When Bad Breath Happens to Good People

Is something rotten in the state of your mouth? Kill halitosis with costly new technologies!

A strange, disturbing ailment is, by some accounts, rampant in South Florida and across the country, ruining lives, destroying relationships, even bringing people to the brink of suicide. This menace is an equal-opportunity destroyer, afflicting both gays and straights, men and women, young and old.

AIDS? Hepatitis B? Alcoholism? No, this latest peril is known as chronic bad breath, or halitosis, and in recent months a pioneering crew of dentists in the greater Miami area has launched a battle against this malady. They're armed with high-tech equipment, new research, an arsenal of mouth rinses A plus a determined promotional campaign to alert the public to the menace they face and the fresh (so to speak) hope for solving the problem. Since last fall, the Richter Center Program, developed by Philadelphia periodontist Dr. Jon Richter, has been offered by five different dental offices in Dade, Broward, and Palm Beach counties. Richter Centers' newspaper ads speak directly to sufferers: "She's got a good job and a great wardrobe. But the problem is her breath," states one, showing a worried-looking woman standing all alone next to a window, phone grasped in her hand. "Chronic bad breath can affect your success and self-confidence." Another ad shows a couple sitting close to each other on a couch: "Life is more fun when you don't have to worry about bad breath," the headline points out.

Richter offers an industrial-strength treatment. A key element of this supposed breakthrough approach is the use of a special rinse, ProFresh (made exclusively by a Richter company), which contains an antibacterial chemical called chlorine dioxide. This ingredient is so powerful that it also is used as a disinfectant in municipal water plants, according to Richter and several studies in dentistry journals.

The Richter approach isn't the only method designed to administer to victims of "breath malodor," as it's sometimes referred to in the growing number of research studies and dental seminars devoted to this topic. Tucked away on the first floor of a Brickell Avenue office building is the Fresh Breath of Florida Halitosis Center, also known as the dental office of Dr. Brian Tschirhart. "We saw an opportunity to help the problem A and to meet new patients," Tschirhart says of his decision to open a breath clinic last year targeted primarily at Latin American and Hispanic patients. Indeed, bad breath may be especially "noticeable" to them because "in the Latin community people stand closer together," the Anglo dentist asserts. The centerpiece of his method is the use of another mouthwash, Oxyfresh, which allegedly contains a form of chlorine dioxide, although the ProFresh faction disputes that claim A just one of several points of contention between the ProFresh and Oxyfresh forces. Both camps, not surprisingly, seek to dominate the bad-breath marketplace. Accusations and hints of fraud, profiteering, and questionable dental care are being hurled back and forth between the rival odor fighters.

What's not in dispute is the profit to be found in catering to those with bad-breath concerns. They make up a potentially lucrative market: Polling by mouthwash companies several years ago indicates that an estimated 25 million people have chronic halitosis. In a typical recent ad in the trade publication Dental Products, a major Oxyfresh distributor alerted dentists to the potential gold mine that awaited them if they joined the bad-breath-battling bandwagon:

"DIAGNOSE and TREAT HALITOSIS while increasing PATIENT FLOW and PRACTICE INCOME," the ad shouted. Underneath the headline was a cartoon of a long line of patients snaking through a door waiting for an appointment, while one dentists says to another, "Wow! Who would have believed that treating bad breath would have led to this?"

The Miami area patients who have turned to such treatment programs in increasing numbers don't see themselves as a new revenue source for dentists, but rather as people desperate for help. On a recent afternoon, one of them (we'll call him Alan) sits in a dental chair in the office of a Richter acolyte, North Miami Beach periodontist Isaac Garazi, an earnest, dark-haired man who says that bad-breath patients make up only a small portion of his business.

Before Garazi and his staff get down to the uncomfortable business of actually smelling and measuring Alan's breath, the dentist needs to probe the history and psychological impact of the problem. (In fact, he says, at least ten percent of the patients seeking treatment from him don't really have serious bad breath A they just think they do. As a result, he sometimes suggests psychological treatment.) Alan, still in his twenties, could have a genuine problem, though, Garazi believes, and only a painstaking examination by the bad-breath detectives can determine just how serious it might be.

Alan's parents first called it to his attention when he was in his late teens, he explains, but even after gum treatment the problem persisted. Garazi, sitting a short distance away from Alan in an adjoining chair, asks, "Anything make you think that it is still a problem?"

"There were no comments, but people backed off a little," Alan notes. Garazi asks about his use of mints and mouthwash to mask the smell, then presses on. "When we think about breath, we think about distance. Is this a comfortable distance for you?" The two men sit about three feet apart.

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