Bad Breath in Children – It could be Sign of Underlying Disease


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Dr Pooja Langote
Pooja has done BDS. She is a dentist by profession and is devoted to creating bright smiles all around. She is an intense reader and is vibrant at heart. She aspires to become a healthcare administrator.

Children fail to maintain their oral health. The poor oral hygiene practices land them in oral issues such as dental decay, oral infections, bad breath, etc. Bad breath, also known as halitosis, is one of such common oral problem in children.

If you feel that your little one’s breath is unpleasant, then there might be the possibility of bad breath. Underline reason for bad breath varies greatly.


Bad breath originates due to poor oral hygiene, dry mouth, oral infections, systemic illness, etc. Whatever be the reason, you must visit a pediatric dentist to rule out the cause.

You can also opt for some effective home remedies to get rid of bad breath and that includes proper brushing, use of floss, alcohol-free mouthwash, increase in water intake and so on.

Don’t stress yourself for your kid’s bad breath. It is not a serious oral illness, and it is very easy to get free from foul breath. But it is essential to know the root cause of halitosis in children. Let’s discuss them in detail. (1)

What causes bad breath in children?

The reason that your kid has a bad breath can be because of the oral problem or other systemic illness. Here are a few reasons which cause bad breath in children –

Poor oral hygiene

Poor oral hygiene is the most common cause of bad breath. Improper brushing causes accumulation of the plaque on the tooth surface. Plaque contains colonies of gram-negative anaerobic bacteria which produces bad breath. (2)

Also, improper brushing fails to remove food particles. Retained food particles on deterioration produce bad breath.

Dry mouth

Saliva cleans the oral cavity, and it has antibacterial property. A child who produces less saliva will have bad breath issue.

Dry mouth naturally occurs during sleep and that is why morning breath is always unpleasant.

Dry mouth is also a symptom of dehydration or salivary dysfunction. Drugs such as antihistamines, tranquilizer, phenothiazine, etc. reduce saliva production.

Bacteria on the tongue

Bacteria are present on the tongue surface in large entities. The child should be taught to clean his tongue every day. Use a brush or plastic tongue cleaner to clean the tongue.

Mouth breathing

Mouth breathing is breathing through the nose rather than the mouth. It may be habitual or present with nasal congestion.

The open mouth does not produce saliva and affects the cleaning and antibacterial action of saliva. A child with the habit of keeping his/her mouth open during sleep suffers from bad breath.

Oral infections

A child may develop oral infections due to a lack of proper oral care. Oral infections which produce foul breath includes a dental cavity, oral ulcers, gum diseases, and dental abscess.

The abscess is a collection of pus that produces a foul smell. It can occur due to a grossly decayed tooth or trauma.

Tooth decay is the destruction of the normal anatomical structure of a tooth. Cavitation of tooth harbors bacteria in it and contributes to bad breath.

Also, gingivitis is an inflammatory condition of gum that leads to bad breath.

Foreign objects

The foreign objects that can produce bad breath are –

  • Dental appliances such as orthodontic braces, space maintainers. (3)
  • Small toy or food particles that get stuck in the nostril of a child.


Children often suffer from tonsil infection. Inflammation of tonsils or tonsil stones is the common finding in children. Tonsil stones have a collection of bacteria, debris, mucus, residual food particles which contribute to bad breath.

Sinus infection

Sinus infection is another cause for bad breath. Mucus makes its way down in throat and comfy on the tongue. The mucus with the collection of bacteria produces a foul smell.


Continuous use of antibiotics in children causes bad breath. Decomposition of drugs produces chemicals leading to the foul smell of breath.


Food items with strong flavor such as onion, garlic, specific spices, etc. produce an unpleasant smell.

Systemic illness

The systemic illness which produces bad breath includes –

  • Juvenile diabetes.
  • Respiratory disorders like asthma, enlarged adenoids. (4)
  • Gastric infection.
  • Kidney failure.
  • Liver dysfunction.

Above systemic conditions are not common in kids. However, you must consult a doctor if you notice anything usual in your child beside the bad breath.

How to avoid bad breath?

Bad breath is not a serious health issue. But it affects the psychological health of your kid to some extent. Hence, finding the cause of bad breath and treating it is very important.

Maintenance of good hygiene is the key remedy for bad breath. Hence, oral hygiene education is the first step to avoid bad breath. (5)

Take care of following things to avoid bad breath in your child.

  • Make your child brush his/her teeth twice a day for an adequate time. Ensure that the brushing technique of you kid is proper to dislodge the accumulated plaque.
  • Ensure that your child flosses every day. It helps to remove the plaque and food particles stuck between the teeth.
  • Teach your child to clean to clean the tongue with the help of tongue cleaner or toothbrush.
  • Get alcohol-free mouthwash for your child to get rid of bacterias.
  • A child with braces should use the orthodontic brush.
  • Ask your child to rinse mouth with water after having a meal, snacks.
  • Ensure that your child drinks plenty of water throughout the day.
  • Cut off the surgery, sticky, carbonated food item in your little one’s diet. This type of food may cause dental caries.
  • Make regular visits to a pediatric dentist for a check-up and professional cleaning.
  • See your pediatric dentist in case of oral infection. Your dentist will treat the infection, and bad breath will automatically go away.
  • If your dentist states that your child’s mouth is healthy, you may be asked to visit a physician. The physician will have a check on your child’s health to rule out the cause of bad breath.
  • For a child with mouth breathing habit. Visit a pediatric dentist for treatment.

Usually, the bad breath goes away if you practice good oral hygiene. In case bad breath is due to systemic illness, treating the illness will help you to get rid of bad breath.

Final words

Bad breath in children is not life-threatening. Though, it is embracing and discomforting for children. The responsibility lies with parents to determine whether their child is suffering from bad breath or not.

Treatment of bad breath is focused on the cause. Practicing good oral hygiene can get your child free from bad breath. Visit a pediatric dentist regularly to have a check on your child’s oral health.


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