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What Causes Bad Breath In Kids And What To Do About It?

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Bad breath is common in children, and even adults, soon after they wake up, mostly because of the bacterial activity in the mouth. Such a bad breath is not something to be concerned about, as it goes away as soon as your child brushes the teeth and rinses the mouth. But, If your child has repeated episodes of bad breath, then you may have to look at what is causing it.

In this post, MomJunction tells you about the causes of bad breath in children, its treatment, and ways to manage the problem.

What Causes Bad Breath In Children?

Here are a few reasons for smelly breath in children (1).

1. Poor oral hygiene

Poor oral and dental hygiene is among the most common causes of bad breath, also called halitosis, in children. Irregular or incomplete brushing may fail to remove the dental plaque residue in the child’s mouth.

  • Dental plaque is the accumulated bacteria that thrive on residual food particles or protein between the teeth.
  • Bad breath is specifically caused by anaerobes that sit on the plaque.
  • Dental plaque is found between teeth, on the front and behind the teeth, and along the gum line.
  • Plaque accumulation in the mouth causes not only bad breath but also other oral problems like gum diseases and tooth decay.

What to do: Encourage your children to maintain proper oral hygiene by brushing and flossing twice every day. Also, remind them to clean their tongue. Avoid giving them foods that are sticky and contain high amounts of sugar. And if you do give them such treats occasionally, ensure that they rinse their mouth after eating.

2. Dry mouth

Finger sucking or pacifier use can cause dry mouth in children. This can increase the growth of bacteria in the mouth and lead to bad breath. If enough saliva is not produced in the mouth, it results in a condition called xerostomia, which causes excessive dryness of the mouth and eventually leads to smelly breath.

What to do: Make your child drink plenty of water to stay hydrated. They can also suck ice cubes and lollies, or chew sugar-free gum. But, if you notice any other symptoms, then dry mouth could be due to an underlying condition. In this case, take your child to the doctor.

3. Bacteria on the tongue

The tongue is where the bacteria settle in the mouth. Also, evidence suggests that wearing dentures may sometimes cause bad breath due to increased plaque deposits on the tongue (2).

What to do: In addition to brushing, your child should also be taught to clean his tongue every day. You can use a brush or a plastic cleaner to remove the white coating that appears on the tongue.

4. Breathing with mouth

Children often breathe through their mouths when they sleep or when they have a blocked nose. Saliva is not produced when the mouth is open. The dryness leads to xerostomia. Mouth breathing also increases the risk of tooth decay (2).

What to do: Observe why your child is breathing through the mouth. If it is because of a stuffy nose, then try to remove the blockage using a bulb syringe. If this does not stop mouth breathing, then consult your pediatrician.

5. Oral infections/gum diseases

Your children may develop oral infections or gum diseases due to a lack of proper care. The infections could be a result of high sugar content in their diet or due to poor dental hygiene.
Gingivitis or gum disease is also an inflammatory condition that causes bad breath in children (2).

What to do: If you noticed symptoms of gum diseases (swollen, bleeding gums), then it is best to schedule an appointment with your child’s dentist.

6. Tooth abscesses or decay

A tooth abscess is an infection that results in pus formation in the teeth, while decay is permanent damage to teeth with small holes in them. Both the conditions can result in highly distinct, foul odors of the mouth.

Tooth abscesses are common in children and can be caused due to injury or cavities, while tooth decay can be caused due to poor diet and oral hygiene.

What to do: Tooth abscess needs to be treated at an early stage to prevent it from becoming worse. It is best to take your child to the dentist, who would then examine and suggest a course of treatment.

7. Foreign objects

  • Dentures or braces in the mouth can lead to prolonged bad breath in children.
  • Bad breath in younger children could be because of foreign objects like small toys or food items that they put in their nostrils.

What to do: Removal of these objects usually eliminates the bad breath. If it doesn’t, check with your dentist immediately.

8. Food

The food we eat is a major factor that affects our breath.

  • Foods like garlic, onion or cheese can cause bad breath in children (3)
  • The diet, combined with poor oral hygiene, may eventually lead to halitosis.
  • A high-protein or low-carb diet can also result in halitosis (4).
  • Fewer carbohydrates in the body result in the production of ketones (4). Unused ketones in the body are released through the air you exhale, giving it an acetone-like smell.

What to do: If you are sure that the bad breath is due to certain foods, then try to cut down on those foods, and maintain a balanced diet. If this doesn’t stop the bad breath, consult your pediatrician or a dentist to figure out the cause.

9. Tonsils

Children with tonsils have deep pockets or crypts where food particles and debris accumulate.

  • Tonsil stones, also known as tonsilloliths, are specks of white debris that can also cause bad breath in younger and older children.
  • These bits usually contain anaerobic bacteria with some amount of mucus and residue food particles, which make the breath offensive.
  • In addition to bad breath, you may notice throat irritation and whitish node or lump on the tonsils (rear end of the throat).

What to do: The best way to treat tonsil stones is by keeping them debris free. Brushing your child’s teeth and tongue thoroughly, and gargling each time after eating can help prevent any buildup, says Dr. Kyra Osborne, a head and neck specialist from Cleveland Clinic (5).

10. Medications

Continuous use of antibiotics for a month or more can cause bad breath in children. Also, medications such as antihistamines, tranquilizers, and phenothiazines can reduce saliva production and cause dry mouth or xerostomia (1).

What to do: Always check with your child’s doctor before giving them any medications. In case the medications are prescribed by the doctor, strictly follow the doctor’s instructions. Also, discuss with your doctor about ways to increase saliva production during the period of medication.

11. Other medical problems

Halitosis can sometimes indicate a medical condition.

  • Respiratory conditions like sinus, asthma, and enlarged adenoids can be a common cause of bad breath in children.
  • Other conditions like diabetes, gastric reflexes and can cause bad breath (5) (3)

What to do: In any case, prolonged bad breath that cannot be treated with proper oral hygiene and diet needs proper diagnosis by a medical professional. The sooner you address it, the better it is for your child.

When Is Bad Breath A Problem?

The striking sign of bad breath is the foul odor you get when your child is talking or whispering. However, symptoms can vary from one individual to another, based on the underlying cause. Some of the common symptoms that warrant a doctor’s visit include:

  • Distinct foul odor: Breath can smell like raw liver, ammonia, acetone, dead fish, rancid butter, or sweaty socks.
  • A bad taste in the mouth, which persists even after brushing
  • Dry mouth, and white surface on the tongue.
  • Bleeding gums while flossing (1).

Your children may not be aware that their bad breath is problematic. Therefore, it is up to you to watch out for these symptoms.

Tips To Prevent Bad Breath In Children

Teaching your children about oral hygiene is the first step you should take to prevent bad breath. Ensure that your children:

  1.  Brush their teeth regularly, for at least two minutes each time; make a habit of cleaning or rinsing their mouth after every meal.
  1. Use a mouthwash (without alcohol content) recommended by a dentist.
  1. Help your children floss daily.
  1. Clean or brush the posterior or back part of the tongue regularly.
  1. Make your children drink lots of water as dehydration can lead to dry mouth.
  1. Give them a healthy breakfast and include fruits and vegetables in their diet while reducing sugar intake. Do not skip meals.
  1. Clean their braces or other dental implants, if any, regularly.
  1. Go for regular dental checkups.

Talk to your children about the importance of oral hygiene so that they take care of it willingly.

Home Remedies You Could Try To Reduce Bad Breath

Poor oral hygiene is known to be the most common cause for bad breath. So, if your child has bad breath, then the first thing to check is if they are following a proper dental routine. Along with that, you can also try some of the following home remedies that might work in reducing bad breath.

1. Water

Staying hydrated is important to keep bad breath away. Studies suggest that lack of saliva could cause dry mouth, which is an ideal environment for the bacteria to grow. (6). Children should drink five to eight glasses of water (not sugary drinks) daily to help saliva production (7). So, make sure your child is drinking enough to stay hydrated.

2. Plants products

Parsley, cloves, and guava peels have been traditionally used to brush teeth or chewed to treat bad breath (8). Since little is known about their effectiveness, you may consider trying them after consulting with your child’s doctor.

3. Chewing neem and mango twigs

Brushing with neem and mango twigs, and chewing neem leaves are traditionally practiced in India, for maintaining oral health. Stems of neem contain nimbin and nimbidin, which are said to have anti-inflammatory and anti-microbial activities.

Also, a study on 105 children found that neem and mango extract mouthwashes have found to reduce plaque and gingival scores (9).

4. Healthy diet

Reduce the amount of sugar that goes into your child’s body every day. Cut down on carbonated, sweetened drinks and snacks, including chocolates and candies. Also, include foods that increase saliva flow like brown rice, orange and dark green vegetables, fruits, nuts, fish, and beans, in your child’s meal plan.

5. Fennel

Traditionally, sugar-coated or uncoated fennel seeds are consumed as a mouth freshener, or digestive aid, in many parts of India and Pakistan (9). So, if your child is old enough to chew fennel seeds, then this could be used to mask bad breath temporarily. However, make sure they chew the seeds properly and not swallow them to avoid the risk of choking on the seeds.

6. Yogurt

Yogurt contains good bacteria that could help fight bad breath. Studies show that bad breath decreased by 80% in volunteers who consumed yogurt, than in those who did not. So, encouraging your children to eat a serving of plain, low-fat, and sugar-free yogurt might help control bad breath (10).

7. Apples

Research states that raw apples can oxidize the sulfur compounds (which cause bad breath) after eating garlic. This remedy might work if the smell of garlic lingers in your child’s breath (11).

8. Citrus fruits

Citrus fruits like oranges can help in producing more saliva in the mouth. Eating one orange after lunch, or a grapefruit during breakfast can be good for the teeth (12).
Use these remedies alongside any medical treatments prescribed by your doctor. Also, it is imperative that you maintain oral hygiene for these natural remedies to work.

Frequently Asked Questions About Bad Breath In Children

1. My child has a bad breath even after brushing. Why?

Brushing can prevent bad breath only if it is done right. Brushing for less than two minutes and not cleaning the different parts of the mouth in the process can be the reason why children have bad breath even after brushing. Also, sometimes, bad breath could be an indication of an underlying disease. In such a case, brushing might not have any impact on the bad breath until the condition is treated.

2. Can I fix my child’s bad breath with mouthwash?

If the bad breath is caused by eating certain foods like onions, garlic, eggs, or cheese, it can be fixed by rinsing the mouth with mouthwash.

However, according to a letter published in the British Dental Journal, daily usage of mouthwashes is not recommended until further studies are done, as they are potential risks such as

lowering the pH which can lead to erosion, and the chlorhexidine containing mouthwashes can also trigger allergic reactions (13).

3. Can I identify bad breath by breathing into my hand?

There is no scientific evidence to back this method. Anecdotally, you can identify your child’s bad breath when they come close to you to speak or whisper.

A medical measurement, known as organoleptic measurement, where the patient takes deep breaths and blows the air through the mouth and into a pipe, can be used. The examiner sniffs the odor at 20cm and grades it accordingly. However, this might not be accurate as it is said to have limitations (3). There are more accurate methods to identify bad breath, which your doctor could suggest.

4. Will brushing teeth twice a day eliminate bad breath?

Brushing is a simple activity that ensures oral hygiene, and it is generally advised that children brush twice a day. However, the effectiveness of it would depend on the amount of time the child is spending in brushing, and if there is no underlying medical condition causing bad breath.

5. Is bad breath in children linked to diabetes?

Not always. Bad breath or halitosis is sometimes associated with diabetes, but other factors can also result in the condition. To know if halitosis in your child is due to diabetes, consult a medical professional.

Oral health is one of the most important aspects of a child’s overall well-being. A healthy mouth is key to a healthy body. Halitosis is a condition that you can prevent with proper care. If the condition persists despite complete oral care, medical help is always there!

Does your child have a bad breath? Tell us how you are dealing with it.

References

1. Mohammad Karimi; The Causes of Halitosis in Children; Pediatric Dental Care
2. Lara Jansiski Motta; Association between halitosis and mouth breathing in children; NCBI(2011)
3. Bahadır Ugur Aylıkcı and Hakan Colak; Halitosis: From diagnosis to management; NCBI(2013)
4. G.S Madhushankari, et al.; Halitosis – An overview: Part-I – Classification, etiology, and pathophysiology of halitosis; NCBI(2015)
5. Type 1 Diabetes Mellitus in Children; Stanford Children’s Health
6. Kleinberg I, Wolff MS, Codipilly DM; Role of saliva in oral dryness, oral feel and oral malodour; NCBI(2002)
7. Choose Water as a Drink; Healthy Kids NSW
8. PK Prathiba; Oral Malodor: A Review of the Literature; Journal of Dental Hygiene
9. Ratika Sharma, et al.; Effect of Two Herbal Mouthwashes on Gingival Health of School Children; NCBI
10. Shamkant B. Badgujar, Vainav V. Patel, and Atmaram H. Bandivdekar; Foeniculum vulgare Mill: A Review of Its Botany, Phytochemistry, Pharmacology, Contemporary Application, and Toxicology; NCBI(2014)
11. Put culture in your life and reduce bad breath: Eat yogurt!; International & American Associations for Dental Research
12. Munch R, Barringer SA; Deodorization of garlic breath volatiles by food and food components; NCBI(2014)
13. Muhvic Urek; Soft Laser, Chewing Gum, and Citric Acid Effects on Salivation
14. A. Dagher, N. Hannan; Mouthwash: more harm than good?; British Dental Journal

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