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If your breath smells bad even after brushing, the cause may be more than just your teeth. Persistent bad breath is often linked to bacteria on the tongue, gum disease, cavities, dry mouth, plaque buildup, or even certain medical conditions. Brushing alone may not remove odor-causing bacteria hiding below the gumline or on the back of the tongue. If bad breath continues despite good oral hygiene, a dental exam can help identify and treat the underlying cause.