Dear doctor;

My eight-year-old daughter suffers from severe bad breath which smells like a chemical, especially in the morning and even after brushing her teeth and tongue. The dentist says there’s nothing wrong with her teeth. The doctor suggested blowing her nose more regularly, but nothing is working. Could there be some internal problem as in metabolism and such?

Mukakanani N. Butare

Dear Butare,

Bad breath or halitosis occurs in children as well. The most common cause being poor oral hygiene. Bacteria causing halitosis live in oral debris and dental plaques. They feed on sulphur containing substrate thus producing hydrogen sulphide in the process, which gives bad breath. These plaques can form at the base of the tongue, in between teeth and under the gums. Food particles remaining in the mouth, particularly sweet ones attract more bacteria, increasing susceptibility to infection. Mouth breathing leads to dryness which increases risk of oral infections and hence bad breath.

Infections like frequent rhinitis, sinusitis which cause post nasal drip, tonsillitis etc. also cause a bad breath. But in such cases, bad breath will be associated with cold, cough, fever, throat pain etc. 

Encourage your daughter to improve oral hygiene. She should brush teeth correctly at least 2 times everyday, once in the morning and at bed time. If possible, doing it after anything eaten,  would be ideal. Avoid fluoride containing tooth pastes  because they are potentially harmful if swallowed and children have tendency to swallow tooth paste, if they like the taste. If possible teach child to floss the teeth. Taking a crunchy fruit like apple after a meal helps to remove debris.

Also encourage the child to drink more water to provide rinsing of the mouth and preventing dryness. Chewing on sugar free candy is useful to increase salivation which is helpful in removing germs.

An antiseptic mouthwash can be used to rinse the mouth and a dentist can suggest a suitable one. All these measures would definitely solve this problem.