Several conditions can cause bad breath, sometimes in combination. Since he hasn't brushed or flossed regularly until only recently, he could be suffering from advanced periodontal gum disease which can also form abscesses within the gums and/or teeth.
Stones often form behind the tonsils from repeated sinus/throat infections that have a terrible smell. Kidney disease, stomach problems and dietary issues can also cause very bad breath.
He should see a dentist first, followed by a visit to the GP...and the sooner the better for his sake as well as yours.
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