Oral odors - is it more than just bad breath?

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As dentists, we all know just how prevalent halitosis is across the United States, and it’s something we see in our patients each and every day. Reports suggest that as much as 65% of the population have bad breath, but fortunately halitosis is rarely more than a sign that patients have been brushing properly. 

But what if it is bad brushing?

Oral Causes of Halitosis

Most cases of halitosis are simply caused by a failure to maintain good oral hygiene, and can be effectively treated at home through interdental cleaning, tongue cleaning, and the use of mouth rinses both morning and evening. Sometimes, there can be a little more to it, with bad breath being caused by conditions such as gingivitis or periodontal disease, but again these are all oral causes that we’re trained to both identify and treat at the practice. In total, it’s estimated that between 65 and 85% of halitosis cases are the result of problems arising on the tongue or in the parodontium area of the mouth. 

Non-Oral Halitosis

The remaining 15 - 35% of halitosis cases can be a little more tricky to manage. While it is statistically most likely that non-oral causes are minor, it can’t be overlooked that bad breath can indicate very serious localized or systemic conditions. Diabetes, liver failure, and lung diseases such as respiratory infections and cystic fibrosis can all present with bad breath as one of the most prominent symptoms. 

Perhaps even more incredibly, MIT reports that bad breath can also signal lung cancer. It has been found that, in some cases of lung cancer and some forms of lung infection, bad breath can present as the first noticeable symptom. This occurs long before fever, cough, or chest pain are experienced by the patient. 

Knowing What to Look For

While we are not trained to diagnose or treat these types of conditions, as dentists it is essential that we understand that oral symptoms are not always indicative of oral health or oral conditions. Knowing what’s normal — and what’s not normal — in the presentation of halitosis really could save a life. 

Here are two of the most common indicators that halitosis has a non-oral cause:

  • Acetone / Nail Polish Remover

If a patient’s breath smells like nail polish remover, it should be recommended that the patient makes an appointment with their physician to have their blood sugar levels checked. In cases of diabetes, diabetic ketoacidosis occurs when there are very high levels of ketones in the blood, resulting in a greater odor. Ketones have a strong smell which is most commonly associated with nail polish remover. That’s because many nail polish removers contain acetone, a form of ketone that’s often used for cleaning purposes. 

  • Sweet / Musty / Perfume

If a patient’s breath smells somewhat perfumey, with a definite sweet and musty aroma, it may be that the cause isn’t due to ketones, but to limonene. Studies have found that those suffering from liver disease have more of the chemical compound limonene in the body than healthy individuals. The link is so strong that limonene is on track to be used as an official biomarker for early stage liver disease. With symptoms rarely presenting in early stages, bad breath could be key to more timely diagnostics. 

Share, Don’t Scare

The most important aspect to keep in mind is that different odors smell different to different people, so even if you do identify an unusual smell on your patient’s breath it does not always mean there is cause for alarm. If there is uncertainty as to the cause of bad breath, or halitosis is not responding as expected to common forms of treatment, advise your patients to visit their physician for further examination.

Is Your Dental Practice Ready for Halloween?

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Is Your Dental Practice Ready For Halloween?

Halloween is right around the corner, and for dentists it can definitely be one of the most frightening times of the year! According to IHS Global Insights, Halloween candy sales now exceed $3.8 billion, and a whopping 94% of American children go trick-or-treating based on figures published by the American Dental Association (ADA). Yet the ADA also reports that less than half of kids brush twice a day. Yuck. 

So it’s really not that surprising to learn that emergency dental appointment rise by 80% on Halloween, with more people requesting appointments on the 31st than any other day in October. That’s according to Sikka Software, who analyzed appointment bookings for 13000 practices in the US...

Spooky stuff indeed! 

Preparing for Halloween

Of course, Halloween poses a bit of a dilemma for dentists. On the one hand, we’re trained to advise against sugary snacks. On the other hand, it’s important to keep our patient base — particularly the little ones — satisfied with their visits. Because of this, around 60% of all dentists in the United States will hand out candy to their patients. Dental insurance firm Delta Dental estimates that 5% hand out toothbrushes, and 25% don’t give anything at all, which isn’t particularly festive of them!

Getting into the spirit of the celebration is important for many practices, but what’s surprising is that around 13% of dentists are giving out hard candies and lollipops… not exactly the best choice in terms of oral hygiene. Fortunately, the majority give out chocolate, which clears more quickly from the mouth to minimize the risk of decay. Other good snacks to hand out, according to research by the Forsyth Dental Center, include certain ‘sticky’ foods, such as caramels, which clear quicker than dried fruits and chips and far quicker than the aformentioned hard candy offenders. 

Think it’s just children that you need to keep an eye on over the spooky season? Think again! The National Confectioners Association confirms that three quarters of adults buy Halloween candies for their households (happily eating what they don’t give away), and 72% tuck into their children's swag. 

The Silver Lining

Halloween is rarely a dentist’s favorite time in the holiday calendar, but there is a bright side to this traditionally candy-fuelled occasion. Halloween is an excellent time to educate your patients not only about caring for their teeth, but also about disease prevention and about making healthy choices.

Here are some great tips to make the most of a tricky holiday:

  • Show kids — and their parents — that good oral hygiene isn’t about avoiding sweet treats at Halloween, but about choosing better options (like chocolate) and brushing well afterwards. 

  • Don’t be afraid to ‘scare’ your younger patients with a few dental-related Halloween horror stories. Nothing too frightening, of course, but this is a holiday based on ghouls and goblins!

  • Do hand out some Halloween treats, but remember that there are non-candy alternatives that kids will love, such as themed coloring sheets and even spooky stickers. 

  • And finally, use the holiday as an excuse to reinforce good behaviors and ensure that all your patients understand the best ways to care for their teeth at home and reduce the risk of damage. There are learning moments everywhere at this time of year!

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Should you recommend at-home teeth whitening to your patients?

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Discoloration, caused by either extrinsic or intrinsic stains, is a remarkably common concern. As dentists, we all want our patients to feel happy and satisfied with the appearance of their teeth. At a time when the value of the global teeth whitening market is rising at an almost unprecedented rate — now exceeding $3.2 million according to the American Dental Association — it’s natural that many people are beginning to look into at-home treatments. But should you recommend these systems to your patients?

Is At-Home Teeth Whitening Safe?

The official line from the American Dental Association is that at-home whitening systems, including trays, strips, pastes, and rinses, are generally safe to use, and can be effective at minimising the appearance of discoloration from the use of certain medicines, removing surface stains from food and drink intake, and lightening and brightening teeth that have become darker with age. However, as a dentist it is essential to understand the risks of at-home teeth whitening, and ensure that all patients are aware of these risks before using any at-home kits, regardless whether they are purchased over-the-counter or from your office. 

Teeth Whitening Risks

Perhaps the most common side effect of teeth whitening is a notable increase in tooth sensitivity, which the ADA estimates affects up to 41% of all patients who undergo a whitening procedure. Gum irritation is also frequently noted, especially when using off-the-shelf trays which have not been purpose-made to match the size, shape, and layout of the individual’s mouth. This is due to movement of the tray and rubbing.

However, the risks are understood to go above and beyond these minor side effects, with a study in the British Dental Journal reporting that products containing sodium chlorite could actually increase the chance of extrinsic stains through the creation of greater surface abrasions, giving stains more to adhere to. The study also noted cases of infections, blistering, and burns as a result of using bleaching gels. 

And that’s not all. While more investigation into the area is needed, researchers have posed the idea of cellular damage as a result of peroxide-based products with the potential for peroxide to interact with DNA to have a wider impact upon human health as a whole. Peroxide has been cited as a carcinogenic, an irritant, and a cytotoxic. Dentists should be aware of this when recommending products. 

Suitable Alternatives

While dentists may wish to recommend at-home whitening products to those presenting with healthy teeth which are in good condition, other options are available that may well prove to be safer overall. 

Dentist-administered whitening treatments carried out by a trained professional may be offered as an alternative, while mild extrinsic stains often respond positively to the Gazelle nanocomposite polisher which restores and shines the surface of the teeth with either a satin or high gloss finish. The results may not be as significant as those that can be achieved through dedicated teeth whitening systems, but polishing can be hugely effective at minimising surface stains and creating a brighter appearance. And best of all, it's safe!

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3 Money Saving Tips for Dental Practices

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Did you know that dental office overheads are amongst the highest across all industries? According to the American Dental Association, who analyzed figures from the Bureau of Labor Statistics, the average overhead for dental practices in the US stands at almost 75% (74.62% to be exact); much higher than the 35% that is typically agreed to be standard for well-performing organizations.

It’s no secret that running a busy and successful dental practice can be costly, but overheads of nearly 75% can — and should — be avoided to ensure a solid and stable financial future for the firm. 

Here are 3 easy-to-implement ways to minimize outgoings and reduce dental overheads:

1. Switch Supplier

A major challenge that dentists are facing is that many patients are finding it difficult to access the necessary care they need due to rising healthcare costs. A Health Policy Institute Report by the ADA confirms that 40% of American adults do not attend dental appointments because they cannot afford to do so. As a dentist, it is tempting to purchase cheaper, lower quality supplies to reduce the cost of dental work for our patients, but in doing so practices could find that they’re actually paying out much more.

Low cost, low quality tools and equipment not only put our patients’ health at risk, but in many cases also increase the number of products we need to buy. Many low quality polishers, for example, can crumble easily, meaning that they’re unable to fully complete the job they were designed to do. Similarly, the industry is seeing a rise in ‘absorbent’ pads which aren’t absorbent, and burs with very short life spans. Higher quality burs like NeoBurr, are up to 70% stronger than other brands. 

2. Automate Processes

Automation is a hot topic right now, and it’s working its way into practically every industry. One industry that appears reluctant to implement new technology, however, is dentistry. While advanced technologies such as robotics are certainly a long way from being introduced into the average practice in the US, there are many other forms of automation that do have a place. Predictable tasks, such as appointment setting, repeat ordering, and staff rotation, for example, can all be managed by dedicated software. 

In automating many front-of-house and management processes, practices could find that they’re able to free up their valuable internal resources for other, more productive, profit-making tasks such as marketing. More pressingly, automation not only removes the need for skilled employees to spend their time completing mundane tasks, but could actually help to improve attendance rates, too. One study found that no-shows (which can be costly) can be reduced by 23% with automated reminders

3. Know Your Audience

Marketing plays a significant role in the overall success of dental practices, helping to raise awareness of the unique skills and experience of the team and getting local patients through the doors. Marketing is certainly an area that’s worth creating a budget for, but one of the primary concerns right now is that dental practices are wasting this budget by failing to tailor their marketing campaign to their niche audience, and are instead attempting to appeal to a very widespread and broad demographic. 


As dentists, we all have a commitment to both promoting and encouraging good oral care for everyone, so it’s natural to want to market the dental practice to all demographics. However, in terms of financial responsibility, it is perhaps more effective for practices to customize their campaigns specifically to attract and engage those most likely to visit a dentist. Colgate reports that women are twice as likely to visit a dentist as men, for example, so campaigns tailored to men could end up being money down the drain.

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NeoDiamond Celebrates 30 Years!

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NeoDiamond, the pioneer and #1 single-patient-use diamond, is celebrating its 30th anniversary. Three decades ago, Microcopy co-founder Thom Maass, Jr. achieved his vision to offer a high quality, sterile and efficient dental diamond bur — even coining the phrase “Single-Patient-Use”. NeoDiamond launched, outfitted in the distinctive magenta packaging, in early 1989. The original NeoDiamond line consisted of 16 shapes. Unbeknownst to Thom, NeoDiamond would go on to become a highly regarded brand by dental professionals around the world.

“Much has changed since NeoDiamond launched in 1989,” said Paul Tucker, CEO, “But through the years Microcopy has stayed true to its mission to bring products to the dental market that make dentistry easier and safer.” The NeoDiamond line now consists of 126 shapes in various grits. Most recently, in May 2019, 6 new pediatric short shank diamond burs were released. Microcopy has expanded globally and maintains a focus to offer innovative, single-patient-use products that enable dentists to fulfill a social responsibility to provide better, healthier patient care. It’s no longer 1989 but Microcopy is planning to keep NeoDiamond around for the next 30 years. As Heather Siler, marketing manager puts it, “NeoDiamond was developed with safety and performance in mind, which is still the driving force for the brand today. Great products like NeoDiamond will never go out of style.”

To celebrate NeoDiamond’s golden anniversary, Microcopy wants to hear from NeoDiamond customers, old and new. Microcopy has launched a photo submission campaign, encouraging customers to submit their “NeoDiamond Story” along with a photo, sharing why they started using or what they love about these single-patient-use diamonds. Entries will be submitted into a drawing to win a trip to Atlanta for a tour of Microcopy and select from a list of other exciting places to visit while in the city. To share your NeoDiamond Story visit: https://microcopydental.com/nd-30form

For more information about NeoDiamond visit www.NeoDiamond.com or call 800-235-1863.

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