Bad breath in kids can be a serious concern for parents and caregivers. When bad breath is severe and prolonged, experts call it halitosis, and it can impact everything from social development to personal relationships with friends and family. If your child has halitosis, you can take steps to help them address it, and the first one is to identify the cause.
What Causes Children to Have Bad Breath?
While adults may battle halitosis because of gum disease, most kids don’t develop periodontitis (or advanced gum disease) until they’ve reached adulthood. But the cause of their bad breath usually comes from similar issues: bacteria in the mouth. Residue from meals and snacks often lingers between the teeth, on the tongue, or inside cavities, providing food for bacteria. Plus, in some cases, medical conditions can cause bad breath. Let’s break down the top causes of bad breath in kids.
Poor oral hygiene
The most common reason why a kid has bad breath is because of poor oral hygiene. Daily brushing and flossing are essential for removing food debris between teeth and plaque along the gumlines. Adults and children should brush for two minutes twice a day and floss daily.
Even though a lot of families understand the importance of brushing and flossing, not all are aware of the bacteria-filled white coating on their child’s tongue. This filmy residue tends to house what are called volatile sulfur compounds (VSCs), which can be extremely odorous. Removing tongue bacteria with a tongue scraper can help treat bad breath. To use a tongue scraper, start at the back of the tongue and work toward the tip.
Unfortunately, some children have sensitive gag reflexes, which may make using a tongue scraper difficult, if not impossible, until they become older. If your child doesn’t have success with the practice, wait and introduce it later.
Does your child always seem to have a runny nose or cough? Non-dental sources such as tonsillitis, ongoing sinus drips, or other respiratory infections can cause bad breath in kids.
In the case of tonsillitis, bacteria can accumulate inside the tonsil “crypts,” deep indentations in the tonsils. It may also form in tonsil stones, white deposits consisting of food and other particles that sometimes form on the tonsils. In either case, this bacteria can cause halitosis in kids. Similarly, the bacteria in sinus drainage — because of an infection or allergies — can drip down the back of the throat and produce an unpleasant odor.
Medications used to treat sinusitis and allergies tend to also cause dry mouth, which can make bad breath symptoms more prevalent.
Treating bad breath in children may start with altering your child’s diet. For example, even though many children don’t enjoy onions or garlic, they’re loaded with sulfur particles which can cause halitosis to be worse than normal.
On the other hand, plain yogurt can improve the breath according to a smaller Japanese study from 2005, likely because it contains natural probiotics that may help regulate oral bacteria levels. Moreover, eating fresh fruits and vegetables like carrots, celery, or apples may also help prevent bad breath because their fibrous texture wipes away plaque as your child bites into them. In addition to making healthy food choices, encourage your child to drink water frequently throughout the day and rinse their mouth out after snacks or lunch at school.
Xerostomia is the term dental professionals use to describe dry mouth. It’s a common side-effect of many over-the-counter and prescription medications, including those for seasonal allergies or managing ADHD. But dry mouth alters the way the breath smells, too.
Does your child tend to breathe through the mouth during the day or while they sleep? Mouth breathing syndrome” (MBS) can cause bad breath in children because it causes xerostomia. Having enough saliva in the mouth is important because it contains antimicrobial agents.
Mouth breathing doesn’t just contribute to halitosis in kids. It also places teeth at a higher risk of decay because it dries up saliva. The more the child breathes through the mouth, the drier the oral tissues will become.
If your child’s lips are extremely dry and cracked or if they have red, swollen gums despite brushing and flossing regularly, they may be mouth breathing instead of keeping their lips closed together.
During the COVID-19 pandemic, some parents and dental professionals have found “mask mouth” to be a legitimate concern. Children may breathe through the mouth while wearing a mask or may not pay as much attention to oral care because their teeth aren’t visible while masking.
Encourage your child to keep their mouths closed and stay hydrated throughout the day. Drinking tap water will also provide them with added fluoride if you live in a municipality with fluoridated water.
While less common in children, gastrointestinal diseases like acid reflux, stomach ulcers, and even stomach cancer are all known to cause bad breath. Certain types of endocrine and metabolic conditions, such as diabetes, can change the way a child’s breath smells. Liver and renal failure, as well as dehydration, may also alter the smell of your child’s breath.
How to Treat Bad Breath
The best way to manage bad breath in kids is to prevent it from happening. These steps can help.
Oral care routine
Until your child has the dexterity to tie their shoes, they probably aren’t brushing and flossing as thoroughly (or accurately) as they should. Although it’s important to encourage independence, parents and caregivers should follow up behind their child to make sure their teeth are being cleaned well twice a day.
Consider changing the oral-care products your kids use at home to make them more appealing. For instance, you may want to invest in an electric toothbrush or convenient floss picks if they make your child more excited about oral care. And don’t forget a tongue scraper.
A smouthwash option to help with bad breath in children can help neutralize the odorous sulfur compounds responsible for halitosis. When paired with a dedicated brushing and flossing routine, a mouthwash may also help prevent gingivitis (gum inflammation).
Be sure to read the labels when selecting a mouthwash. Some mouth rinses contain alcohol to maintain shelf life or to serve as an antiseptic, but this ingredient can be drying. It may be best to avoid these products since dry mouth can contribute to bad breath in children.
Regular dental check-ups
Dental experts recommend a checkup and cleaning for kids every six months. During your child’s visit, the dentist or hygienist will let you know if they see heavy plaque buildup, problem areas, or active tooth decay. All these scenarios can lead to bad breath in children.
In addition to white film on your child’s tongue, cavities are also known to contribute to bad breath. Even if the decay is in a baby tooth, your dentist will likely want to treat it quickly. Otherwise, the decay can spread, leading to additional complications and treatment expenses.
Your dentist can also check for tonsillitis, tonsil stones, and a nasal sinus drip that may contribute to bad breath.
Partnering with your dental team helps your child learn from an early age that good oral hygiene keeps their smile healthy. Their dental provider will educate them on how to properly brush, floss, and rinse to maintain a healthy mouth.
When to Call the Doctor
If your kid has bad breath that doesn’t get better even after you take the above measures, it may be time to make an appointment to rule out or treat any underlying medical conditions. First, schedule a visit with your pediatrician. Then, depending on your child’s symptoms, your pediatrician may refer you to a pediatric ear, nose, and throat (ENT) doctor or gastroenterologist.
It’s usually not hard to treat bad breath in children once you know the cause. In most cases, you can improve bad breath by modifying your home oral care, changing your oral hygiene products, getting regular checkups, and addressing issues like allergies or dry mouth. Using a tongue scraper and an alcohol-free mouthwash may also dramatically improve bad breath symptoms in kids.