My teenager is so worried and paranoid about this he says its ruining his life.

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My ds is constantly worried his breath smells, he's cleaning his teeth up to 5 times a day and when he's around people you can see him trying to keep his mouth shut and standing back from people, which can appear quite rude.
Anyway, his breath does not smell, nobody has ever told him that it does he tells me but he says he feels like it does.
He's already got a diagnosis of ocd so this seems to be a new theme. CBT has recently states via camhs but they're just getting to know each other for the time being and sessions are few and far between.
Any ideas of what I can do to help?

poor DS. Would it be worth buying him a breath spray or something so he felt confident and minty fresh?

Could you book a hygienist appointment so he can have a full check? It probably would be worth a dental check tbh. Is he aware that brushing teeth after meals containing anything acidic can brush the enamel away, so leave him with darker/yellow teeth as dentine isn’t as white as enamel?

Other than breath spray/mints/strips/sugar free gum I’m not sure what to suggest. I’m an ex smoker and have spent years chewing sugar free gum after I once smelt someone’s breath after they’d just finished smoking, so I was always conscious of my own breath, but not to the extent of your DS.

I’d ask the dentist if there’s any problem with brushing that often.

Seems simplistic, but has he seen a dentist. Maybe a professional could put his mind at rest?

My ex had this ! Both his breath and a fictitious BO smell. It was a nightmare as we’d be out socialising at the pub or something and he’d insist we went home so he could shower and brush his teeth. There was never any smell. It was psychological . I don’t think he ever recovered tbh. Your young son probably has a much better chance to get over the issue with therapy and possibly getting old enough to consider anti anxiety medication and CBT ?
I think lots of us developed anxiety / OCD like behaviours during the teen years and managed to overcome them . I think it’s as you get older they get stickier .
Definitely speak to someone about this though. Bless him I hope things improve.

My first thought is that some other child is bullying him, and has told him his breath smells.

Can you gently talk to him and see if you can find out why he is worried about it, and if there is anything he can pinpoint that started it?

CBT use a fear plan if you want to help him from home.
F eeling anxious, E xpecting bad things to happen, A ctions and attitudes, Results and rewards.
There is an incredible mouthwash on Amazon called ultradex. Recommend mint one. If the mouthwash would help him feel better.