Q: My nine-year-old son has horrendous breath. He brushes his teeth, but the odour returns quickly. Could there be an intestinal problem?
A: Halitosis or bad breath in an otherwise healthy nine-year-old can have a number of causes. These include dry mouth, post-nasal drip (from colds or allergies), sinusitis, dental decay, gum disease or tonsil enlargement. Some medications may also cause bad breath. Esophageal problems — such as slow movement of the esophagus or reflux — may also cause an unpleasant odour.
The treatment relates to the cause: Non-sugar drinks for dry mouth; treatment of sinus infection or allergies; and changing medications that cause dry mouth (antihistamines) or yeast infection (steroids for asthma). Brushing three times a day, flossing, brushing the tongue and seeing a dentist regularly may decrease or solve the problem. Encourage your son to eat a fibre-filled breakfast to stimulate saliva and prevent bacterial growth and dry mouth.
Note that children should not use mouth rinses that contain alcohol as they may dry the mouth further and are a poisoning risk.