"Why does Andrew have terrible breath?"
"How come Sophia’s breath is so strong every morning?"
"My kid has terrible breath, but we always brush!"
With apologies to our fictional examples above, it is not their (or your) fault. Children who exhibit strong breath odor may do so for a few different reasons, all of which (and fortunately for everybody involved) are perfectly treatable.
One frequent cause of bad breath is oral bacteria. Many bacteria responsible for breath odor live on the back of the tongue. Under a microscope, the surface of the tongue looks like millions of tiny fingers called papilla; they are constantly waving, eagerly trapping bacteria. Think of the backyard from the movie Honey, I Shrunk the Kids and remember how many tiny treasures our heroes found in the grass. That is sort of what the microscopic surface of our tongue looks like. A parent's instinct tells them to brush their child’s tongue; however, brushing the tongue actually pushes some of the bacteria further into its surface. It also results in some of this bacteria sticking to the toothbrush and re-entering the mouth the next time you brush.
The appropriate solution to bad breath is to use a tongue scraper. There are both adult- and pediatric-sized tongue scrapers available. They look like a stick with an upside-down triangle on the top (see above example). To use a tongue scraper properly, gently but firmly scrape your child’s tongue starting as far back as comfortable. Try scraping a few times in the morning, rinsing the scraper under hot water between each scrape. You can find tongue scrapers in the dental aisle near the pharmacy at your nearest grocery store or even Amazon.
A second cause of bad breath is oral bacteria found in the deepest reaches of the back of the throat. Children often have large tonsils and/or adenoids, or just a healthy amount of soft tissue back there. These are perfect areas for bacteria to collect. Furthermore, school aged children, or children in regular childcare settings are constantly exposed to a variety of germs resulting in low level respiratory infections which leads to excess mucus production. While it might seem like your child has a constant runny nose, this mucus is also draining down the back of the throat and can also be a cause of bad breath. Thankfully, this stage in most children’s lives are short-lived, and as the immune system matures, older children are less likely to develop bad breath associated with respiratory issues and post nasal drainage.
...and finally, children who are old enough to use mouthwash should be encouraged to do so. For children over the age of 6, mouthwash with the word “antiseptic” on the bottle can be used. We recommend Listerine Naturals, or Smart Mouth mouthwash.