Tooth Bleaching Solution Helps Banish Halitosis Bacteria
WASHINGTON, July 14-Low concentrations of the same chemical solution dentists use to bleach patients' teeth can significantly reduce chronic halitosis, according to a clinical demonstration presented here.
Carbamide peroxide, at about a third of the tooth-whitening dose, can destroy the sulfur compounds and Gram-negative bacteria that cause bad breath, reported Louis J. Malcmacher, DDS, a general and cosmetic dentist in Cleveland.
The finding is based on 10 years of evidence involving about 40,000 patients, Dr. Malcmacher reported. Dentists thought the bleaching technique might work for halitosis when they noticed that patients enjoyed clean breath after getting their teeth whitened.
For the treatment, carbamide peroxide at 3% is mixed with gelatinous fillers and placed in a customized mouth tray or mouth guard that fits tightly around the teeth, much like a plastic retainer. Carbamide peroxide at 10% is the dose used for tooth whitening, said Dr. Malcmacher, who demonstrated the procedure at the Academy of General Dentistry meeting here.
For halitosis, mouthwash and tooth-brushing merely mask the problem, Dr. Malcmacher said in an interview. This technique goes "straight to the root of the problem. This is where 95% of bad breath comes from."
Patients keep these tailored trays in their mouths for an hour. After the first treatment patients can repeat this process on their own at home for an hour every day. It takes about three treatments for patients to notice a difference in their breath, Dr. Malcmacher said.
The treatment costs about $500, which includes the one in-office treatment and then a four to six-week supply to be used at home. There are no reported side effects, he added.
How long patients have to continue this process depends on the severity of their halitosis. Even for patients with severe halitosis, regular daily treatment will eventually improve their bad breath to the point where they don't have to do it everyday, but rather every few months, Dr. Malcmacher said. For patients with a milder problem, this treatment can take care of the problem for the long-term, he added.
However, long-term may not mean indefinitely. Some patients are simply more prone to excess Gram-negative bacteria growth than others. Scientists don't know why or how to identify who is most susceptible. "That's the only piece of the science we don't know," Dr. Malcmacher asserted. "We don't know why 25% of the population has chronic bad breath."
Oral Gram-negative bacteria cause most bad breath cases. However, 5% of cases are due to postnasal drip, and nose, ear, and throat infections, he said. Conditions such as diabetes, gum disease, and xerostomia, or even tobacco use, stress, aging, snoring, and hormonal changes can all affect breath.
Dental bleaching has become increasingly popular in the past few years, particularly the use of over-the-counter whitening strips. Whether using carbamide peroxide for halitosis will catch on in a similar way remains to be seen. Dr. Malcmacher said the technique has not been widely marketed, and there is no patent on the procedure.