National Fresh Breath Day lands on August 6, and the data says Missouri needs it most. Action Network built a Bad Breath Index for all 50 states and Washington, D.C., then converted each score into an implied probability, essentially the odds that a given state has the worst breath in the country.
Missouri comes out on top with a 49% implied probability, just short of a coin flip. West Virginia is next at 41.6%, followed by Kentucky at 40.7% and Tennessee at 40.4%. On the other end, Utah's implied probability is just 2.9%, the lowest in the country by a wide margin.
The index behind those numbers combines five equally-weighted factors: tobacco use, skipped dental visits, alcohol consumption, and two measures of search interest in bad breath and halitosis. Each state's score gets converted into that implied probability, then into standard betting odds.
At Action Network, odds, implied probabilities and prediction markets are our game. If you want to put a number on something less minty, our prediction markets odds converter turns any prediction market price into American odds or implied probability in seconds, and platforms like Kalshi and Polymarket let you trade on real-world outcomes the same way.
The 10 States Most Likely to Have Bad Breath
1. Missouri (+104)
Missouri tops the country with a Bad Breath Index Score of 67.17 and an implied probability of 49%, the shortest odds of any state in the study. Missouri's 65 bad breath keyword searches per 100k people is the highest total in the country, while 20.8% of adults use tobacco, both well above the national average of 16.9%.
2. West Virginia (+141)
West Virginia jumps into second at 59.08, up from further down the board in the previous ranking. Its 26.0% adult smoking rate is the highest in the country, and its 143 search score for bad breath-related keywords is the second-highest nationally, trailing only Wyoming's 200.
3. Kentucky (+146)
Kentucky scores 58.13. Its 24.6% adult smoking rate is the second-highest in the nation behind West Virginia, and 41.3% of adults skipped a dental visit in the past year, more than eight points above the national average.
4. Tennessee (+148)
Tennessee comes in at 57.80, just behind Kentucky. A 22.6% tobacco use rate and 40.5% of adults skipping the dentist both land Tennessee comfortably inside the top four.
5. Arkansas (+155)
Arkansas scores 56.50. Its 41.3% rate of skipped dental visits ties Kentucky for among the highest in the country, paired with a 22.3% smoking rate.
6. Delaware (+156)
Delaware sits at 56.40, just hundredths of a point behind Arkansas. Alcohol consumption drives the ranking here: 4.09 gallons of ethanol per capita annually, the second-highest rate nationally behind only New Hampshire.
7. Louisiana (+159)
Louisiana scores 55.89. Its 38.8% rate of skipped dental visits and 23.1% tobacco use rate mirror the pattern seen across most of the top 10: heavy smoking combined with limited dental care.
8. Nevada (+166)
Nevada comes in at 54.79. A 3.55 gallon per-capita alcohol consumption rate and a 36.3% rate of skipped dental visits both sit above average, pushing Nevada into the top eight.
9. Texas (+195)
Texas cracks the top 10 for the first time at 50.80. Its 41.9% rate of adults skipping a dental visit in the past year is the highest of any state in the country, even though its 15.7% tobacco use rate sits below the national average.
10. Mississippi (+200)
Mississippi rounds out the top 10 at 50.16, a steep fall from the top of the board in the previous ranking. Its 22.2% tobacco use rate and 132 search score for bad breath-related terms, the third-highest nationally, keep it inside the top 10 despite a more middling dental visit rate.
The Safest State for Fresh Breath
Utah isn't just the best state in the country for bad breath odds, it's in a different tier entirely. Its Bad Breath Index Score of 17.15 is more than 11 points clear of the next-safest state, Connecticut (28.43), the largest gap between any two states in the entire dataset. Utah's implied probability sits at just 2.9%, priced at +3357, longer than every other state by a wide margin.
The numbers explain why. Utah's 8.9% adult tobacco use rate is the second-lowest in the nation behind only Wyoming's outlier 0.2%, and its 1.21 gallons of per-capita alcohol consumption is the lowest of any state, roughly a third of leaders like New Hampshire and Delaware.
Connecticut, Washington, Vermont and Idaho fill out the next tier of the healthiest states, all scoring in the high-20s to low-30s, but none come close to touching Utah's outlier status at the bottom of the board.
Conclusion
The states with the worst bad breath odds share a clear pattern: high tobacco use, skipped dental visits and heavier drinking, often more than one at once. West Virginia, Kentucky and Tennessee jumped into the top five behind Missouri because they combine multiple risk factors rather than leaning on just one. Utah stands alone at the other end, posting the lowest or second-lowest score in nearly every behavioral category tracked in the study.
With National Fresh Breath Day here, the data offers a simple takeaway: wherever you rank, a dentist visit and a pack of gum go a long way.
Methodology
Action Network ranked all 50 U.S. states and Washington, D.C. on bad breath risk by combining behavioral risk factors with search query volume. Five metrics were weighted equally at 20% each: adult tobacco/nicotine use (World Population Review/CDC), the share of adults who skipped a dental visit in the past year (CDC BRFSS), annual per-capita ethanol consumption in gallons (NIAAA Report #122), Google Trends search interest for "bad breath," "halitosis" and related terms, and total search volume for halitosis-related keywords (Google Keyword Planner).
All raw metrics were aligned so that higher values indicate worse breath, then rescaled from 0 to 100 using min-max scaling: (State Value – Minimum Value) / (Maximum Value – Minimum Value) x 100. The final Bad Breath Index Score for each state is the weighted average of all five normalized columns.
Each state's Bad Breath Index Score was then converted into an implied probability using a blended approach. The first component treats each state's score as a share of the combined index score across all 51 entries, so all shares sum to 100%. The second component rescales each state's score independently on a 0-100% scale between the lowest-scoring state (Utah) and the highest-scoring state (Missouri), compressed into a 5%-95% band to avoid probabilities of exactly 0% or 100%. The two figures were averaged to produce the final implied probability for each state, which was then converted into standard sportsbook decimal odds (1 divided by the implied probability) and American odds using the conventional formula.
You can find the raw dataset here.
