By Michael E. Miller
By Ryan Yousefi
By Kyle Munzenrieder
By Sabrina Rodriguez
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With such encouraging results, why is there, well, a bit of a bad odor about the treatment of halitosis? One reason, of course, is that the field itself is so new. Richter opened his first center to the public only two years ago and is only now seeking to publish data about his method's efficacy; the Oxyfresh people have been marketing their mouth rinse since 1984, but have no scientific studies showing that their product works. "There's no standard practice for treating bad breath," says American Dental Association consumer advisor Richard Price, a clinical instructor at Boston University's dental school. "It's all in its infancy."
Thus far Oxyfresh has generated the most controversy because of its aggressive marketing tactics, and questions A raised mostly by rival ProFresh A about its products' claims. The Spokane-based Oxyfresh has a network of thousands of distributors, including dentists, for its extensive line of skin, hair, and dental products; it even sells a breath rinse for dogs. Oxyfresh, in essence, is structured like an Amway program for dentists and other marketers, with each distributor getting a slice of a new recruit's revenues. Consequently, the dentists who sell the mouth rinse and other Oxyfresh dental products are becoming increasingly visible at dental conventions and in trade journal advertisements. This faddishness worries consumer advisor Price, who cautions, "Let's not turn this into tanning salons."
Oxyfresh's sales strategy also has drawn fire, not surprisingly, from Richter and his representatives. Says Richter, "I'd be concerned about the advice you receive if your dentist's source of income hinges on whether you buy a product." And Garazi charges, "The problem is that most of them use it as a come-on to get patients into their office and sell them dental work."
These sorts of charges raise the ire of Oxyfresh dentists, including Dr. Ronald Scheele, director of health profession relations for Oxyfresh. "That's absolutely ludicrous!" he fumes. "We have 7000 highly ethical dentists [offering our product], and they're not out hustling for business." (The company won't disclose how many dentists offer the product in South Florida, but Garazi estimates about twenty.) Scheele portrays the Amway-style marketing technique as merely "colleague referral to the program by those who have been finding success with it. They get a finder's fee for referring others."
Pointedly addressing Richter's accusations, Scheele adds, "This is a competitor's response to the competition. There's a profit motive on both sides. Why don't you ask him how much he makes on his seminars? It's substantial." (Richter counters by noting that he doesn't make a profit on his introductory or training seminars, although he estimates he grosses about $500,000 annually from the sale of ProFresh products through ten dental offices around the country, including his own. By the end of the year, he expects to have authorized and trained personnel in 200 more offices in the use of his product.)
Despite Scheele's protestations, there's little doubt that dentists offering Oxyfresh A and to a lesser degree, ProFresh A hope that the rinse will increase the number of new patients needing actual dental work. There's the evidence of those crude trade journal ads, of course. And Tschirhart, who specializes in crown and bridge work, says, "We like to take patients to as healthy state as possible, so we need new patients." Currently, people seeking treatment for bad breath make up about forty percent of his patients, compared to about five percent for Garazi's practice. In addition, as an article by a pair of dentists in the trade publication the Profitable Dentist points out, thanks to the Oxyfresh program, "we have found ourselves diagnosing and performing a four-fold increase in periodontal therapy...."
Oxyfresh's partisans, including Tschirhart, emphasize the importance of a thorough periodontal exam and treatment for any gum disease as an essential element of fighting bad breath. But Garazi and Richter, among others, disagree with that perspective. Garazi says, "We have patients with severe gum problems who we treat for bad breath without clearing up their gum problems." (Garazi says he usually refers halitosis patients with gum disease back to their own periodontist or dentist unless they ask otherwise.) Richter, citing various recent research articles, is more adamant: "The current wisdom that infectious gum disease causes most bad-breath problems does not hold water. Less than twenty percent of bad breath is caused by gum disease." The most definitive recent article on this earthshaking subject appeared in the January 1994 issue of the Journal of Periodontology; it concluded, "A large proportion of individuals with oral malodor are periodontally healthy."
The dispute between the bad breath behemoths gets even more heated over another burning issue: What the hell is in Oxyfresh anyway? Oxyfresh's advocates use the patina of scientific research to support A indirectly A their claims that their product contains an effective form of chlorine dioxide, a proven antibacterial agent that also neutralizes the sulfur-containing compounds that cause bad breath. In a more concentrated form, this volatile gas, after being dissolved in a liquid, is used to disinfect some city water supplies. (The Dade County Water and Sewer Department does not use it.) Oxyfresh's promotional material includes several studies showing the value of chlorine dioxide as a deodorizer and antibacterial agent. The only problem, Richter notes, citing laboratory studies paid for by him and independent research results he faxed New Times, is that Oxyfresh doesn't actually contain any chlorine dioxide. "It's fraudulent," he says.