A Matter of Life and Breath

MacKenzie Carpenter of the Pittsburgh Post-Gazette has written an interesting article on one of life's little concerns which is a big deal to those affected ...

When you open your mouth these days, be careful. You may be, in the words of an American Dental Association report, emitting "malodorous products of oral bacterial putrefaction."

In other words, bad breath.

In our appearance-obsewssed culture, looking bad is certainly to be avoided, but smelling bad is almost an indictable offense, one that has led to a veritable boom in mouthwashes, breath strips, home kits and clinic treatments -- not to mention fierce competition by dental experts to promote their products.

"Get your breath tested in person by Dr. Katz on Valentine's Day!" crows the Web site of Dr. Harold Katz, a native of Sharon who spent his freshman year at the University of Pittsburgh.

Today, though, as a Los Angeles dentist and founder of California Breath Clinics, he bills himself as "the world's leading bad breath expert." He most recently appeared Feb. 14 at an Eckerd's Pharmacy in Manhattan on behalf of his TheraBreath system, which is described, quite simply, as "the most complete scientific breath control treatment kit available anywhere in the world."

Dr. Mel Rosenberg of SmellWell.com ("Smell Well with Dr. Mel") might beg to differ. A professor of microbiology at Tel Aviv University and sometime musician -- he recently released a romantic jazz album titled "The Aroma of You" -- Dr. Mel, as he's known, is the inventor of Dentyl pH mouthwash, which he says is the second-best-selling mouthwash in the United Kingdom and the only product "that you can actually see working. You shake it and rinse with it and the oil in the mouthwash binds with the bacteria and debris, and when you spit it out in the sink, you can see the junk on the droplets ..."

Hold it right there, Dr. Mel. Your products aren't available in the United States yet, so let's move on to Dr. Israel Kleinberg, distinguished professor of oral biology and pathology at Stony Brook University on Long Island, N.Y. and inventor of the just released "SmartMouth."

This particular mouthwash, which touts 24-hour protection, is actually similar to Dr. Katz's patented Therabreath system although it touts zinc rather than oxygen as its main ingredient. It doesn't kill bacteria -- a no-no in advanced microbiological circles -- but works by "rebalancing the flora" in the mouth, Dr. Kleinberg says. Fine, counters Dr. Katz, but SmartMouth requires mixing two liquids together. His product doesn't.

So what's a sufferer of bad breath -- or oral malodor, as it's commonly known by scientists -- to do?

"For the vast majority of people, it's best to brush and floss properly twice a day," says Betty Onik, an instructor in the University of Pittsburgh School of Dental Medicine. While the above-mentioned products work by neutralizing the mouth's bacteria that cause bad breath, they're less effective for someone with advanced gum, or periodontal, disease.

And since 75 percent of the adult population has some form of periodontal disease, the best way to prevent bad breath -- not to mention gum transplants -- is brushing and flossing.

In a small percentage of cases, chronic bad breath is caused by stomach problems, post-nasal drip, diabetes or liver malfunction. Certain drugs may create dry mouth, which can exacerbate the problem. Diet, especially the low-to-no carb approach originally touted by Dr. Atkins, can sometimes be a factor.

"People always want to say, 'My bad breath is from something I ate,' and that is sometimes the case, but 90 percent of the time bad breath is due to poor oral hygiene," Ms. Onik said.

Using a product such as Listerine will help kill bacteria temporarily, she added, "but it won't take the place of floss. After all, you can't get your car clean by spraying it with a hose."

Regent Square dentist Dr. David Sultanov generally frowns on Listerine and other mouthwashes that contains alcohol, which he believes can aggravate bad breath in people with dry mouth problems "because it dries out the tongue even further, allowing more bacteria to grow."

However, he noted, there are other mouthwashes that don't contain alcohol, although he also steers clear of those that contain saccharine, preferring to use alternative products like Tea Tree Oil mouthwash.

"I'm Mr. Organic," he admits. "I don't like a lot of conventional toothpastes and mouthwashes. They have too many chemicals in them."

Still, too many dentists ignore a critical part of the mouth when it comes to bad breath, Dr. Kleinberg believes. It's a ridge along the back of the tongue that he calls "Breath Valley," where up to 70 percent of the bacteria that cause halitosis lurk. They can include such bad actors as hydrogen sulfide, which smells like rotten eggs; methyl mercaptan, which smells like stinky socks: indole and skatole, which smell like feces; and cadaverine, which smells like death.

But if in the course of brushing your teeth and gums, you also brush along "Breath Valley" -- tongue scrapers aren't that effective, he claims -- you'll go a long way toward eliminating these critters.

And for those who have bad breath but are blissfully unaware of it, Therabreath's Dr. Katz has come up with another solution: the "Tell-A-Friend" program, whereby his company will send an e-mail to the odiferous offender that will "very nicely" alert him or her about the problem, all the while protecting the identity of the accuser.

We've come a long way since Lavoris.