Items filtered by date: September 2019
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.
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?
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!