January 4, 2005, Updated September 12, 2012


Health Science

The Boston Globe
January 4, 2005

Bad breath, or halitosis, is often caused by bacteria in the mouth or upper airway that produce sulfur-containing compounds. Usually it can be banished by flossing and brushing teeth twice a day, and brushing and scraping the tongue. If bacteria also are lurking in deep “pockets” in the gums, a dental professional must scrape them out.

But even with excellent oral hygiene, some people need more dramatic approaches.
About 90 percent of bad breath is caused by bacteria in the mouth, and a small percentage by bacteria in the tonsils, said Dr. Richard Price, a retired Newton dentist and a spokesman for the American Dental Association.

An Israeli scientist, Dr. Yehuda Finkelstein, director of palate surgery in the department of otolaryngology, head and neck surgery at Meir Medical Center, is testing a high-technology solution to get rid of bacteria lodged in tonsils lasers that burn away small “crypts” or hollow spaces in apparently normal tonsils that harbor bacteria.

In a study of 53 people, one 15-minute laser session got rid of halitosis in 50 percent of people; the rest needed two or three treatments, Finkelstein said in a telephone interview. A seemingly simpler solution, antibiotics, does not work well against the bacteria found in tonsils, he said.

In Boston, Bruce Paster, a microbiologist at the Forsyth Institute, also turned to sophisticated technology to study bad breath. He and his team used DNA sequencing to study bacteria from tongue scrapings in people with and without halitosis. The people with halitosis often had “bad” bacteria on their tongues, while the sweet-breathed people had an abundance of “good” bacteria, he said. The solution was an initial scraping of bacteria from the tongue and antimicrobial mouthwashes for a week, followed by tongue-brushing with an antimicrobial zinc gel for a year.

The result: The “bad” bacteria disappeared, he said, and were replaced by “good.”

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