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Question: Even though he brushes his teeth regularly, my toddler has breath that could take out an elephant. What could be causing this?

Answer: Bad breath, known also as halitosis, can certainly affect toddlers as well as older children. Tooth and mouth care, often connected to halitosis, is an important part of taking care of the whole body. Seeing a dentist by your child’s first birthday is recommended by the American Academy of Pediatrics and the American Dental Association, especially if you suspect dental problems. Good oral hygiene includes limiting sugar intake, which can help avoid cavities, and carefully cleaning teeth, gum, and tongue surfaces at least twice a day. Until children can spit out toothpaste reliably, use a fluoride-free version—swallowing excessive amounts of fluoride is potentially harmful and can lead to a condition called fluorosis, where permanent white spots appear on the teeth. Many natural toothpastes contain mint flavorings that can help bad breath, and even chewing on mint leaves works as well. Parsley is another herb that can be munched on for cleaner breath. Also, make sure your child gets plenty of fluids, as a dry mouth is often a stinky mouth.

Sometimes really bad breath, despite good oral care, comes from dysbiosis, or the growth of abnormal bacteria in the gastrointestinal tract. Children who have underlying gastrointestinal conditions or food allergies, and those who frequently take antibiotics, may be at increased risk. Taking a daily probiotic can fix this problem. Probiotics are those live, beneficial bacteria found in cultured foods like yogurt or kefir, or found in supplements containing the bacterial strain lactobacillus acidophilus.

Another culprit could be a chronic sinus congestion, especially if there’s an overgrowth of abnormal sinus bacteria. Think about rinsing regularly with saline via a neti pot. While it may be difficult to imagine a toddler using a neti pot, I’ve seen it done—some even seem to get a kick out of the whole procedure. If addressing these issues at home doesn’t seem to be helping your toddler’s bad breath, consult your pediatrician or dentist.

Lawrence D. Rosen, M.D., is the founder of the Whole Child Center in Oradell, New Jersey, one of the first green, integrative primary care practices in the U.S.

Have a question for Dr. Rosen? 
E-mail him at [email protected]

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