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Winter Park Dentistry Podcast-Bad Breath (Halitosis)


Dr. Ramzi Matar (Winter Park Dentistry): Today we're here to talk about bad breath and some of the solutions and reasons why people have bad breath, and how you can try to avoid it.  I'll start off by saying there are some medical indications, or medical causes of bad breath that me, as a dentist, obviously cannot manage.  I might be able to recognize them, but I cannot manage them and treat them.  These are some stomach problems, GI diseases.  Most notably is GERD, G-E-R-D, if you've heard of GERD, or gastroesophageal reflux disease, also known as acid reflux.  Some people refer to it as heart burn or something where some of the stomach acid or food is coming up into the throat area and that could cause bad breath.  There are also some tonsil issues.  People get these things called tonsillar crypts, which--or tonsil stones, sorry--that are these little balls that lodge themselves into the cavities, into the grooves of the tonsils, and those are things that can cause bad breath.  Obviously smoking, if you drink a lot of alcohol, things that are kind of obvious.  In the dental world, we tend to see bad breath--chronic bad breath--commonly with gum disease--uncontrolled gum disease, let me be clear.  If you have periodontal disease, that can lead to bad breath, and so that can be treated pretty easily.  Those are some of the more chronic things that we deal with.  As older patients, and I say older patients that are on a lot of medications, they can have dry mouth, also known as xerostomia and people with dry mouths tend to have more issues with bad breath because they don't have the lubrication from the saliva that helps clean the food out from around their teeth and they have food debris.  For the common layperson out there, the ninety percent of the population who doesn't have these major issues, most of bad breath is caused by what's called VSC, Volatile Sulfur Compound.  VSC, Volatile Sulfur Compound.  Basically, it's debris or whatever that ends up into sulfur-containing compounds and they tend to build up.  They mostly build up on the tongue, usually the back of the tongue, and you have to get rid of those and you also have to try to neutralize those.  So the most common treatment for bad breath, if a patient asks me, is I give them a tongue scraper, or I advise them to go buy a tongue scraper.  Something--not a toothbrush--a tongue scraper is a flat, usually, piece of plastic that tends to clean.  You don't want--you can sort of--it's almost like a squeegee for your tongue and if you use it regularly and you don't cut up your tongue, you'll be amazed as to how much plaque and tartar and debris you'll get off your tongue.  I usually tell patients when they first start using to hang on because they're going to see a lot of stuff coming off their tongue, especially the patients that have a white coating over your tongue.  Your tongue should be reddish-pink color and, especially smokers, they get these long brown stains on their tongue or the white layer on your tongue.  If you're looking at your tongue and you see that, it should be pink, and it can be pink if you start cleaning it with a tongue scraper.  So that's probably the most common advice I give.  Of course, getting your teeth cleaned, making sure you don't have cavities.  Those are all, like I said, overwhelming issues that you have to address, but for the layperson I'm talking about, a tongue scraper's number one.  The way that you can neutralize--and I use this product every day--the way you can neutralize these VSCs is with a stabilized chlorine dioxide and you saw the name chlorine in there.  It does contain some version of chlorine--it's chlorine dioxide.  It's not the chlorine you use in a pool, although it's similar, and that chlorine can neutralize and eliminate the bad breath caused by the sulfur.  The most common product that's easily attainable is called Closys.  I hope I'm pronouncing that right.  C-L-O-S-Y-S. And I use this every day.  It doesn't have a flavor.  You'll notice when you use it, again, I warn patients: be aware, it's not going to taste like Listerine, it doesn't have a minty flavor to it.  It actually sort of tastes like pool water.  I taste the chlorine in it.  It's not necessarily bad; it's very mild.  But I like it.  There's also another product line called Therabreath that I've never tried.  Thera, T-H-E-R-A-B-R-E-A-T-H.  One word, Therabreath.  And again, it contains some sort of a chlorine dioxide, something containing chlorine that helps to neutralize the VSC, the Volatile Sulfur Compounds.  So that's usually my double whammy for bad breath: get a tongue scraper, get Closys.  And I'll tell you, ninety five percent of patients don't come back reporting any issues.  Between those two things, you can get them at any drugstore.  It's a few dollars--it's less than ten bucks you have all this and you can pretty much manage most of that.  Some people ask me about breath mints or anything like that.  Generally pretty superficial, temporary aids, but they can help.  Probably, if I had to recommend a mint, my favorite, my winner, what I have bought and used, is something called a Forever Mint.  It's  It's by Neuoura Microceuticals, that's N-E-U-O-R-A Microceuticals.  It's  It's a small little tablet and you put it in your mouth and it softens up and it sticks to your gum and you'll feel it--you can put it somewhere conspicuous and it'll stick to your gums and it has a more long lasting effect, then it sort of dissolves over time.  And it does actually freshen your breath for about three hours and that's what it claims to do and I found that to be pretty accurate.  And there is also some suggestion that it increases saliva, so I've recommended to some of my older patients that are suffering from dry mouth because that constant mint flavor tends to promote saliva flow so sort of helps that way.  So that's my recommendation if you wanted to use a mint, whether you're using it after dinner or out in some sort of a social occasion, I think that's fine.  So, hope this helps.  Feel free to comment.  I'll be happy to try to reply and help out.  Thank you so much