Bad breath in kids

MOST people often equate bad breath with problems of the teeth and oral malodour is primarily a dental problem. With this belief there is a tendency to focus ones attention on the teeth forgetting the other important contributors of bad breath such as the lips, the cheeks, the palate (roof of mouth), the tongue, the throat, and its relationships to the general well being of the child.

Changes in the odor coming from the mouth may not necessarily be problems from the teeth but may be related to problems of the other local structures of the oral cavity or to some systemic problems such as diabetes, systemic infections, metabolic disorders, etc. that may need the proper evaluation and management of a qualified health care provider.
t is not difficult to identify the source of bad breath in children. Most can be treated without difficulty. However, most children are not aware that they have bad breath. Patients who complain that they have bad breath cannot determine reliably the degree of the oral malodour and that parents especially mothers tend to exaggerate the problem.

When you suspect that your child or somebody you care has bad breath, try to use your sense of smell at a distance of about 5-10 cm. At this distance you will be able to confirm easily foul odor coming from the mouth or the nose. If the odor comes from both the mouth and the nose, suspect a systemic origin of the bad odor.

When in doubt let the patient speak since bad breath will become prominent when the patient is talking.

Before trying to smell for bad breath, be sure that the patient avoids eating, chewing, drinking, smoking, and brushing teeth for at least three hours before you smell for bad odor. Bad breath is known to be influenced by changes in the weather (as in seasonal allergy), time of the day in relation to the flow and stagnation of saliva, temporary gingivitis during menstruation, and antibiotic treatment suppresses multiplication of bacteria, a necessary participant in the production of bad breath.

Haliometer is an instrument that can help detect the presence of bad breath.

Haliometer measures the amount of volatile sulphides of one's breath. The normal amount of volatile sulphides is less than 2 parts per billion. Haliometer is probably found in clinics specializing in bad breath. The specialist of "bad breath" is called the halitosilogist.

Just imagine a clinic full of people with bad breath and in one of those days, the haliometer is out of order. As the specialist, you have to use your organoliptic testing for halitosis--that is using your nose and sense of smell...not an enjoyable specialty.

But halitosis is a big concern in adults and a big deal in teenagers. They will do anything to get rid of the problem.

Although it is hard to imagine someone specializing or making a living in the field of halitosilogy, one can easily see that it must really be a profitable undertaking though not so pleasant an occupation.

Prevention:

1. Children should eat fibrous foods and eat good breakfast as the act of chewing increases the flow of saliva, washing away bacteria from the surfaces of the mouth, teeth and tongue.

2. Children should brush their teeth at least 2-3 times a day.

3. Do not use too much fluoridated toothpaste as it may cause dental fluorosis.

4. Avoid use of alcohol containing mouthwashes as they may lead to xerostomia (dry mouth).

5. Children should visit their pediatrician and dentist regularly.

Management:

Old remedies that are the forerunners of modern control of bad breath include: chewing of clove a fragrant aromatic source of clove oil used by the Iraqis for centuries as an effective remedy for bad breath. Later, oil of clove was noted to have antibacterial properties. The same is true for chewing gum mastic, the forerunner of modern chewing gum, also with potent antibacterial properties.

Other folk remedies against bad breath are the eggshells from China, parsley use in Italy, guava peels from Thailand and even mint commonly used in toothpastes and mouthwashes.

Most causes of bad breath can be managed by simple methods such as maintaining proper oral and dental hygiene. Since the thickened coating at the back of tongue is the most common source of bad breath, cleaning this part of the tongue should be a daily ritual.

Encourage children to brush their teeth two to three times a day, smaller children with the help of the parents using small amounts of fluoridated toothpaste. Children with dental problems such as dental caries, dental abscess, periodontal disease, defective dental restorations, etc. should be under the supervision of a dental professional.

Drying of the mouth (xerostomia) may be managed by increasing fluid intake, enhance the act of chewing and swallowing to increase the flow of saliva thereby controlling bacterial growth decreasing bad breath.

Acute rhinitis with bad breath does not need treatment, as bad breath is co-terminus with acute rhinitis. However, in chronic rhinitis and chronic sinusitis medical treatment is necessary. These children should be under the supervision of a physician.

In situations where evidence of upper airway obstruction is present causing the bad breath, surgical intervention may be necessary to relieve the obstruction such as surgical removal of an enlarged adenoids (tonsils at the back of the nose), nasal polyp (a growth protruding from the mucous membrane of the nose), or tumor of the nose. Foreign body in the nasal cavity should be removed as soon as detected by a qualified health care professional.

Stool examination should be part of routine in the evaluation of bad breath in children, and give the necessary anti-parasitic drug if found positive.

(Important data included in this article was taken from: Beating Bad Breath, Rosenberg, M., Robinson, G., Amir, E., Contemporary Pediatrics. March 2002.) (PVI)
http://www.sunstar.com.ph/static/dav/2008/07/22/feat/bad.breath.in.kids.html