Take my ‘bad’ breath away

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Laiba, a five-year-old girl has been experiencing bad breath for several months. She brushes her teeth regularly twice a day under her mother’s supervision but still has a smelly breath. “I feel bad when no one wants to hug her or have close range conversation with her. But I feel helpless as I have tried everything possible yet cannot get rid of the problem,” says her mother Saira.
Smelly or offensive breath in adults or in children is a medical condition known as halitosis. It becomes a social problem when it affects daily socialization of an individual. According to research, it is the third most common reason for people to seek medical assistance. “Majority people get affected by it some time in their life but it becomes great trouble if it persists for prolonged periods due to medical conditions,” says Dr Uzma Haroon, a dentist at Uzma Dental Care Peshawar.
Dr Uzma further highlights that it is commonly due to bacterial growth on tongue and in mouth. The foremost thing is poor oral and dental hygiene as it creates a number of bacteria in mouth. Underlying dental problems also result in terrible breath. Sometimes, it becomes difficult to ensure that children are brushing, flossing and rinsing thoroughly and regularly. “Skipping brushing leaves the mouth favorable for bacteria growth as food particles left in mouth rot and cause the smell,” she adds. Moreover, many children put foreign objects like pacifiers, toys, fingers or thumb in their mouths that result in the growth of bacteria on the surface of the tongue.
According to American Dental Association, dietary culprits, illness, nasal issues, poor dental hygiene and tooth decay may stimulate halitosis in children.
Dr Ammarah, a dentist based in Abbottabad says there is also a strong connection between mouth breathing and bad breath. Saliva helps wash away bacteria, viruses and food particles that produce mouth odor and prevents tooth and gum disease. “When a child breathes through the mouth because of stuffy nose or as a sleep habit, it prevents the sufficient flow of saliva hence causing the problem.” Infections in the mouth like sores, cavities, gum and teeth problems, gingivitis and plaque are also the culprits. Sometimes certain medicines cause foul smell as well. Moreover, unclean tongue, constipation, sinus infections and tonsillitis can also originate the smell. Similarly, some types of foods like onion, garlic, cheese and citrus trigger bad smell temporarily. “Gastroesophageal problems related to stomach like colic, frequent spitting up and abdominal discomfort can be a reason too,” she adds. Children with teeth treatments like silver caps, crowns or braces may also experience this problem as food particles get easily trapped in the spaces and cause foul smell.
Experts believe it is important to get to the root cause to get appropriate treatment. “If you suspect the problem, ask your child to lick the backside of his hand, let it dry for few seconds, smell the place to see if there is any smell,” says Dr Ammarah. Parents however, do not need to worry about a child who has bad breath during illness especially fever. It will clear up on its own within a couple of days as the child gets better. If it persists then consult the dentist for further investigation.
If left unchecked, this minor problem can grow in to serious medical disorder. To improve most cases of bad breath, the goal is to decrease mouth bacteria and increase saliva production. The better the brushing technique, the lesser will be the bacterial growth. Make a habit of brushing, flossing and rinsing after meals under supervision. Brushing should be done twice a day and cleaning the tongue should be part of it. Children need all dietary nutrients, but some parents tend to disregard monitoring their children’s diet. They feed them anything. Sugar in different forms is common in children’s diet and this is a reason for frequent buildup of plaque and bacteria. Therefore, the best way to avoid this is to limit sugary food intake like sodas, candies, chocolates, bakery items etc. “You actually need to taper your child off these foods gradually. Make your child drink lots of water throughout the day to keep mouth hydrated,” says Dr Uzma.
She further emphasizes on giving children breath friendly foods: fruits like apples, melons, mangoes, avocados and guava and add parsley, coriander, cinnamon and clove in your child’s diet. It will take care of the problem to a great extent. “Green tea has antibacterial properties that knock out the stink. Cardamom and fennel seeds are also helpful as temporary solution.
There are some home remedies that should be used only with the doctor’s advice. Boil one teaspoon methi (fenugreek) leaves in one liter water, then strain and drink the water. if you child is in the habit of thumb sucking, take care of its cleanliness. If using a pacifier then sterilize it often. Keep a tongue scrapper to clean the tongue. Consult a doctor if your child has a sinus problem, blocked nose or digestion problem. Anything from a rotten or an abscess tooth to medical issues can turn the breath nasty. Therefore, a professional help is necessary. “Severe bad breath in children can be alarming especially when all preventive measures have been taken,” warns Dr Ammarah.
Suffering from bad breath can isolate your child and cause low self-esteem as it is embarrassing when someone points out to your child that he has a bad breath. Halitosis can be tackled with hygiene, knowledge and care.

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