halitosis and bad breath in children: little girl covering her mouth

Parents are often worried about the offensive smell of their toddler’s breath. We all have bad breath from time to time – even children, but if it’s a constant occurrence, there might be a reason for this. Most of the time, better oral hygiene will get rid of bad breath. If there is an underlying condition that’s responsible for the smelly breath, poor oral hygiene will certainly make it worse.

Causes of bad breath (halitosis) in children

Poor oral hygiene

The leading causes of bad breath are plaque (a waste product of acid-forming bacteria), calculus (calcified plaque) and food debris. Brushing alone is not enough to ensure that plaque is removed. Plaque forms on all the surfaces of the teeth, even between teeth and underneath the gums, which is why it’s essential to floss daily to remove the plaque and food particles that get trapped where a toothbrush can’t reach.

Gum health

Make sure that you brush the gums as well as the teeth – the gum line is an often neglected area. People mistakenly think that gums bleed because they are brushed but this isn’t true; gums will only bleed when brushed if there is an accumulation of plaque. Plaque is responsible for inflammation and that inflammation causes the bleeding. Not only will the plaque and food debris contribute to bad breath, but so will bleeding gums.

What about the tongue? 

Plaque doesn’t only form on the hard tissue like teeth, it also forms on soft tissue such as the tongue. Make sure you brush the tongue as regularly as you brush the teeth, especially the back of the tongue where it’s difficult to reach with the brush – it’s the ideal place for bad breath bacteria to hide.

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The toothbrush

Make sure you replace your child’s toothbrush regularly as bacteria accumulate on the bristles. Always rinse a toothbrush thoroughly after using it and store it in an airy place to allow the bristles to dry.

Abscesses and cavities

Both cavities and abscesses are filled with bacteria, and food also tends to get trapped in cavities. The mouth is the ideal environment for food to rot – it’s dark, moist and warm. Food trapped inside a cavity or between the teeth will smell as bacteria break it down.

Dehydration and mouth breathing

When the mouth is dehydrated there is less saliva flowing. One of the many functions of saliva is a cleaning action where food and plaque debris get washed away. With less saliva, this function is compromised and can contribute to the accumulation of bacteria.

Nutrition and diet

Eating garlic, onions and strong spices will increase your risk of bad breath. Odorous molecules enter the bloodstream and are excreted through the lungs when breathing. High protein foods like red meat, fish and cheese can make this even worse.

Infection and medical conditions

There are a number of medical conditions that can contribute towards bad breath in children.

  • Acid reflux is caused by the regurgitation of stomach acid and partially-digested food.
  • Enlarged tonsils might harbour large amounts of bacteria.
  • Sinus infection is caused by the collection of sinus fluid in the nasal passage and throat, which is the perfect breeding ground for bacteria.
  • Diseases such as diabetes, stomach infection, kidney failure, liver problems and mouth cancer can have a similar effect.

Side effects of medication

Some medication decreases the flow of saliva, causing dehydration that, in turn, can contribute to bad breath in children.

bad breath and halitosis in children: girl at the dentist

Foreign objects

Some items are just the right shape and size to fit in orifices like the nose and ears and children like to experiment. If an item is stuck in there for some time, it can cause an infection and result in a rotten smell.

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Treatment for bad breath or halitosis in children

Improve oral hygiene

Make sure your child practices good oral hygiene habits on a daily basis and schedule an appointment with an oral hygienist who can recommend a maintenance program.

Treatment by the dentist

Schedule an appointment with the dentist to make sure your child has no cavities, abscesses or infections – if they do, treat these accordingly.

Diet

If there is no obvious reason for your child to have bad breath, you might want to consider  increasing the amount of certain foods your child eats:

  • Apples – the fibre will help scrub the teeth and remove some of the plaque.
  • Carrots, celery, cucumber – chewing these will stimulate saliva flow.
  • Plain sugar-free yoghurt with live active cultures – will reduce hydrogen sulfide (a compound that causes bad breath).
  • Oranges – odour-producing bacteria don’t like foods rich in Vitamin C.
  • Cherries and lettuce – these counteract methyl mercaptan, which can be responsible for bad breath.
  • Water – odour-causing anaerobic bacteria prefer a dry environment. Water, like saliva, will help wash away debris.

Consultation with a physician

It might be possible to treat underlying medical conditions or alter the use of certain medications that are responsible for dehydrating the mouth.

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Does a mouth wash or rinse cure bad breath or halitosis?

Do not overestimate the power of a mouth rinse. Although some might have a very strong taste and smell, a mouth rinse does not have the ability to cure bad breath. Together with brushing and flossing, mouth rinse can help to reduce the amount of bacteria in a mouth. Sometimes a mouth rinse can mask bad breath, but only for a short time. To cure bad breath, you need to treat the underlying cause.

Sarie Liebenberg, dental hygienist and lecturer
Sarie traded a glamorous career as a lecturer at a finishing school for a new adventure as a dental hygienist and lecturer when she went to university to retrain at the age of 31. Sarie found her passion in helping people, saying ‘it’s much more than working on someone’s mouth, it’s restoring confidence, creating opportunities and being part of making it all happen, not only for the patient, but also for myself.’ A mom of one herself, Sarie has a special interest in working with children.