Periodontal Disease and Bad Breath – Are They Related?

7th Workshop of the ARPA Foundation

Mel Rosenberg presenting on
Periodontal Disease & Bad Breath

Are They Related?

Friday, 2010-03-19 - 2.15 pm, Munich

Dentists often assume that periodontal disease is a major cause of bad
breath. Indeed, bad breath is often cited as being a warning sign of
periodontal disease. But is it? This is the issue which I will address
in my presentation. Indeed, various studies have demonstrated
significant associations between gingival index and probing depth (on
the one hand), and oral malodor, as determined by odor judges and
volatile sulphides (see, for example the review by Morita and Wang in
2001). However, several publications, notably that of Bosy et al.
(1994), conducted on over 120 Canadian subjects, did not find a
significant association between the two (although the level of malodor
was slightly elevated in the periodontal disease group.

Specific questions to be addressed:
• Why do some studies show significant differences between periodontal
disease parameters and bad breath whereas other studies do not?
• What role does the posterior dorsal tongue play in this relationship?
• Is interdental plaque an important factor?
• Should we find other ways of measuring bad breath to identify the
periodontal contribution?

• Should bad breath be a factor in determining how dentists and
periodontists view the oral cavity, instruct patients and monitor
treatment?


Address: Europäische Akademie für zahnärztliche Fort- und Weiterbildung der BLZK GmbH –eafz
Zahnärztehaus München
Fallstr. 34
81369 München

Prof. Mel Rosenberg, Sackler Faculty of Medicine, Tel Aviv University Tel Aviv 69978 Israel (melros@post.tau.ac.il)

A Trip to Dortmund

My Trip to Dortmund

Traveling to Germany is always an issue for me. For decades, I wouldn't go at all. Then, when I was about forty-five, I broke the ice and started going there for business. I found three things: i. A lovely country; ii. Nice people (with a few exceptions, like anywhere); iii. Ghosts. I keep coming back to the war, wherever I am. Where did the Jews live here? Where were they picked up – here, at this very train station? Sometimes there are stark reminders. For example, when we saw someone selling silver synagogue ornaments from a stall in Berlin (I freaked out). Or when I was given a body search by a German soldier guarding the basement museum in downtown Berlin underneath the concrete slab monument (the frisking was particularly disturbing, I broke out in a cold sweat).

Somewhere in my collective memory I am wearing the pajamas of a concentration camp inmate. Non Jewish people do not seem to understand that Jews have a common fabric. I am often asked there (and other places), "Did you have relatives in the war?" The answer is that I had no close relatives, but all the millions of Jews that were shot and gassed are my relatives. To paraphrase Humboldt, we are all a single entity, a single organism. Perhaps that is why the Jewish community is so proud of its successful offspring, and equally outraged at miscreants such as Madoff, whether or not we invested with the goniff.

As usual I digress. So here we are in Germany (two weeks ago) for the 8th international conference on breath odor research. The meeting is in Dortmund, a city that appears to have lots of trees, fields of rapeseed, and no downtown. To make matters worse, the conference is near the university which is itself out of town (if you call it a town), so much for geography.

The meeting has two parts. The first has to do with bad breath and is organized by ISBOR – the International Society for Breath Odor Research. This is a society that I organized together with Prof. Daniel van Steenberghe in 1995. The second meeting is about using the non-smelly gases from the breath to diagnose medical conditions (such as asthma, diabetes, and even lung cancer). This part of the meeting is organized by the IABR – the International Association for Breath Odor.

During the smelly part of the meeting, the old rivalries between competing dogmas erupt. On the surface, it appears to be about science, but it is just as much about personal enmities and envities. Is bad breath only due to sulfur gases or are many gases involved? Is periodontal disease an important factor in causing bad breath? Which is more important – odor judge scores or instrumental sulfide measurements? Is the halimeter useful or not (I developed the application, so I think it is). As in other scientific meetings, friends of the meeting organizers are invited to speak, others are excluded. Scientists can on occasion be very authoritative and unpleasant.

You can check out my newly designed website http://www.smellwell.com/ for interesting articles on smell and more updates on, of course, bad breath. Also, read about OkayToKiss, the new, patent-pending saliva test, my team has been working on in the lab. http://http//sciencenow.sciencemag.org/cgi/content/full/2009/522/1

After the meeting, Dr. Nir Sterer (postdoc in my lab) and Yael Gov (star technician) and I head to Cologne to visit my friends Jehudi and Iris, chill out, and play tourists. With our hosts to show us around town, we are treated to a marvelous time. We heard some excellent traditional jazz, and I even sat in (on piano) with a great trio playing outside!!

One of the most amazing attractions in Cologne (at least for me) is the chocolate museum. I am told that there are only two other museums dedicated to this divine treat – in Barcelona and Brussels, if I am not mistaken.

My curiosity here is overwhelming – I have to know how chocolate is REALLY processed. I drive the guides crazy but they are kind in answering my many questions. They even give me a whole bunch of roasted cocoa beans (which I am enjoying one by one).

I discovered several years ago that dark chocolate helps me swallow my food (I have a rare condition known as acchalasia, in which the muscles in the esophagus are not prompted to squeeze the food along). We are now doing a study at Ichilov Hospital to see whether it helps others (initial results are encouraging) and I am trying to track down Sergey Brin to get him to fund a study on the effect of dark chocolate on parkinsonism (PD).

Wherever I go, I compare and stock up on dark chocolate. My favorite tasting one is a 72% bar hailing from Italy (and not expensive!!). I am now in Toronto where one can buy 100% baker's chocolate. I just did. That's a little much for even my palate!