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Afterward, Alan stands near a wall, his hand rising occasionally to cover his mouth. Then he moves closer to the receptionist: to hand over a $495 check for three visits. (Since Alan's visit, the three-session fee has risen to $595, up to half of which may be paid by insurance.)
The dental professionals who treat people such as Alan bravely go where no one has dared to go before: into the heart of darkness itself, odors the rest of us would do anything to avoid. Garazi admits, "I don't want to smell people's breath A that's not what I trained for." But, he adds cheerily, "It's better than being a proctologist or a gynecologist." Facing unpleasant realities is just part of his job, he says with a kind of stoic heroism. "You have to get used to it," he notes. "It's not much different than treating a patient with severe gum disease." On the other hand, he concedes, "Maybe when they're not looking, you make a face."
Arbuz, his assistant, recalls how difficult it was for her to evaluate breath initially. "The first time I was very nervous. It was traumatic A he had really bad breath," she notes. "Now I'm very comfortable doing it. You just take a deep breath and put your face four inches away from theirs." The key for her is maintaining her professionalism: "You have to put yourself in their situation. If you were a patient, you wouldn't want anyone going, 'Oh my God!'"
Dr. Brian Tschirhart is a bit more blunt about the downside of his chosen line of work. "It can be very noxious," he says. But he has his own mental technique for dealing with the hazards of slaying the dragon of bad breath: "I focus on the results."
For many patients, those results can be quite positive. According to Esther Hoffman-Gonzalez, a Miami gallery owner, she began noticing a problem over a year ago, when her husband started telling her, "'Honey, you've got bad breath.' Our married life was down to a dull roar," she continues. "It was interfering with my work: You could see people take three steps back. You're embarrassed." Before conquering her problem, she went to an ear-nose-and-throat doctor, visited a gastroenterologist (a doctor who treats stomach disorders), got X-rays of her sinuses, and switched mouthwashes. Nothing helped. She learned about Tschirhart's clinic about five months ago, then went in for treatment that included the scraping away of gum bacteria and the regular use of Oxyfresh toothpaste and mouth rinse. "Everything's back to normal," she says, "and my sense of self-esteem got a push."
Similar testimonials are mustered by the ProFresh side. One convert is a dentist himself, Dr. Carlos Sierra, of Miami Beach, who turned to Richter's ProFresh after using Oxyfresh for about five months. His patients didn't complain about his breath A although, he jokes, "Dentists overall have bad breath; that's one reason we're constantly using a mask." His wife, though, was more forthright about his problem. After learning about Dr. Richter's program, he decided to give it a try. "The treatment was a little hairy," recalls Sierra, particularly the daily use of a plastic, ridged tongue scraper, which made him gag. But, he adds, it's been worth it: "I don't think about whether I have bad breath."
Alan is hoping for similar results when he returns for his second visit a week later. A hygienist cleans his teeth, then uses a special, curved metal device that thoroughly scrapes his tongue while spraying a concentrated version of ProFresh into his mouth. "It's a spray cleaner," hygienist Jennifer Jacobs explains, "like doing a carpet." Alan gags a bit during the process, but about fifteen minutes later, it's all over. Then she gives him instructions about the home-treatment procedure, which includes the tongue scrapings and careful rinsing. He says he's willing to do that, but he balks at her request to have someone he's close to make a "daily assessment" of his breath odor, which he's told to record on an evaluation log for two weeks. The assessment form reads, in part, "The 'assessor' should position his/her nose 4-8 inches from your opened mouth. Exhale slowly through your mouth.... This exercise is designed to provide you with the objective feedback you need to have confidence that your breath odor is no longer offensive."
"I've got roommates," Alan protests. "I don't feel like asking them." As a result, they make arrangements for him to stop by the office for periodic checks. He's sent off into the world with two sixteen-ounce bottles of ProFresh A they're reordered by mail at nine dollars a bottle (plus shipping) A and uplifting words from Jacobs: "I'm going to guarantee that the breath odor will go way down. We haven't had one failure in our office." Alan schedules a return visit in several weeks for a complete retesting.
A few days after the treatment, he stops by for a quick smell check, and the results are encouraging. He says later, "The hygienist told me it was fine. I think I've made progress, and the regimen is getting easier." Still, he admits he hasn't had the nerve to ask his roommates to smell his breath.