Bitter Taste in Mouth: Causes and What Helps

Taste is a partnership between the tongue and saliva. Anything that changes the saliva, coats the tongue or sends something up from the stomach can leave a bitter note, which is why the causes range from trivial to worth investigating.

In the mouth itself, the usual suspects are a coated tongue, plaque along the gum line, gum disease and an infected tooth, all of which release bitter-tasting substances as bacteria break down food and tissue. Our page on bad breath explains how the back of the tongue and the gum pockets produce both the smell and the taste.

Outside the mouth, acid reflux is the classic cause, especially when the bitter taste is worst in the morning or after lying down. If the taste is more sour than bitter, our guide on sour taste in the mouth covers reflux in more detail, and a coin-like taste is covered in the guide on metallic taste in the mouth.

Saliva dilutes and washes away what builds up on the tongue. When there is less of it, flavours turn harsh and bitter. Sleeping with the mouth open, not drinking enough water in a hot Lucknow summer, smoking and tobacco all dry the mouth. Our page on dry mouth explains why this also raises the risk of decay.

Many medicines change taste or reduce saliva, and some are excreted partly in saliva so the taste comes through directly. Iron tablets, some blood pressure and heart tablets, antidepressants and herbal or Ayurvedic preparations are common examples. Do not stop a prescribed medicine on your own. Mention the taste to the doctor who prescribed it, because there is often an alternative.

Taste changes are also common in early pregnancy, and a bitter or metallic taste can come with nausea and reflux. It usually settles without treatment. A dentist can check that the gums are healthy, since pregnancy makes them more reactive.

Start with what you can control. Brush the teeth and gum line twice a day, clean between the teeth once a day, and clean the tongue gently from the back towards the tip. Sip water through the day, and chew sugar-free gum to keep saliva flowing.

If reflux is likely, smaller meals, not lying down soon after eating, raising the head of the bed and cutting back on very spicy, fried and late-night food often help. Reflux that happens often, or that wakes you at night, is a reason to see a doctor rather than keep managing it yourself.

A rinse can freshen the mouth for a short while, but it does not remove the cause. If the taste comes back as soon as the rinse wears off, look for the reason: a coated tongue, gum disease, a decayed or infected tooth, or a medicine.

See a dentist if the taste comes with bleeding or swollen gums, a loose tooth, a tooth that hurts or a pimple on the gum. See a doctor if it lasts more than two weeks despite good cleaning, comes with frequent heartburn, trouble swallowing, unexplained weight loss, or yellowing of the eyes or skin.

Spreading facial swelling, fever, or difficulty swallowing or breathing means same-day care. Go to a hospital emergency department if breathing or swallowing is affected.