Bad breath in 7 year old - dental check up was fine...

[ThisMustBeMyDream]

My just turned 7 year old has had really pongy breath for quite some time, over a year at least. It honestly smells like something died in there 😱.
His dental check ups have always been perfect. He had a check up last week. No issues.
So what is causing this bad breath?! Dentist didn't offer any advice just said to try electric toothbrush.
Brushing twice a day and using mouthwash isn't enough. His brother has the same routine and his breath is absolutely fine. I brush them now but this hasn't made a difference either.
Please can anyone offer advice as I'm beginning to not want my old child to kiss me because it is that stinky. 🥴

Tonsil stone?

Tonsil stones! They honk

Tonsills or sinusitis

Go to the GP, could be caused my a few things

Could be his stomach/diet.

Tonsil stones smell like death. They are utterly vile. DS used to suffer with them. He coughed one up once. Jeez, it was the most disgusting thing I've ever smelt & I've was a theatre nurse. Even the dog turned his nose up at it! 🤢

Does he have anything stuck up his nose (or have any symptoms like hearing loss or sinus infections)?
That would be my next guess after looking at tonsils.
After those, I'd be looking at his digestive system.

He does indeed have hearing loss. He is under audiology and just been referred back to paeds.
I'm told he has excess wax causing the hearing loss. He has had 2 x wax removal done, but his hearing loss has gone from mild to moderate in one ear. I'm about to pay privately again for another ear wax removal and hearing test as he needs them close together to see if it is glue ear or not.
Interesting... I never thought of the two being linked. But now I look back it must have been a similar time as his hearing issues have been going on since Oct 2020.

My 7 year old has terrible breath but it's mainly due to drinking very little during the day. We encourage her to drink more which helps.

Yes, he doesn't drink much in the day either. Neither does his brother who doesn't have this issue. Both are rubbish at drinking probably because they are given water and nothing more exciting! If given juice they drink it like it is going out of fashion. They do drink more at bedtime though, weirdly. Maybe I need to worry less about what they are drinking 🤷‍♀️.

Foreign body up his nose?

He has never complained about anything up there. If there was it would have been there well over a year. Maybe even 2 years!

I'd put my money on a sinus infection coupled with glue ear.
I had it as an adult...
The sinus infection makes it difficult for the middle ear to drain via the Eustachian tubes. That results in hearing loss and the normal discharge from the middle ear being too thick for it to drain in the usual way. (Or thick discharge makes it difficult to drain, so you get an infection.)
After being diagnosed with a chronic sinus infection, I went on to being diagnosed with glue ear. By that point I had 50% hearing loss in one ear. Grommets sorted it out.

Were the any other symptoms to the sinus infection as he hasn't been unwell in a very long time?

If you're asking me, @ThisMustBeMyDream, then no, no major problems other than a nasty 'snotty' (sorry!) nose. In my case, it went on for over six weeks. I gradually realised how bad the hearing loss was.
I also had a feeling of pressure over my clerk, unlike people who have a sudden onset where they have a pounding headache and unbearable pressure k their face.

@ThisMustBeMyDream Hello, I think your kid is suffering from Halitosis. It is caused by poor oral hygiene, tongue coating, pungent food, large tonsils, mouth breathing, allergic problem etc.:Did your kid takes any medications? I know we can't tolerate that strong smell.
One of my cousins also faced the same scenario at the age of 16. She couldn't talk to others after closing her mouth for a while. We both consulted a GP and a dentist to resolve the same. However, the GP didn't find anything related to the throat or lungs issue. He suggested consulting a dentist, and then we realized it was a dental issue. The dentist found out the exact problem that her mouth was dry because of poor saliva. He advised her to get hydrated all time and drink plenty of water and try to chew a piece of gum. Now she is okay with that.🙂

This is going to sound so gross and off the wall but I would get the good breathed sons toothbrush and donate to the bad breathed son. Get a new brush for the good breathed son.

I say this because If there’s no underlying cause it’s probable microbiome dis balance of good and bad bacteria. This hasn’t been proven when it comes to breath but it’s well known for body odour.

Dp has an excellent microbiome and when I start to get whiffy I borrow his deodorant stick for a week. It does work on arm pits so worth a shot in the mouth. Hardly likely to do any harm if the good breathed sons healthy so I would give it a go.

Might not be helpful but I have 2 DS. Oldest never has bad breath (even in the morning he can happily skip off to swimming without brushing his teeth and there is NO smell!!)

Younger one (age 8 now) used to have horrid breath. Age 7 pretty bad. It's getting a lot better. He has big tonsils (couldn't say 'c' sounds til quite old due to this I think) and his teeth are all really jammed close together. I always assumed the breath was related to these two issues. As he's got older, the tonsils are getting smaller in comparison to size of his mouth! And his teeth are getting a little less compact. His breath is correspondingly improving in smell!

Maybe just give it time! :)