My kid has horrible breath!

Q: What cures toddler halitosis? His teeth are clean!

A: Bad breath can be caused by a few factors — diet, dental hygiene, certain respiratory tract infections or, more rarely, systemic illnesses

Dietary factors include foods, such as onions or garlic; and on the adult side (but also possibly teenagers) — coffee, cigarettes or chewing tobacco. 

Infections such as gum disease as well as lingering food particles from not fully brushing or flossing fall under the dental hygiene causes. Make sure you’re also regularly brushing the top of the tongue, as this could be another source of the odor. 

If the bad breath occurs with a fever, stuffy/runny nose or cough, it may be a sign of a throat, sinus or lung infection. And finally, in very rare instances, a pungent odor of the breath may be a sign of a wider systemic condition. 

If your kid is pretty healthy overall — no fever or cough, a good appetite, growing well, lots of energy and playfulness — I would look to see if diet or dental hygiene might be one of the culprits. 

Appearances can be deceiving: Even if the teeth look clean, there can still be a lot of residual food particles or gum disease present. 

The recommended time for brushing is two minutes, which is equivalent to singing the ABC song three times. If your child is anything like mine (aka “Mr. Busy”), he may not be brushing long enough. 

Check out Brush DJ, a free app that offers tips and plays different songs that are two minutes long to help you reach the recommended teeth-brushing time. 

I would also recommend making an appointment to see your child’s dentist every six months, with the first checkup at 12 months old. A thorough exam could also help determine the source of the bad breath.

Kimara Gustafson is a Minneapolis mother who works as a pediatrician at Masonic Children’s Hospital and the Adoption Medicine Clinic, both at the at the University of Minnesota. Send your questions to