the social bother it is now. But it did still exist nonetheless, just not as strong.
What I still haven't done
Sialometry (unstimulated salivary flow rate). Nobody has ever actually measured how much saliva I make. I don't even know
Taking the sleep study back to ENT and asking about the adenoids specifically, given the mild OSA + persistent adenoids + perennial allergies combination. Might request adenoid removal, along with nasal deviation fix.
I just recently got permanent caps for one of my two root canals. Over the next few weeks I'll be getting permanent caps on the other one aswell.
More stomach things? I've done two upper endoscopies, one two years a go, and another just also month. Same with ultrasounds.
Gut Link????
Recently, whenever I standup, it smells like I farted? This is especially true if i was slouching. Sometimes, when i get in my friends car for example, after sitting down, it smells like I farted, even though I didn't feel any farts?
I really just want to fix my hygiene issues, especially given the time and energy I am pouring in.
Thanks for reading all of it. Ten years is a long time to think about the same thing every single day and I'm trying to be systematic instead of just buying the next product.
Link to all results and tests as mentioned: https://drive.google.com/drive/folders/ ... sp=sharing