I take a proton pump inhibitor for acid reflux, but have bad breath despite excellent oral hygiene. if my ppi is to blame, what can i do?

Other sources: Ppis and stomach content regurgitation can alter the mouth odor, but they can arise from other sites: nose, sinuses, throat, tonsils, cavities in the teeth and plaque between the teeth. Have your dentist perform a thorough evaluation and consider talking to your physician. Good luck.

Maybe LERD?: Likely lerd with sourbrash. Stomach acid & pepsin will result in inflammation of the vocal cords and oral cavity (with acid regurgitation) = lerd. Acute laryngitis may result, but watch out for chronic hoarseness, throat clearing, hallitosis, airway spasms, cough, bronchitis, an asthma-type presentation, & even a higher risk of throat cancer. Maybe you need a stronger acid reducer? See doc.