Pediatric Halitosis: What Does it Mean if My Child Has Bad Breath?

This blog has been reviewed by a pediatric dentist. 

Have you noticed that your child’s breath has a discernible and unpleasant scent? When bacteria in the mouth break down amino acids, they convert them into volatile sulfur compounds that smell foul. Halitosis, or bad breath, can impact social life and make your child feel self-conscious in social settings, not to mention that it can be indicative of larger medical issues. Halitosis can arise due to a number of conditions, from tooth decay to dry mouth. Finding the root cause of halitosis is often instrumental in getting rid of the odor. Enlist the help of your pediatric dentist- they can narrow down the cause and determine the treatment. 

12 Causes of Halitosis in Kids

Tooth decay- When tooth decay breaks down the enamel and tooth structure, there can be an accompanying smell, especially as cavities progress. In addition, if your child has a crown or filling that’s broken or loose, bacteria can build up underneath, releasing odor. 

Inadequate brushing and flossing- Brushing and flossing regularly is the best way to keep halitosis at bay. Remember the 2-2-2 Rule- Brush for two minutes, two times a day, and see the dentist two times a year. 

Mouth breathing- There is a strong association between mouth breathing and halitosis. This is because mouth breathing generally causes dry mouth. 

Dry mouth- Xerostomia is the medical term for dry mouth, which can be caused by some medications, mouth breathing, or a medical condition. Saliva washes away food particles and acids, and keeps the mouth clean. When saliva flow is lowered, the self-cleaning abilities of the mouth declines, and odor-causing bacteria thrive. If your child has dry mouth, they will be more prone to cavities.

Allergies- Because allergies often cause post-nasal drip, they can contribute to halitosis. The mucus feeds odor-causing bacteria. Allergies may also cause congestion that results in mouth breathing, a cause of dry mouth. Antihistamines and decongestants can cause dry mouth as well. 

Tonsil stones- These small, white or yellowish pebbles are made of hardened bacteria, food particles, and other debris that have calcified in the tonsils. They have a very unpleasant odor. Just having large tonsils can cause halitosis as well, as food, bacteria, and nasal secretions get trapped in the grooves. 

Infections- Sinus infections, infections like strep throat, and tooth infections all have an accompanying smell. When your body is fighting infection, there is a buildup of bacteria, present in excess mucus or pus, which creates a foul odor or “sick breath.” 

Gum disease- Otherwise known as periodontitis, gum disease can cause pockets to form between the teeth and gums where food gets trapped, plaque gets missed, and bacteria multiply. The gums become infected and inflamed, and may even release pus. All these factors combine to create a metallic or rotten egg smell. Professional dental intervention is necessary. Once present, the halitosis caused by gum disease cannot be rectified by brushing and flossing at home.

Morning Breath- Everyone has odor-causing bacteria that live in their mouths. When we sleep, saliva flow lessens, and these bacteria have time to build up, resulting in stinky breath. Luckily, morning breath should go away after brushing. 

Food and drinks- Garlic and onion can cause the breath to smell. Candy and sugary foods can also cause bad breath, as they feed odor-causing bacteria- the same ones that cause cavities. Avoiding these foods when possible can improve breath. This blog has more information about nutrition and oral health.

Uncontrolled diabetes- breath that smells fruity or like acetone can indicate that diabetes is behind the smell. Quick medical intervention here is important, as this smell is indicative of diabetic ketoacidosis.

Thrush- Thrush is a painful medical condition that coats the tongue in thick white patches that smell strongly and unpleasantly of yeast or fruit. The white lesions are a breeding ground for bacteria that release smelly volatile sulfur compounds. Dry mouth is another symptom that contributes to halitosis. It can be treated with antifungals prescribed by a doctor. 

Can I Just Ignore My Child’s Bad Breath?

Halitosis can indicate underlying medical issues. Do not take it as a given to be tolerated. There are many conditions that need to be addressed that cause bad breath. It can be hard to discern the cause of bad breath without the help of a pediatric dentist. Regular checkups are a great time to bring up any concerns you have. The dentist can talk to you about the suspected cause behind your child’s halitosis and intervene if necessary. Whether that is with a filling or with another intervention depends on the case. 

Treatment for Pediatric Halitosis

• Follow the 2-2-2 Rule

• Invest in a kid-friendly tongue scraper

• Give xylitol gum if they are old enough not to swallow it

• Encourage water consumption

• Avoid smelly foods

• Eat breakfast daily
• Myofunctional therapy for mouth-breathers

• Visit the dentist for help

The gold standard for preventing halitosis is maintaining good oral hygiene at home. Make sure your child brushes twice a day for two minutes each time, flosses daily once their teeth touch, and help them scrape their tongue with a kid-friendly tongue scraper or toothbrush. If they use orthodontic appliances, ensure they are cleaned regularly (every day). 

Visit the dentist twice yearly for a dental checkup and cleaning. Encourage your child to drink plenty of water. Children who are old enough to chew sugar-free gum without swallowing can chew xylitol gum between meals. Xylitol is a cavity-fighter that ups saliva flow, helping improve dry mouth and reduce cavity occurrence. Don’t forget the importance of breakfast. Eating and drinking increase saliva flow and can help get rid of morning breath.

If your child is a mouth breather, try to break the habit with myofunctional therapy. Myofunctional therapy consists of targeted exercises that retrain the muscles of the face, mouth, and throat. Mouth breathing has consequences beyond just bad breath. It increases cavity risk, alters the facial structure to be longer and narrower, and reduces sleep quality.  

Further treatment for halitosis depends on the cause behind it, something your child’s pediatric dentist can determine. Whether your child needs to make changes to their oral routine or whether they need more significant intervention, we’re here to help. If you do notice persistent halitosis that is not lessened by improved oral hygiene, it’s time to visit CDND. 

Questions Your Dentist May Ask About Your Child’s Halitosis

• When did you first notice the bad breath?
• Is the odor constant or does it occur only sometimes?
• How often is your child brushing?
• How often is your child flossing?
• What foods do they frequently eat?
• What medicines or supplements do they take?
• Do they have any health conditions?
• Do they breathe through their mouth (at night or constantly)?
• Do they snore?
• Do they suffer from allergies?

Social Implications of Halitosis

Did you know that quality of life can be reduced by halitosis, as it often makes children (and adults!) feel insecure in social settings involving friends, family, or strangers? Intervening to address the cause of halitosis can make a world of difference, not just medically, but socially. 

When Should You See a Dentist About Halitosis?

Bad breath accompanied by tooth pain should prompt a visit to the dentist, as it could be tooth decay. Bad breath accompanied by a fever may indicate an infection, in which case, medical care should be promptly sought. Mild halitosis that comes and goes is not an emergency. Remember, you can always call us here at Children’s Dentistry of North Dallas with any questions you have about your child’s bad breath. If you need to schedule an appointment, click here.

FAQS Frequently Asked Questions

What is halitosis?

Halitosis is the medical term for bad breath coming from the mouth.

Does bad breath always mean my child has a cavity?

No, bad breath can be caused by a number of factors, not just tooth decay. 

What is the main cause of bad breath?

The most common culprit is bacterial buildup, which can often be mitigated with good oral hygiene habits.

Should I take my child to the dentist if they have bad breath?

Even if your child is maintaining good oral hygiene habits and hydration, a pediatric dentist can still take a look for cavities or infections. We recommend coming in to see us if you notice a change in their oral health, such as a foul odor on their breath consistently. 

What will the dentist do at the appointment?

Your dentist will check your child’s breath, as some causes of halitosis have easily identifiable odors. They will perform a thorough exam, looking for problems like cavities, signs of infection, loose restorations, and plaque buildup. 

Should I be concerned about bad breath?

Bad breath does not always indicate an underlying medical problem, but it does generally point to a buildup of odor-causing bacteria, which often indicates that oral hygiene can be improved. 

Does halitosis cause problems beyond an unpleasant odor?

Yes, bad breath can be a symptom of many health issues. In addition, halitosis can impair social life and functioning due to the child feeling self-conscious.