The colloquially used term bad breath describes the appearance of foul-smelling breath from the oral cavity. Bad breath is generally perceived as extremely annoying and unpleasant by those affected.
Bad breath (also Halitosis or Foetor ex ore called) is a problem that men and women suffer equally. Even with children the occurrence of bad breath is not uncommon, although its development can be observed somewhat more frequently in people of older age.

Basically, the sense of smell plays a subordinate role in humans compared to senses such as sight or hearing, but unpleasant body odors of any kind seem to have a decisive influence on interpersonal interactions. A strong body odor (such as bad breath) can be offensive to other people.

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Bad breath in children can have many, completely different causes. In medicine, a distinction is made between so-called systemic and local causes in connection with the occurrence of bad breath.

The group of systemic causes includes all reasons that are located inside the organism. It is therefore about organ-related causes. In many cases, dysregulation or pathological processes in the gastrointestinal tract play a decisive role in the development of bad breath in children.

Local causes however, are mainly due to diseases of the oral cavity, the nose or the nasopharynx. In a direct comparison, most children suffering from bad breath are caused by local causes.

Local causes

Below is a list of the most common local causes of bad breath in children.

  • By far the most common reason for bad breath in children is poor or simply incorrectly performed oral hygiene, which leads to pathological processes in the oral cavity.
  • Teeth destroyed by caries or the presence of severe inflammation of the gums (technical term: Gingivitis) on the one hand cause a bad taste and on the other hand they lead to the formation of unpleasant smells within the oral cavity.
  • In addition, bits of food that get stuck between teeth and are not regularly removed are often responsible for causing bad breath in children.
  • In rare cases, the occurrence of bad breath in children is due to an inflammation of the gums (so-called periodontal disease). Here, gum pockets have arisen due to permanently accumulating dental plaque, which require professional cleaning.
  • Furthermore, infections in the oral cavity are a potential trigger of bad breath in children. Above all, fungal infections (so-called candidiasis) and bacterial overgrowth play a decisive role.
  • In many children suffering from bad breath, inflammation of the tonsils, a severe runny nose and other infections of the nasopharynx can also be determined.

While the local causes can usually be treated quite easily systemic reasons have serious consequences and be difficult to treat.

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Find out more at: Bad breath in young children

Systemic causes

To the so-called systemic causes include a wide variety of underlying diseases, in which the grade of bad breath differs greatly from one another. In many cases, the type of bad breath in children can be an initial indication of the causal systemic disease.

  • Children who suffer from an early onset of diabetes (type I diabetes) or who are in a diabetic coma often develop a strong ketone-smelling bad breath (sweetish, similar to nail polish remover).
  • In addition, children who are temporarily hypoglycemic often have a similar smelling exhaled air.
  • The bad breath in the presence of liver disease, on the other hand, has a completely different scent note. Exhaled air, which increasingly smells of urine or ammonia, can indicate severe inflammation in the urinary tract with involvement of the kidneys, kidney weakness or the onset of kidney failure. In children, too, the specific type of bad breath in kidney problems is due to the fact that the urea accumulating in the body can no longer be properly excreted due to the decline in kidney function and accumulates within the organism. As a result, the resulting urea is released into the bloodstream and exhaled through the lungs in a compensatory manner. The typical ammonia-smelling halitosis arises.
  • Inflammation of the stomach lining or esophagus can also occur in children. The inflammatory processes ensure that gastric juice and / or bad smelling gases can rise into the oral cavity and bad breath develops in children.
  • Furthermore, so-called hiatal hernias and Zenker's diverticula, which are bulges in the esophagus on which leftover food can collect, are among the common reasons for bad breath in children.
  • Also in the course of general disorders of the gastrointestinal tract, which are triggered by food allergies, for example, are among the causes of bad breath in children.

Read more on the topic: Diabetes in children

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The mechanism behind the development of bad breath in children depends primarily on the underlying cause. This also explains why the halitosis in children has a different scent note depending on the basic problem.
The American chemist Linus Paulinger (1901-1994) examined several hundred breath samples from patients suffering from bad breath in a study. He succeeded in detecting up to 200 different compounds in these samples that mix with the exhaled air and lead to bad breath. It is now even assumed that there are up to 3000 different compounds that can lead to bad breath. These compounds are mainly chemical compounds containing sulfur and nitrogen (for example ketones and ammonia).

Sweetish bad breath

Depending on the eating habit, the child's bad breath also changes.
In this case sweet means a Smell of overripe fruit. This often occurs in connection with diabetes or tonsillitis. However, even with the infectious disease diphtheria, the typically sweet smell is groundbreaking for the diagnosis. Since this disease can trigger life-threatening complications if left untreated, a visit to the doctor should not be delayed too long.

Fishy bad breath

With fishy bad breath in childhood, which persists despite brushing your teeth, an inflammation in the throat / pharynx area can often be seen.
An increase in the number of pathogens then causes the unpleasant breath. Some parents can even “smell” their child when inflammation of the tonsils and throat is imminent. An examination can then be carried out as quickly as possible and the correct medication prescribed. In rare cases, there is a metabolic disease behind it, which should be diagnosed and treated by a doctor.

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Putrid bad breath

A putrid bad breath can spread, especially with a dry mouth.
Many children sleep with their mouths open at night, especially when a cold or otitis media makes it difficult to breathe through the nose. The dry mouth contains a lot of bacteria and can cause or intensify a putrid bad breath.
However, it can also be due to a systemic disease of the entire body. Liver diseases and diabetes in particular should be considered and should be excluded if the foul odor persists.

Bad breath despite brushing your teeth

If all teeth are healthy and, despite regular dental hygiene, there is still an unpleasant smell from the children's mouth after brushing their teeth, the cause must be looked for elsewhere. Sometimes the origin lies in the eruption of a new tooth. The gums become more porous at this point, allowing bacteria to penetrate the tissue more frequently. Especially with the white teeth, a place that is almost inaccessible to hygiene, an extremely serious inflammation occurs, which causes unpleasant bad breath.

In addition to other very harmless reasons, which are often to be found in a poor or unbalanced diet with cola, onions or other caffeinated drinks, diseases of the head and neck area also come into consideration. Above all, symptoms of the paranasal sinuses, the throat and inflammation of the oral mucosa. In all of these cases, the number of bacteria in the upper respiratory tract is greatly increased and the odor is generated by the metabolic products of the germs. But also various underlying diseases, such as diabetes or liver inflammation, often affect the breath of the youngest, a specialist must be consulted in order to avoid complications.

Also read our topic: Sinus infection

Bad breath after almond surgery

An almond operation popularly means that the tonsils are removed in the event of an active and recurrent (recurring) inflammation.
In this type of surgery, the wound is not sutured, which results in secondary wound healing. After a few days, a whitish layer of wound forms, which is part of normal healing, but to which bacteria can adhere and which cause bad breath odor. If the symptoms persist for more than 10 days, there may be a wound infection. This must be examined and, if necessary, treated by the doctor with antibiotic therapy.

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Concomitant symptoms

Bad breath can be accompanied by many other symptoms, even for the youngest. If the teeth are not properly cared for, the bacterial film spreads and leads to tooth decay. The result is premature tooth loss with improper eruption of the permanent teeth. Inflamed whiteness teeth also cause bad breath because more bacteria settle in the oral cavity. Accompanying symptoms here are a reduced mouth opening and pain when chewing in the corner of the jaw.

Since bad breath itself is often the symptom of various underlying diseases, it can be accompanied by many other symptoms. If it occurs together with a sore throat, it is often caused by a sore throat or tonsillitis. An otitis media should be considered if the associated earache occurs. If there is a disease of the whole body, such as diabetes or liver inflammation, then it can continue to become severe stomach pain or large Weight loss come within a short time.

As with adults, the following rule applies: if the symptoms cannot be fought sustainably within a few days or at most a week, the specialist should be consulted and the disease should be professionally tracked down.


Since bad breath is often associated with the presence of carious defects, especially in children, caries therapy and the subsequent prevention of renewed tooth defects can help to counteract the bad smells. In the course of this, special emphasis should be placed on regular and thorough oral hygiene. The teeth must be properly cleaned with a toothbrush at least three times a day. In addition, the weekly use of special tooth substance-hardening toothpastes (e.g. Elmex-Gelee®) can help to make the teeth more resilient.

Mouth rinses are a good addition to brushing your teeth. They are specially made for children with a pleasant and not so sharp taste.

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Home remedies for bad breath

Careful oral hygiene can also be enhanced with home remedies.

Food that causes bad breath should be avoided. These are onions, garlic and spicy foods. Lemon juice, which is drunk diluted with water, can help neutralize odors. It stimulates the flow of saliva and washes away odor-causing residues quickly. The juice should be drunk regularly after meals for long-term results.

Slowly chewing various herbs such as peppermint also helps or cloves, if you have bad breath. The released essential oils ensure fresh breath, similar to a mouthwash. If the stomach has a sour smell, chewing a coffee bean will help reduce it.

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Ginger, for example, which is cut into thin slices and placed on the back of the tongue, ensures fresh breath after a few minutes. However, since many children do not like the taste of ginger, this method is not suitable for everyone. Chewing a few leaves of parsley also helps prevent bad breath in children.

You can find more on the subject at: Home remedies for bad breath

Homeopathy for bad breath

Depending on the cause of the bad breath, there are different homeopathic globules that are used. If the tongue is yellowish-whitish with an accompanying dry mouth Kalium phosphoricum D12 act helpful. For bad breath, which is linked to inflamed gums, can Creosote D12 act supportively against it. In addition, if there is inflammation of the tonsils and a sore throat, the remedy is used Guaiacum D12 used.

However, these homeopathic remedies are no substitute for a visit to the doctor. You can try it for a few days, but you must always consult a doctor if the symptoms persist.


As with adults, proper oral hygiene must be observed with the little ones. Because here, too, the following applies: a well-groomed oral cavity leaves little room for harmful bacteria. Teeth cleaning should take place at least twice a day and the parents should check whether it is successful. In addition, the teeth must be checked every six months and the teeth must be professionally cleaned by the dentist. In this way, the causes of bad breath in children can be quickly identified and quickly eliminated in an emergency.

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Patients who have frequent occurrences of bad breath (Halitosis) sufferers are in most cases unable to perceive their own exhaled air as malodorous. This phenomenon is due to the fact that the sense of smell generally only reacts to changes in the concentration of fragrances. However, since the odor concentration remains largely constant if the bad breath persists, the olfactory receptors of the nose only perceive it temporarily and adapt after a certain time so that they no longer perceive a bad odor. This problem is exacerbated, especially in children who suffer from bad breath. Children only perceive their own bad breath in very rare cases.
Various devices are available to scientifically and medically prove the presence of bad breath in children. So-called breathing measuring devices are able to measure the sulfur content in the exhaled air and make it perceptible to the human eye. In addition, bad breath can easily be tested at home using a quick test. For this purpose, the back of the hand must be moistened with saliva and then dried. When you then breathe on the back of the hand, bad smells can be detected on the back of the hand if there is bad breath. In addition, so-called gas chromatography using a Halimeter (odor measuring device) can be carried out, in which the concentration of volatile sulfur compounds in the exhaled air is detected.

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