Bad breath in a child. Causes of bad breath in children

Children should smell like milk, sweets and childhood. But sometimes parents notice that the child has bad breath. This is most noticeable in the morning after sleep. At the same time, the baby is healthy, active, does not complain about anything, is not sick with anything. With questions about the reasons for such an unpleasant phenomenon, moms and dads turn to pediatricians, dentists, other parents, on the Internet, and, quite often, to the authoritative doctor Evgeny Komarovsky.

About the problem

Doctors are precise people, they like to systematize and name everything. There is a “name” for such a phenomenon as bad breath - halitosis. Medical encyclopedias describe it as a symptom of certain diseases of the stomach and intestines, as a sign of a violation of the microflora of the mouth. The term does not mean an independent disease, medicine considers bad breath to be an exclusively external manifestation of certain internal problems.

Komarovsky about the problem and causes

The reasons for the appearance of unpleasant amber from the mouth of a child can be different. But almost all of them ultimately boil down to the fact that the smell is a consequence of the multiplication of bacteria in the oral cavity. At the same time, microbes secrete special substances containing sulfur components. It is this substance that is responsible for the occurrence of a bad smell. Usually, saliva has a detrimental effect on microbes, it literally paralyzes them and prevents them from multiplying. But if the properties of saliva, its composition are violated, the saliva itself is not enough, then the bacteria feel like "masters of the situation."

Lack of saliva or a change in its chemical composition lead not only to the appearance of an unpleasant odor, but also to the occurrence of some bacterial infections - in the nose, in the larynx, in the bronchi and trachea, in the ears, for example. And this is quite natural, since the multiplying harmful microorganisms need a new living space, the oral cavity is no longer enough for them.

Officially, medicine calls one of the causes of bad breath diseases of the gastrointestinal tract, but Yevgeny Komarovsky is convinced that there is no such relationship at all. If only for the reason that the smell from the esophagus cannot enter the mouth through a special “valve” that closes the digestive organs.

But the food that the child took, can greatly affect the occurrence of odor. For example, if he ate garlic, grapes. Such a smell should not cause concern, as it passes by itself.

Bad breath can also be a concomitant symptom of diseases of the nose, or rather the maxillary sinuses. Then the stench is associated with the accumulation of pus in them. The same symptom accompanies angina, when bacterial inflammatory processes occur on the tonsils, in the larynx. Even with the usual slight runny nose, the child begins to breathe through his mouth, saliva dries up, and pathogenic microbes get a favorable environment for reproduction.

The main reasons for the appearance of an unpleasant odor will be told by Dr. Komarovsky in the next video.

The most obvious cause of bad breath is dental problems. It is easiest to install it, it is enough to carefully examine the teeth, and if incipient caries, swelling of the gums, their redness, swelling are noticeable, you should go to an appointment with a pediatric dentist. After removing the cause, the smell will disappear on the same day.

In addition, there are other reasons, which will be established by specialists - doctors at a personal appointment.

Not the last role in the diagnosis is played by the specificity of smell. For example, the smell of acetone can be a sign of acetone syndrome, diabetes, gallbladder problems. The sweetish smell should alert you most of all, so often they are accompanied by serious liver pathologies, hepatitis, and severe exhaustion of the body.

The smell of ammonia from the mouth may indicate possible problems with the liver, metabolism, excess proteins that the child receives from food. And the smell of drugs is usually not dangerous, it quite naturally occurs when taking certain medications, for example, vitamins or antibiotics.

In any case, bad breath in a child cannot be ignored. The sooner you contact a pediatrician for a personal appointment, the sooner he will establish the cause and help you choose a treatment strategy. The downside of modern health care is that doctors, unfortunately, determine the nature and intensity of breath odor empirically by sniffing on their own. For accurate diagnosis, you need a special device that determines the amount of sulfur in the exhaled air.

But the tests of feces, blood and urine, beloved by our pediatricians, which prescribe to take all children with complaints of bad breath, are completely useless here. This ritual is rather a tribute to the tradition of the old pediatric school. They are made because it is customary to do them every time you go to the clinic with any complaints.

Treatment

In the case of liver damage and diabetes, as well as other serious causes of odor, you should follow all the recommendations of your doctor. If the reason is a violation of the microflora of the oral cavity, which can be handled independently.

Getting rid of such a bad smell is quite simple, says a well-known pediatrician. It is enough to be attentive to the humidity of the air in the apartment where the child lives. Too dry air dries out the mouth. It is best to keep the humidity level in the house at around 50-70%. For this, Evgeny Olegovich recommends buying a special device - a humidifier.

To maintain sufficient saliva production, Yevgeny Komarovsky advises giving the child to drink lemon water - ordinary water or mineral water without gas with the addition of lemon juice and a large lemon slice. The acidic environment will irritate the taste buds, saliva in response to irritation will begin to be produced more actively and the microbes in the oral cavity will not be good. The doctor emphasizes that sometimes it is enough just to show the child a slice of lemon if he is already familiar with its taste. Saliva in this situation begins to stand out reflexively.

With an unpleasant smell against the background of a runny nose, the doctor recommends doing saline nasal rinses and giving the child more to drink. As soon as nasal breathing is restored, saliva will no longer dry out.

Bad breath from a child should worry parents. It can be a symptom of many diseases. It is very important not to miss the right moment by starting treatment on time. Let's take a closer look at the reasons why a child has bad breath and how to deal with it.

Why does a child smell unpleasant from the mouth

There are many reasons for bad breath. First, parents should pay attention to oral hygiene. Parents need to teach the baby to brush his teeth, rinse his mouth after eating.

Important! Starting at the age of two, buy a special children's toothpaste. Brush your teeth with a soft bristle brush.

A very common problem is diseases of the oral cavity, nasopharynx, gastrointestinal tract. For example:

• periodontitis;
• dysbacteriosis;
• periodontitis.

Such problems lead to a change in the microflora of the mucous membranes, the multiplication of bacteria, and inflammatory processes. The result is that the child has bad breath.

The reasons

Bad breath is often caused by dry mouth. Causes of dryness:

• the appearance of adenoids;
• catarrhal disease of the baby, which is accompanied by a runny nose;
• falling asleep, the child breathes through the mouth;
• dehydration of the body;
• deviated nasal septum. This problem often occurs after a nose fracture;
• insufficient air humidity.

All these factors contribute to the drying of the mucosa, which causes an unpleasant odor.

Important! The process of salivation is controlled by the central nervous system, so a stressful situation often causes stench.

Why does it smell in the morning

The most common reason for the appearance of a bad odor in the morning is a decrease in the production of saliva at night, which is a natural antiseptic. With its help, all the bacteria that are in the oral cavity of the child are washed off.

The situation can worsen significantly if the baby sleeps with open lips. The smell appears due to or. By eliminating health problems, bad odor will also decrease.

Teach your baby to brush his teeth after sleep, using baby toothpaste with a pleasant taste. A thorough cleaning of not only the teeth, but also the tongue will eliminate all problems.

Also try not to feed your baby a heavy meal three hours before bedtime. Then she will have time to digest, and will not linger in the stomach all night, creating an unpleasant odor.

Important! Remember that onions, garlic, excessive consumption of sweets are the cause of a bad flavor that is difficult to get rid of.

Smells like acetone

The aroma of acetone from a child's mouth can signal many pathologies and diseases. For example:

• violation of the activity of the pancreas;
• neuro-arthritic diathesis;
• diabetes;
• Availability ;
• liver disease;
• dysbacteriosis;
• intestinal infections.

If, in addition to the acetone odor, there is an elevated temperature, weakness, we can talk about the appearance of acetone syndrome. This is due to an excess of ketone bodies in the blood, which are formed as a result of the breakdown of protein metabolism products. Most often, the disease is genetically predisposed.

To relieve symptoms, you need to give the baby a saline solution to drink in small doses so as not to provoke vomiting. Also follow a special diet. Every day, dairy products, eggs, lean meat, vegetables, fruits, cereals should be present in the diet.

Important! When the symptoms of acetonemic syndrome increase, do not hesitate. Call an ambulance to start treatment in a hospital.

Smells sour

A sour smell indicates the presence of diseases of the stomach, such as:

• reflux (reflux of gastric juice into the esophagus);
• increased acidity.

To determine the cause of the appearance of a bad odor, consult a gastroenterologist.

Smells like feces

Most often, the smell of feces occurs due to neurosis and intestinal obstruction, dysbacteriosis. Such a symptom is a very alarming sign. Toxins accumulate in the baby's body, which poison him and cause a bad smell.

What will help:

1. To get rid of such a nuisance, consult a doctor to identify and eliminate the cause.
2. To reduce the odor, brush your teeth and tongue every day.
3. After eating, it is advisable to rinse the mouth with infusion of chamomile, mint, oak bark.

Do not take the problem lightly, because diseases can become chronic. Then eliminating the smell will not be so easy.

Smells like rotten eggs

The smell of rotten eggs appears when the acidity of the stomach is low, which is why food is not digested and begins to rot. Another reason is overeating.

If an unpleasant symptom occurs frequently, this indicates a chronic disease:

• atrophic gastritis;
• atony of the stomach;
• duodenal ulcer;
• diseases of the liver and gallbladder.

Important! If it smells like rotten eggs, diarrhea, fever, the child has poisoning.

Smells like rot

The inflammatory process in the nasopharynx is often accompanied by a putrid odor. Plaque forms on the tonsils, plugs, from which the stench emanates. After adequate treatment prescribed by the doctor, all symptoms disappear.

What other causes of bad breath:

• caries;
• periodontal disease;
• pharyngitis;
• angina.

This can often be the result of low stomach acid.

Smells like iodine

If a child smells of iodine, it means that there is an excess of this microelement in his body. Parents should definitely contact an endocrinologist to diagnose the body.

Important! Sometimes the reason for the smell of iodine can be a long stay of the baby near the sea.

When you are breastfeeding your baby, bad breath can occur if you are taking iodine-based products. This trace element has the ability to accumulate in the body. Sometimes children have iodine intolerance or hypersensitivity to this element.

How to eliminate the smell, what to do

Teach your child to follow the rules of oral hygiene. You need to brush your teeth twice a day, using a special children's toothpaste. Also, it will not be superfluous to rinse your mouth after eating. To do this, you can use decoctions of herbs.

Limit your intake of sweets, which also cause cavities. Replace sweets with fruits and honey. The baby will not only lose the bad smell, but also improve digestion.

Important! Apples are an excellent product for cleaning teeth from plaque.

Do not let children drink sweet compote, juice, soda. They cause fermentation processes in the stomach, which is the cause of the problem. Replace these drinks with plain water or unsweetened dried fruit compote.

All these preventive measures will not work if the child is sick. Therefore, go through examinations with a pediatrician, dentist, gastroenterologist, otolaryngologist.

Odor from the mouth (halitosis) is not just a discomfort and a violation of the quality of life, it is a problem that requires the close attention of parents. The reasons , on which the child smells of rot from the mouth , are different: serious and easily eliminated. For example, poor dental care can interfere with fresh breath, but it can also be a symptom of a serious illness.

It can even appear in infants. There are many reasons for this, which can be divided into 3 groups:

• local (dental), the causes of which are embedded in the oral cavity;
• psychogenic, caused by psychological reasons (false halitosis);
• general, provoked by a disease of any organ.

If there is bad breath in the morning, this can be considered as the norm, since the remnants of food begin to decompose and rot overnight. Too much protein or carbohydrate on the menu that is difficult to digest also causes putrefaction.

The most common case of odor is considered. Untreated caries develops, the tooth deteriorates, this process is accompanied, especially with insufficient. If caries is not found, the gums should be examined. Inflammatory lesions of the gum tissue (periodontitis, gingivitis) cause an unpleasant odor.

Putrid odor from the mouth at a small child is provoked by a crumb or a piece of food that is stuck in the nasal cavity. If the child began to constantly sneeze, third nose, then you need to go to the clinic.

Other causes of odor:

Reading time: 6 minutes

An unpleasant repulsive odor can be a sign of illness. By its nature and localization (nose, mouth), the disease is determined, treatment is prescribed. What diseases can bad breath in a child speak of? And is it possible to get rid of the problem forever?

Halitosis in children: causes

Little children smell like milk, old people smell like medicines. The appearance of an unpleasant odor in children from the mouth or when breathing is often the result of pathological processes in the nasopharynx, and occasionally - problems with digestion.

The immediate source of the heavy odor is bacteria that produce hydrogen sulfide gas. They are present in saliva and are part of the microflora (break down proteins). To neutralize odor, healthy saliva contains antigens (antiseptics) that neutralize hydrogen sulfide gas. Halitosis occurs when there are not enough antiseptics or when there are too many bacteria to digest proteins.

To measure the amount of hydrogen sulfide in the exhaled air, a special device is used - a halimeter. It shows the actual amount of gas and how urgent the problem is.

An indirect cause of stench or a bad smell from a child’s mouth can be malnutrition, allergies or diathesis, as well as inflammatory processes in the mouth, larynx. Let's take a closer look at what can be the source of infection, and how to deal with odor in childhood?

ENT diseases: adenoids

There are two most common causes of halitosis in children - dental problems and ENT diseases. Diseases of the nasopharynx (runny nose, tonsillitis, adenoids) make nasal breathing difficult and disrupt the microflora of the oral cavity, the bacterial balance of saliva. In addition, they form a focus of infection - purulent lacunae, boils, which form a strong unpleasant odor.

One of the most common causes of bad breath in children is sore tonsils. Their inflammation leads to swelling and blockage of the nasal passages. In this case, the child begins to breathe through the mouth. The mucous membrane inside the mouth dries up, saliva becomes insufficient, bacteria cease to be neutralized by salivary components. Enlarged "adenoids" are treated surgically (too overgrown tissues are removed). After the operation, nasal breathing is restored, the smell from the mouth disappears.

Dentistry

Any problems inside the mouth disturb the bacterial flora of the oral cavity. Foci of inflammation in dental tissues are a source of toxins and opportunistic cocci. Infection and purulent formations on the roots of the teeth contribute to the formation of an unpleasant odor.

The strongest "odor" is formed with a bacterial or fungal infection. The lesion inside the mouth occupies vast areas of the mucosa, they exude a strong repulsive odor. This happens with stomatitis, gingivitis, periodontitis and other dental infections. Also, a strong odor is formed with abscesses (boils) on the gums in the oral cavity.

Other reasons

A small child often puts his fingers in his mouth - when he wants to eat, when he cries, or to stop the blood (in case of injury - a bruise or a cut). This instinctive movement has a physiological basis. The composition of saliva has bactericidal components that provide the secret with antiseptic properties.

As a result of some processes, the composition of saliva changes, and its antiseptic properties weaken. This happens when the oral mucosa dries out, which is caused by the following reasons:

• Excessively dry indoor air (thickens saliva and reduces its bactericidal properties).
• Stress - many of us have noticed that when you are nervous, your mouth “dries up”. This is due to the fact that the work of the salivary glands is controlled by the central nervous system.
• Runny nose (an accompanying symptom of various acute respiratory viral infections and acute respiratory infections, as well as bronchitis, pleurisy, tracheitis and allergic manifestations). A subtle chronic runny nose often causes halitosis in the morning of a child (due to stagnation of saliva and its filling with purulent mucus from the nose).
• Colds and viral diseases - lead to a decrease in local immunity and a violation of the composition of saliva, which forms heavy breathing. The appearance of a smell from the mouth may be the first symptom of the disease.

Digestive diseases: dysbacteriosis and worms

If the number of worms is small, the children's body copes with their removal without visible symptoms. If pinworms and giardia occupied a vast space of the intestine, then part of the toxins entering the liver is excreted with the bloodstream through the lungs, forming an unpleasant odor.

Permanent (chronic) poisoning leads to diseases of the liver and digestive tract (gastritis, cholecystitis), which in turn form a bad smell of varying strength. It may resemble rotten fish, spoiled eggs, or other stale animal protein. More often such problems bother adults, and less often they are observed in children.

The smell of acetone

If the child smells of acetone, it means that ketone bodies have accumulated in his blood. Their formation leads to the breakdown of fats with a lack of carbohydrates. Often such processes occur during hunger and diabetes, when the lack of glucose in the blood is replenished by the breakdown of fat cells.

Also, the state of hunger can occur with high temperature and viral infection, when there is no appetite, and the cells require nutrition. Or when teething, when the child also refuses to eat because of pain in the gums.

Analysis of the symptoms and identification of the sources of halitosis allows you to choose the right effective treatment. You can read more about the causes of halitosis in this article: Bad Breath: Causes and Treatment. And now we will consider what means of traditional and traditional medicine can neutralize the smell.

What to do: bad smell products

The main cause of halitosis in children is a violation of saliva secretion, which neutralizes bacteria and neutralizes sulfur components. Therefore, it is often enough to normalize the microclimate (humidity not less than 40% and temperature + 20-22 ° C), introduce a walking regime and drink enough water. In addition, teach your child to brush their teeth daily, be sure to clean the gaps between the teeth from food debris, and clean the tongue (the place where most bacteria accumulate).

It is important to teach your child to brush their teeth daily from an early age.

However, with a disease of the nasopharynx or respiratory organs, it is not possible to eliminate a heavy odor without special means. What can be applied for a cosmetic solution to the problem? What pills, solutions or traditional medicine help get rid of childhood halitosis?

How to quickly get rid of halitosis: salt and lemon

Salt is the simplest remedy for bad breath. It is a natural antiseptic, and also enhances salivation and thus reduces odor. In addition to salt, increases salivation with a slice of lemon or lemon juice.

Sour and salty foods stimulate the formation of saliva, so sour apples, oranges, grapefruits, and lightly salted vegetables help to resolve the issue. And yet - you can put a little salt under your tongue, or - drink a glass of water with the addition of lemon juice.

Peroxide

The main active substance of peroxide is active oxygen. It neutralizes pathogenic bacteria and thus stops the further formation of an unpleasant odor. This pharmacy remedy is diluted with water (1 teaspoon per half a glass of water) and used for rinsing. It cleans the surface of the teeth, tongue and gum mucosa.

It is important to know: hydrogen peroxide is an active substance that, with an increase in concentration, can burn the mucous membrane. Therefore, you should dilute it in a sufficient amount of water - 1 teaspoon per half glass (100 ml).

How to get rid of the smell with spices: cinnamon, cloves

Spicy herbs and seeds have bactericidal properties. However, their taste does not always suit the child, so it is possible to successfully use cinnamon or clove seeds to eliminate halitosis in older children - middle schoolers, adolescents.

How to eliminate the terrible smell of feces?

The smell of feces is quite rare. It is formed when the child's food valves are not closed tightly, and gases from the intestines rise into the upper part of the esophagus. It is difficult to do something with such a smell. It is necessary to treat the problem - to determine the cause of non-closure (often it is neurology) and treat the underlying disease in the baby.

Another cause of fecal odor is intestinal obstruction, in which gases accumulate in the intestinal cavity. They lift the digestive valves and enter the esophagus. In this case, medical assistance is needed.

How to remove the smell of pus?

The smell of pus indicates purulent processes in the nose, mouth or throat. It is not possible to eliminate it with any cosmetics, procedures or rinses. It is necessary to treat inflammation and stop the purulent process (breakthrough of the boil or its puncture, followed by removal of the purulent contents). After removing the source of pus, the smell disappears during the day.

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She divorced her husband five years ago. From marriage, two children 9 and 11 years old. Tired of solving and dragging on all family problems, and besides, my husband began to walk. She left him, as they say, "with one bundle" ... All this time I was equipping a house from scratch, paying off three loans, raising children, it was not easy. Thank God I was lucky and I changed jobs, began to earn more. More or less life began to improve. A year ago I met a man... And Oh God... This is the man I dreamed of. The complete opposite of my ex-husband. And care and attention. One But ... He is a single father ... His wife left him with a child, went to his best friend. In principle, this situation did not frighten me and I thought, well, where are two children there and the third will not be a hindrance ... But it turned out that everything is not so simple ... As a wise woman, I immediately began to look for an approach to the child, bought her toys, completely replaced her wardrobe, the poor child did not even have decent things, everything was washed out so much .... I bought her a bunch of beautiful rubber bands for the garden. I tried my best to please. The girl is 5 years old ... The child is problematic, does not understand anything, in the garden they complain about her that she does not obey, does not want to study .... At home she does whatever she wants, does not respond to comments. He says that he understood and immediately creates again !!!
Mom does not participate in the upbringing of the child in any way, does not pay alimony, referring to the fact that she pays a joint loan ... Well, okay, God bless her ...
We all lived together for a year ... I thought that she would change and we would live happily ... But nothing changed ...
I was infuriated by her behavior and because of this I was constantly not in the mood, so we began to swear with Alexei. I couldn’t tell him that his daughter infuriates me ... I understand that he loves her more than life ... I thought of leaving, but I love him and he loves me very much .... and he communicates well with my children, with his son goes to chess.... I don't know what to do.. It seems to me that his daughter will never change and I will never be able to love her....

Olga Morozova

Hello. I've already somehow created a topic about neighbor's dogs, how to scare them away. In the autumn, in September, a neighbor's dog bit our kitten, in the middle of the day, one might say, in front of a neighbor (the owner of the dog) and ours (I and my son saw it). They simply simply did not have time to do anything, how much does a 3-month-old kitten need. I then said a lot of things to the neighbors because of their dogs. They apologized, promised to look after them, but at the same time the phrase sounded: hunting dogs (ordinary mongrels at the same time) and cats will still be attacked, they called it happy (((
To be honest, I didn’t want to have cats anymore, but in October, for my daughter’s birthday, they brought her a gift-kitten .. There is a tray at home and the cat goes there, but only in a small way, but in a big one she got used to the street. They let her out, looked after her all the time. And that week, the neighbor's dog jumped over the snowdrifts to our yard and grabbed the cat right at the porch. At that time, I was hanging clothes to dry under a canopy, he did not see me, but I did not immediately see / did not hear him, he attacked without a sound. I jumped out at the squeal of a cat. I repulsed it, while he slashed his teeth on the sleeve of the jacket and tore my sleeve. When I calmed down and treated the cat a little and calmed down myself, I went to the neighbors and said I would complain. The weekend passed, they did not take any measures (the dog both ran down the street and continues to run). Today I wrote a complaint to the district police officer, but I was struck by his words, they say, we cannot take any measures in relation to the owner of the dog, there is no punishment or fine for this. Only if you go further and sue them for material and moral damage. But I don’t want to get involved with the court because of the cat and the torn sleeve. Are there really no laws so that the district police officer, relying on them, could somehow influence the owners of dogs who strangle cats on their own and in other people's yards? In general, I wrote a lot, just if you start a war with your neighbors, then relying on the laws ... Maybe someone will tell you something ...

Katerina

Topic to chat. Do you think about the skills of your children? Will explain. A friend's son is a couple of months younger than mine, and now she proudly sends me a video where her baby crawls on the floor like a worm. She happily writes that he is starting to crawl. But for me, it's just a fuss on the carpet))) Or he kicks his ass back, and she thinks that he gets on all fours. I'm just either too critical of my son, or a realist. But until he specifically crawled at least 30 centimeters, I somehow didn’t say that he was starting to crawl. And if he sits with support on one arm - this is not yet sitting. Which camp do you belong to and why?

Anonymous

I got a job half a year ago. Child 3.5. He goes to the garden. Walked well in autumn. I went out for a full day. And now, for almost the whole of February and half of March, I have been sitting at home. I got a job through an acquaintance, no one said anything to me for the omissions, but last time they already hinted that something should be done with the sick leave. I found a nanny through an agency, but my mother panicked that a nanny was not needed (my mother has the same commander), she herself meets him from the garden, but the hospital says we will sit in turn, she will be 2 days, I will be three. But often she either flies away somewhere, then she has a theater, then she doesn’t want to at all and everything is unreliable. And nothing good came of it. The nanny eventually found some other shift work and now she can’t come at the click of a button, only on her own weekends. Mom also teases that I will give half of my salary to a nanny. I can't work normally. I don’t want to leave, because now my husband doesn’t earn enough for everything, I buy clothes for myself, for women’s necessities, plus I pay for vacation, I can save for a mortgage, we save up. Mom realized that we just couldn’t save up for an apartment, she stopped reproaching the purchased apartment, before that her husband was constantly baling, what was he thinking about when he created a family. The husband, although he considers himself a breadwinner, is not enough for everything. And I don't want to lose my job, experience, qualifications. And it’s also very difficult mentally to sit with a child for 2 weeks. I'm better at work, but I can't get there. Only goes to the garden for 5 days and again for 2 weeks at home. I am constantly nervous. How to work and look at the child at the same time. How do women do it?

LTA LTA

Good afternoon, dear forum users. We need a collective mind, my brain is no longer working. Given: there is a small studio for preparing for the Unified State Examination and the OGE: Russian, English, Society and Math. I plan to expand - open a second one in another area, and change the name of both studios. The so-called rebranding to produce. Now the name is AbveGE. I want something interesting and to the point. The husband suggests "a studio for preparing for the Unified State Examination, last name, first name." I don't like it, it's too pretentious. The room is small, three classes and an admin desk, which I stand behind if there is no lesson. Don't call it a course. I would be grateful for advice: how can I call it more interesting.