My views on bad breath
Posted: Wed Nov 07, 2007 11:25 pm
I am new to this forum, although I am not new to bad breath. I, like many others, was teased at school, failed to make new friends or keep the old ones, embarrassed at work, and lost the love of my life. Instead of boring you with all-too-familiar heartbreaking stories, I want to share my views on bad breath with you. I'm a physician/scientist-in-training (by no means I am implying that I have authority on this subject), so I would like to share some thoughts here:
1) What I know about halitosis
I believe that there are many causes to this problem, although I will say that bacteria in our oral cavities will probably be the cause for the majority of the cases (especially if you don't have other health problems). According to some researchers at the Forsyth Institute at the Harvard University, we have probably more than 700 bacterial species in our mouths. Many of them are not cultivable outside the mouth, so the researchers are using different molecular biology tools to characterize them now. Some bacterial species are present in the mouths of the people with halitosis but not in the mouths of the people with fresh breath. It doesn't mean those bacteria definitely are the culprits of bad breath, but it's a possibility. There are several issues that needed to be investigate: 1) Why do "bad" bacteria manage to colonize / wipe out (or decrease the level of) "good bacteria"? 2) Does genetic disposition make a person more susceptible to developing bad breath? 3) What are the metabolism/ cell cycles/ biochemical characteristics of the bad bacteria? 4) How do these bacteria interact with each other (intraspecies and interspecies-wise)? 5) How can we remove the bad bacteria but keep the good ones? We don't have answers to these questions yet.
2) About claims that can eliminate bad breath
I personally do not believe that there's a permanent cure for bad breath at this point. Most of the mouthwashes kill bacteria (both good and bad), so they may reduce the odor but won't eliminate it. That's because the normal floral composition is not restored that way. About all those "halitosis kits" - you may try them if you want to, but beware of side effects. First of all, most, if not all, of them are not tested rigourously. Research has to be done in an unbiased manner (preferably no financial implication, but most of the "dentist-sellers" actually gain profit by selling you those kits). Research has to be published in a well-respected peer-reviewed journal and the results must be reproducible by other researchers who follow the method. So far, most of the "bad-breath" products on the market are not tested this way, and most of the success stories are anecdotal. Don't be misled by the word "clinically proven" - these kits are not approved by ADA or FDA. They can say whatever they want. Moreover, US dental schools offer very few microbiology classes and none of them is specifically about bad breath. Dentists in private practice seldom have enough knowledge to address bad breath adequately.
Dr. Mel Rosenberg's product, seems to be theoretically most scientifically sound. I know a lot of people say his stuff doesn't work. I am not a microbiologist, so I cannot really comment on the hydrophilic/hydrophobic principles of the mouthwash. However, if it does lift the bacteria off the tongue as it claims, then it should reduce the overall load of bacteria (just like many other mouthwashes, although they use different mechanisms to reduce the load) and thus reduce the odor. I do not think it's a perfect solution because it doesn't specifically target bacteria that cause bad breath. I am not a fan of alternative medicine largely because most success stories are anecdotal and no mechanism of how it works has been established.
3) What should we do now?
Okay, so we don't have a cure for this at this point, but we do have a general idea of what causes it. Unfortunately, the academic scientific community does not pay much attention to this problem at all. Only a handful of academic researchers are working on it. In general, people in academia are more interested in solving challenging problems than making money (I say in general, not always). If you're in college or younger, I encourage you to go into sciences. I know it's hard, but it's also interesting. Plus, you have an issue that you feel passionate about, so do something about it if you think others are not doing well enough. I am not a microbiologist (yet), but I will jump at the opportunity if I can do some research in this area. For people who cannot actually go into science to study this by yourself, try to organize yourselves on this forum and send letters (rational and calm, not emotional) to people who may sympathize with your cause and/or have the ability to bring attention to this matter. Sometimes it's like a snowball, you start small but once you generate a large crowd, people will notice. Look up pubmed, look up dental school departments and microbiology departments in universities and see if someone is working on biofilms/ halitosis. Don't try to send indivdual emails. That can be annoying. Organize everything here and send ONE letter. If more people work together here, you will generate more power to push things forward.
4) Kudos to this site!
Being a sufferer myself, I have to thank jimi for organizing this site so that people with similar problems can come together. Just one thing though: I know how emotional we can be because of this humiliating problem, but we should try to keep our heads cool and try not to use swear words and attack each other. I think the main goals here are to support each other through this difficult time and to get the message across to researchers (real researchers, not pseudo-science reseachers) that we do have a problem here that is challenging and affects a lot of poeple negatively. We need to let them know it's a problem that should be investigated, for both intellectual curiosity and and practical reasons. Thanks again for this site!
Something of interest:
http://www.hno.harvard.edu/gazette/2003 ... reath.html
1) What I know about halitosis
I believe that there are many causes to this problem, although I will say that bacteria in our oral cavities will probably be the cause for the majority of the cases (especially if you don't have other health problems). According to some researchers at the Forsyth Institute at the Harvard University, we have probably more than 700 bacterial species in our mouths. Many of them are not cultivable outside the mouth, so the researchers are using different molecular biology tools to characterize them now. Some bacterial species are present in the mouths of the people with halitosis but not in the mouths of the people with fresh breath. It doesn't mean those bacteria definitely are the culprits of bad breath, but it's a possibility. There are several issues that needed to be investigate: 1) Why do "bad" bacteria manage to colonize / wipe out (or decrease the level of) "good bacteria"? 2) Does genetic disposition make a person more susceptible to developing bad breath? 3) What are the metabolism/ cell cycles/ biochemical characteristics of the bad bacteria? 4) How do these bacteria interact with each other (intraspecies and interspecies-wise)? 5) How can we remove the bad bacteria but keep the good ones? We don't have answers to these questions yet.
2) About claims that can eliminate bad breath
I personally do not believe that there's a permanent cure for bad breath at this point. Most of the mouthwashes kill bacteria (both good and bad), so they may reduce the odor but won't eliminate it. That's because the normal floral composition is not restored that way. About all those "halitosis kits" - you may try them if you want to, but beware of side effects. First of all, most, if not all, of them are not tested rigourously. Research has to be done in an unbiased manner (preferably no financial implication, but most of the "dentist-sellers" actually gain profit by selling you those kits). Research has to be published in a well-respected peer-reviewed journal and the results must be reproducible by other researchers who follow the method. So far, most of the "bad-breath" products on the market are not tested this way, and most of the success stories are anecdotal. Don't be misled by the word "clinically proven" - these kits are not approved by ADA or FDA. They can say whatever they want. Moreover, US dental schools offer very few microbiology classes and none of them is specifically about bad breath. Dentists in private practice seldom have enough knowledge to address bad breath adequately.
Dr. Mel Rosenberg's product, seems to be theoretically most scientifically sound. I know a lot of people say his stuff doesn't work. I am not a microbiologist, so I cannot really comment on the hydrophilic/hydrophobic principles of the mouthwash. However, if it does lift the bacteria off the tongue as it claims, then it should reduce the overall load of bacteria (just like many other mouthwashes, although they use different mechanisms to reduce the load) and thus reduce the odor. I do not think it's a perfect solution because it doesn't specifically target bacteria that cause bad breath. I am not a fan of alternative medicine largely because most success stories are anecdotal and no mechanism of how it works has been established.
3) What should we do now?
Okay, so we don't have a cure for this at this point, but we do have a general idea of what causes it. Unfortunately, the academic scientific community does not pay much attention to this problem at all. Only a handful of academic researchers are working on it. In general, people in academia are more interested in solving challenging problems than making money (I say in general, not always). If you're in college or younger, I encourage you to go into sciences. I know it's hard, but it's also interesting. Plus, you have an issue that you feel passionate about, so do something about it if you think others are not doing well enough. I am not a microbiologist (yet), but I will jump at the opportunity if I can do some research in this area. For people who cannot actually go into science to study this by yourself, try to organize yourselves on this forum and send letters (rational and calm, not emotional) to people who may sympathize with your cause and/or have the ability to bring attention to this matter. Sometimes it's like a snowball, you start small but once you generate a large crowd, people will notice. Look up pubmed, look up dental school departments and microbiology departments in universities and see if someone is working on biofilms/ halitosis. Don't try to send indivdual emails. That can be annoying. Organize everything here and send ONE letter. If more people work together here, you will generate more power to push things forward.
4) Kudos to this site!
Being a sufferer myself, I have to thank jimi for organizing this site so that people with similar problems can come together. Just one thing though: I know how emotional we can be because of this humiliating problem, but we should try to keep our heads cool and try not to use swear words and attack each other. I think the main goals here are to support each other through this difficult time and to get the message across to researchers (real researchers, not pseudo-science reseachers) that we do have a problem here that is challenging and affects a lot of poeple negatively. We need to let them know it's a problem that should be investigated, for both intellectual curiosity and and practical reasons. Thanks again for this site!
Something of interest:
http://www.hno.harvard.edu/gazette/2003 ... reath.html