Symposium to discuss fresh perspectives on halitosis
Garlic, hygiene not the only culprits of unpleasant breath
By Jennifer Morita
Daily Bruin Staff
People avoid those who have it, refuse to work with them and
won’t be kissing them anytime soon.
It’s a condition that no one likes to talk about and can be
caused by anything from hunger to menstruation.
It’s bad breath.
Chronic bad breath, or halitosis, affects an estimated 25
million people in the United States, yet according to UCLA dentists
and researchers, little research has been conducted on this
problem.
Beginning today, the UCLA School of Dentistry will be hosting a
two-day symposium on oral malodor, or bad breath, to discuss
treatment, the latest mouthwashes and toothpastes, and the growing
number of "fresh breath clinics."
"People have always been complaining about bad breath," said
Diana Messadi, co-director of UCLA’s new fresh breath clinic.
Although lots of people complain about bad breath, Messadi and
other experts explained that there is a difference between bad
breath and chronic bad breath.
"Some people have bad breath because they eat a lot of garlic or
smelly foods or they have morning breath. During the night, while
you sleep, you don’t eat and so saliva isn’t cleansing your
breath," Messadi said. "These things are all temporary.
"What’s interesting is our chronic bad breath patients, who
really have pathological bad breath," Messadi said.
Halitosis is caused by volatile sulphur compounds, or gases
produced by bacteria that can be found in the mouth. According to
Messadi, some patients have more of this bacteria than others and
thus emit more compounds that cause bad breath.
"Halitosis really affects the patients’ lives," said Sushma
Nachnani, a researcher and co-director of the UCLA fresh breath
clinic. "People don’t want to work with you and are afraid to tell
you about your problem. Patients are very sensitive about this.
"It can also affect your love life," Nachnani added.
But the emission of volatile sulphur compounds can be caused by
a variety of different conditions ranging from sinus infections,
mouth-drying drugs, liver and kidney disease as well as other ear,
nose and throat problems. In order to treat a patient’s halitosis,
doctors have to find its source.
Halitosis patients at UCLA’s new fresh breath clinic first have
their volatile sulphur compound emissions measured with a machine
called a halimeter.
"Bad breath can come from the mouth or the nose," Messadi said.
"We have this halimeter that can differentiate between both."
Using a straw that is hooked up to the halimeter, patients are
told to blow into the machine. Next, the patient is told to put the
straw in his or her nose.
"If the emission goes above a certain range, this patient has
bad breath above what’s normal," Messadi said.
Patients who are above the normal volatile sulphur compound
range are treated with special mouthwashes and toothpastes that
neutralize the gases.
"UCLA is the first institute in the United States to use these
mouthwashes and toothpastes for clinical trial," Messadi said,
adding that patients have to use these new treatments
regularly.
"They can’t just use them one day and the next day say nothing
happened," she said. "It’s a long-lasting treatment but it is
definitely effective."
But if the patient continues to use these special treatments and
still has high volatile sulphur compound levels, doctors will begin
looking for other causes such as sinus infection.
"There are many causes of halitosis," said Joel Sercarz, a head
and neck surgeon who will be discussing sinusitis at today’s
symposium. "From an ear, nose, and throat perspective there are a
number of ways we can help dentists if they can’t find the source
of halitosis in the mouth."
The case of the "Dragon Lady" is a famous halitosis case.
"There was this lady who for a long time had such terrible bad
breath that people called her the ‘Dragon Lady’," Messadi said. "By
chance, she had these other problems with her chest and x-rays
showed that she had a piece of a christmas tree in her lungs. Her
body treated it as a foreign body and it became infected."
The bacteria from the infection emitted volatile sulphur
compound gases, causing her bad breath, Messadi said.
Another example is a woman whose halitosis was caused by a bead
that was lodged in her nose.
"Because there was fungal growth around the bead, she had bad
breath," Nachnani said.
Some patients think they have bad breath, but according to the
halimeter they don’t, researchers say.
"There are some kinds of patients who keep thinking they have
bad breath but they actually don’t," said Nachnani. "It’s called
haliotophobia.
"There’s this one case in Japan, where a psychiatrist treated a
woman who had this," Nachnani added. "It changed her whole life.
She thought she had bad breath and so she’d stay at home and do
nothing all the time. He convinced her that she didn’t have bad
breath."
UCLA’s fresh breath clinic, which opened last month, is part of
a growing number of malodor clinics.
"We have a unique team because we have people who deal with oral
medicine, a microbiologist, and we are teaming up with sinus
specialists and even a psychiatrist," said Nachnani, adding that
most clinics in the city are one or two-person operations.
"We also incorporate all the research data into our treatment
and we’re constantly setting up research projects," she said.
In addition, Nachnani said the UCLA clinic is an added service
for the community.
"If you see ads in dental journals they say establishing fresh
breath clinics increases business," Nachnani said. "We are not
doing it for that reason. We want to serve the community."
UCLA’s fresh breath clinic … is part of a growing number of
malodor clinics.
NOTE: People who would like more information about the UCLA
Fresh Breath/Halitosis Clinic may call the UCLA Orofacial
Pain and Oral Medicine Faculty Practice at (310) 825-5082.
It’s located in 100 Medical Plaza, suite 355.