Bad breath, or halitosis, in kids can be an embarrassing problem.  Bad breath in kids can be caused by many things including post nasal drip, dry mouth, dental problems, and inflamed sinuses.  Halitosis in children is most commonly due to the breakdown of the mucus build up and debris which can accumulate on the tongue, in the nose, and between the teeth.
Certain types of bacteria that naturally live in the mouth can begin to break down the mucus, oral skin cells that the body has shed and dental plaque within our mouth.  When these things are broken down by the mouth bacteria they produce certain molecules called volatile sulfur compounds (VSC) and have a strong “rotten egg” smell.
Unfortunately we cannot make a child’s mouth stop creating mucus, sloughing off oral skin cells, or creating plaque, but we can try to control the amount of these bacteria on the gums, between the teeth and on the tongue.
Normal brushing and flossing removes plaque bacteria on the teeth and gums that cause bad breath in kids.  A lot of these bacteria reside in the cracks and crevices of the back part of the tongue.  Removal of these bacteria requires an instrument that can firmly scrape the bacteria and debris away.  A toothbrush will only swirl the material around.  Mouthwash masks the smell but does nothing to eliminate the cause.
Most pharmacies carry a half-moon shaped scraper device that is designed to clean the back surface of the tongue.  This device is problematic for kids due to their natural gag reflex which is complicated by the large size of these devices.
We recommend using a smaller more readily available device:  A plastic spoon!

A plastic spoon!! 🙂

1. Begin the first week by scraping the front half of the tongue once each evening.  If your child has a particularly strong gag reflex, start only by scraping the front ½ inch of the tongue.
2. During the second week start to drag the spoon on the tongue, beginning near the molars.
3. At week three begin to firmly drag the spoon on the tongue and forward, starting about ½ inch behind the last set of molars.  The bad breath causing bacteria usually reside deep in the tongue crevices behind the last set of molars.  Scrape once or twice and wash the spoon with water.  Keep the spoon near your child’s toothbrush and use it whenever you brush the teeth.
If our child has large tonsils, the bacteria may be hiding in the grooves (or crypts) of the tonsils and thereby causing the odor.  Since we can never have our tonsils comfortable scraped, a 10 second gargle with warm salt water is recommended.  Place a small pinch of table salt in an 8oz glass of luke warm water, gargle and spit.  This flushing action along, with the salt tends to reduced bacteria numbers on the tonsils.
If bad breath in kids is something you have questions about, or want to learn more about the ways to prevent it, please contact Kona Kids Dentistry and we would be happy to help answer them for you!