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)

Why I love the UK

Bad breath has been good to me. I write these words in the lobby of the Thistle Marble Arch, near Oxford Street right next to Marble Arch and Hyde Park. I'm on my way home in a few minutes, after five days dedicated to the two-phase mouthwash which I invented and help develop, first in Israel, then in the UK. As I write, the invention (Dentyl pH) has become a hit here. One out of every five (!) mouthwash bottles sold in the UK is Dentyl pH.

I walk into drug stores all along Oxford Street, and stand beside my mouthwash bottles, admiring them as if they were some kind of progeny. No matter that I don't own the patent (the university does). No matter that the millions of people using it have no idea who invented it. The important thing is that they are improving their oral hygiene, self esteem, and social lives, rinsing and gargling with a product that I nutured for so many years, in the face of criticism and nay sayers.

The mouthwash story is one of pure luck, happenstance and chance. Louis Pasteur, one of my scientific heroes of all time, said that "Chance favors the prepared mind". If that's the case, then the only credit I can take is cherishing the unexpected. Most of the turning points in the development of this product were born out of accidents and flukey experimental results. Only very few inventions succeed in becoming products, and among those few products, most fail commercially. So the success of the mouthwash is rare indeed. And as someone with quite a few patents, and less-than-successful products, I know just how lucky I am.

I'm attaching a picture I took this afternoon of the 'baby' at a Boots store on Oxford Street.

The UK success has made me even more of an Anglophile. I love London, the Queen, the royal family (I've heard that the Queen may have a breath problem, I'd love to help her out, why doesn't she just ask me?). After all, I grew up as a British commonwealth subject in Ottawa, I collected coins displaying the Queen and her predecessors. I sang the British anthem at movies and football games. Actually as a child, I got the words wrong, thinking that the second part went:

"Send her Victoria, Happy and Gloria…"

I thought that these were the Queen's children, missing during the Second World War.

I've had a good trip, meeting reporters, explaining how the mouthwash works (at least how I think it works). This included a fancy Japanese lunch overlooking the Thames, and tea at Claridge's (including, inter alia, lavender flavored chocolate sweets, in honour of the Chelsea flower show). And an overnight train trip to Harrogate, an enchanting spa resort in Northern England.

Most important of course, as always, is meeting up with the friends I've made here over the past decade. A lovely island.

What I do for a living

People call me Mr. Bad Breath to my face, other things behind my back ("Honey, do you know what Mel Rosenberg actually does for a living? He sticks his nose into people's mouths and smells their breath!"). When I was that pudgy kid growing up in Ottawa, I originally wanted to be an astronomer. But I ended up doing my Ph.D. in microbiology. When I joined the dental faculty of Tel Aviv University as a young lecturer in 1982, I wanted to do something new, but didn't know precisely what. At the time we were commencing work on our two-phase mouthwash project and someone told me to check whether it worked against bad breath. I went to the library and found that very few academic scientists (Joe Tonzetich at UBC, Ken Yaegaki in Japan, and maybe one or two others) were working on this very common and embarassing problem. I remember coming home that night and telling my wife that I had stumbled onto my scientific future. Indeed, I've been very lucky. We developed a method for measuring the volatile sulfides associated with bad breath (the Halimeter) that is used in laboratories and clinics around the world. In addition, the reformulated two-phase mouthwash (Dentyl pH) has taken off in the UK and is a highly successful product there. I was also fortunate enough to write an article on bad breath for Scientific American in 2002. These days I'm on sabbatical, writing a book on bad breath (following two edited scientific texts) for the public, working on our new website (www.smellwell.com), and trying to get our anti-odor flavor ("Breathanol") into more products in more countries. In August, I'll be joining scientists from around the world at the 7th international conference on breath odor, which will be held in Chicago. This is especially exciting for me as I co-founded this society in 1996 with Prof. Daniel van Steenberghe, and we have watched it grow and develop. These days, Alon Amit and I are working on fixing the entry for bad breath in 'wikipedia'. The current one really stinks (literally as well as figuratively). It will be interesting to see whether they accept a more scientific, less commercial version. Stick around to find out soon.