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Curing Halitosis: 3 New Profit Centers

by Dr. Richard Miller

Forget the mouthwash; forget the gum; forget the mints. This is a real professional CURE, not a treatment; and, it doesn’t depend on products to be successful. Never heard of a cure for halitosis? It’s not surprising. Search for “bad breath” on the ADA website and all you’ll find are antiquated recommendations – brush and floss, avoid odorous foods, and see your dentist, none of which will help halitosis. Even professional strength mouthwashes have limited effectiveness and cannot eliminate the cause of the problem.

For almost 30 years, the National Breath Center® has cured thousands of people with chronic halitosis using an evidence-based approach of hands-on professional treatment that can now be incorporated into any dental practice. But what makes this so appealing, aside from creating 3 new profit centers is that you’ll never find a more grateful patient than one you cure of severe bad breath.

Here’s more good news. Research shows that halitosis affects 22-50% of the population to some degree; dollar-wise, the market for fresh breath is huge – over $10 Billion each year, expected to be $23B by 2026; and, wanting fresh breath or freedom from bad breath is a social necessity in our culture. So, offering fresh breath something everybody wants – to a huge market is a win-win situation.

Medical Problem or Myth?

So why isn’t a cure for halitosis commonplace? For dentists, it’s the fear that halitosis is a medical problem, not a dental one. Yet the research is very clear – over 90% of all halitosis is of oral origin (the other 10% is easily distinguished during an odor exam); that bad breath is predominately made up of Volatile Sulfur Compounds (VSCs) produced by mostly anaerobic bacteria living in the biofilm on the tongue and to a lesser extent, under the gums.

But doesn’t bad breath come from the stomach? Rarely. Researchers agree that a constant production of moving up the esophagus – a closed, flat tube – is nearly impossible. So, remove the biofilm, keep it from returning and you have a reproducible cure.

Efficient, Effective, and Hygiene Driven

To incorporate professional halitosis elimination and prevention into a dental practice, you need to remove the biofilm and address the other contributing factors – everything that contributes to bacterial activity. Here are the three cornerstones for successful treatment:

• Tongue Rejuvenation®, the total and verifiable elimination of all tongue biofilm

• 5 Biofilm Removal Instruments™ (BRI) designed exclusively for the efficient elimination of biofilm and,

• The Total Cure™ – non-medical intervention of extra-oral contributing factors.

In combination, this technique is so successful and predictable that any office can offer a money-back guarantee as we have. That alone brings new patients into the practice.

3 New Profit Centers

The same principles used to cure new patients with severe bad breath, allow two other profit centers – the Forever Fresh® program, for existing patients who want to be assured of fresh breath for months to come; and the Forever Fresh Plus™ program for existing dental patients with noticeable breath odor. Simple presentation techniques and reasonable fees – $35-$85 for 10 minutes at a recall visit – allow a dental hygienist to add hundreds daily to the bottom line. And, the Forever Fresh Plus program – like that for new patients with severe halitosis – can result in treatment in the thousands.

What follows is a typical patient who had Tongue Rejuvenation® and the Total Cure™ in July 2017 and returned 2-½ years later while visiting a relative.

Case Report

This patient presented in July 2017 from San Francisco. Before coming for treatment, she had seen her family physician, an ENT, and two dentists, all who “found no reason for my mouth odor”. During the interview, she complained of having bad breath for many years and that it was now affecting her social life: “people I have dated have broken up with me because of my breath” she stated. She also had tried “every mouthwash available” but nothing worked. She was obviously distressed.

Her health history was unremarkable, and she was not taking medication. A comprehensive oral and odor examination was performed and she was diagnosed with severe halitosis. Her initial photographs show a yellow brown biofilm covering about 50% of her tongue. Note the thickest biofilm in the posterior quarter with lesser amounts forward (Figure 1). An intra-oral photo of the posterior area also shows near total coverage of the tongue anatomy by biofilm (Figure 2).

Note: A comprehensive oral and odor examination is done at the initial visit to identify every possible factor contributing to odor and biofilm buildup In addition, gingival condition is assessed for bleeding on probing. Testing includes a breath sample analyzed using a gas chromatograph (Oral Chroma) that measures three of the most common Volatile Sulfur Compounds (VSCs) in halitosis. Other tests are organoleptic testing and two gauze tests specific to tongue biofilm.

Readings from the Oral Chroma (Figure 3) were all high and measured 2.5 times cognitive threshold of hydrogen sulfide, H2S; 3 times threshold of methyl mercaptan, CH3SH ; and almost 2 times threshold of dimethyl sulfide, (CH3)2S. (Cognitive threshold is the level, above which, a particular odor is noticeable by the human nose).

Long Term Results

In December 2019, 2-½ years later, she returned for a maintenance visit. The first photo (Figure 4) shows her tongue at the outset of the visit. Note the near complete absence of biofilm. The Oral Chroma (Figure 5) was also done before any treatment and showed no odor molecules present. The second photograph (Figure 6) was taken after Tongue Rejuvenation® of just a few minutes.

The Total Cure™ has a success rate of 100% when the patient follows the assigned home care routines. This is an excellent example of how a patient can maintain the Total Cure™. If the patient is not able to maintain biofilm elimination, tongue maintenance visits can be performed during regular recall visits.

Conclusion

Since over 90% of halitosis is oral, using specially developed instruments and following proven protocols, the elimination of chronic halitosis can become a valuable service for a large number of new patients and a large profit center for the dental office. And due to the universality of wanting fresh breath, existing dental patients can also benefit from two programs – Forever Fresh® and Forever Fresh Plus™ – that can assure them of fresh breath for months to come.

The tools, techniques, and research are all in place. Dentistry now has the opportunity to take bad breath off the pharmacy shelf and put it in the dental office where it belongs. Are you ready for the challenge?

After all, who wants fresh breath? Everyone!

*All references can be found in Breath Odors by Sterer and Rosenberg. Springer 2011.

 

Dr. Richard Miller


Since founding the National Breath Center in 1993, Dr. Richard Miller has made the treatment and elimination of chronic bad breath the cornerstone of his dental practice. He has presented his findings at 9 major dental meetings and 25 private seminars along with publication in professional journals and media appearances. In almost 3 decades of eliminating halitosis, he has established the effectiveness of protocols that eliminate bad breath and keep it from returning. 703-587-0400 • richardamillerdds@outlook.com


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