The Secrets About Halitosis

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Wendy Parker, RDH

The Secrets About Halitosis

Before we even start trading secrets, what is Halitosis?  Halitosis is the fancy word for “Bad Breath.”  We’ve all had it at one point or another.  Whether that is morning breath, when we’ve forgotten to brush, or when we’ve eaten something with a strong taste.  Whether temporary or permanent, bad breath comes to everyone.  So let’s talk about the secrets of where it comes from, why we get it, and most importantly, how to get rid of it!

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Bad breath can come from several sources.  Here’s a list of some of the most common ones:

  • Tooth decay or / and gum disease such as gingivitis
  • Dentures and bridges
  • Mouth sores
  • Dry mouth
  • Post-nasal drip and congestion of the nasal passages
  • Food stuck between the teeth
  • Coating of the tongue caused by a build up of bacteria
  • Infection of the throat and tonsils
  • Sinusitis
  • Nasal polyps
  • Bronchitis or pneumonia
  • Acid reflux and GERD
  • Chronic constipation
  • Digestive problems and stomach ulcers
  • High-protein diet that includes fish, cheeses, and meats
  • Foods that are strong smelling or spicy such as onions and garlic, exotic spices (ie. curry)
  • Supplements, such as Fish Oil Capsules
  • Low Carb Diets – causing “Ketone breath” as a result of the low carb consumption causing the body to burn fat as it’s energy source which then causes an end product of the body making ketones, which causes a fruity acetone-like odor when exhaled
  • Certain medications
  • Smoking
One of the most common reasons people have halitosis is due to a condition called “Black Hairy Tongue” or a coated tongue.  It sounds scary and unusual, but it’s something that can be cured quickly.
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The bacteria build up on tiny rounded projections called papillae which are on the surface of the tongue, also known as tastebuds. These papillae grown longer catch all the food and bacteria in the mouth.  Without brushing your tongue or removing the bacteria, it can embed in the tongue and causing a coating.  Black hairy tongue is caused by bacteria or fungi in the mouth, which make the tongue to appear black and hairy.

Certain lifestyle habits and conditions can make people more likely to develop black hairy tongue. They include:

  • poor oral hygiene
  • smoking tobacco
  • drinking a lot of coffee or tea
  • using antibiotics (which may disrupt the normal balance of bacteria in the mouth)
  • being dehydrated
  • taking medications that contain the chemical Bismuth (such as Pepto-Bismol for upset stomach)
  • not producing enough saliva
  • regularly using mouthwash that contains peroxide, witch hazel, or menthol
  • getting radiation therapy to the head and neck

Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive.

Now that we learned about Halitosis and Black Hairy Tongue, here are tips and tricks to getting rid of it:

Gently brush your teeth twice a day with a soft toothbrush, but more importantly, don’t forget your tongue!!! Start at the back of your tongue and scrape forward, being sure not to scrub the tongue and embed the bacteria even further.   You can use a tongue scraper to make sure you’re thoroughly cleaning the area. Be sure to come in for your regular check up and cleanings so that your friendly hygienist can help you too!  Soon, the coating will go away and so will the bad breath.

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If you find that you have consistent bad breath you can try our other tips:

  • If you smoke, quit.
  • Add more roughage to your diet. Soft foods won’t clean off the tongue effectively.
  • Drink plenty of water throughout the day to help keep your mouth clean.

Natural home remedies include:

  • Fenugreek should be consumed in the form of a tea made with one teaspoon of fenugreek seeds in one liter of water. Simmer till the water is infused and strain before drinking. When consumed regularly, fenugreek seeds are an excellent home remedy for halitosis.
  • Making a tea or infusion with fresh parsley or cloves is also a good way to treat bad breath. Simply boil water with freshly chopped parsley and drop in a few cloves to the mix. Cool the mixture and strain before using it as a natural mouthwash after eating. There have been numerous studies supporting claims about the efficacy of cloves and clove oil in dental care.
  • include fresh vegetables, fruits and grains into your daily diet.
  • increase your intake of Vitamin C from foods
  • include guava in your diet

An individual should consult their physician for a diagnosis if they have

  • persistent dry mouth
  • sores in the mouth
  • pain with chewing or swallowing
  • white spots on the tonsils
  • Fever
  • any other symptoms of concern

Call your doctor or dentist if the problem doesn’t get better on its own. Your doctor may prescribe antibiotics or an antifungal drug to get rid of the bacteria or yeast. Topical medications, such as tretinoin (Retin-A), are also sometimes prescribed. As a last resort, if the problem doesn’t improve, the papillae can be surgically clipped off with a laser or electrosurgery.

Hopefully this let you in on some of our secrets to a happy healthy mouth!  Happy brushing and breathing everyone!

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources: 

http://www.webmd.com/oral-health/guide/black-hairy-tongue

http://www.home-remedies-for-you.com/remedy/Halitosis.html

http://www.emedicinehealth.com/bad_breath_halitosis/page4_em.htm

What is Vaping Anyways? An Examination of Electronic Cigarettes

Kara

Kara Johansen BS RDH

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What are electronic cigarettes?

Electronic cigarettes are also known as ENDS (electronic nicotine delivery system), electronic cigarettes, or E-cigs. “Electronic cigarettes are designed to look like cigarettes, right down to the glowing tip. When the smoker puffs on it, the system delivers a mist of liquid, flavorings, and nicotine that looks something like smoke. The smoker inhales it like cigarette smoke, and the nicotine is absorbed into the lungs. The e-cigarette is usually sold as a way for a smoker to get nicotine in places where smoking is not allowed.” (www.cancer.org) When people use ENDS it is sometimes called vaping

E-cigs have a vaporization system, rechargeable batteries, controls and areas to refill the liquid for vaporization. The ENDS can contain between 6mg to over 100 mg of nicotine.  Nicotine can be lethal in large amounts, 0.5-1.0 mg per kj of weight of the person. Because the products contain nicotine they can cause dependence and addiction. The chemicals used in the liquid for vaporization is not fully known. The products are not labeled or stated on the bottles.

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ENDS are usually shaped to look like “conventional” tobacco products like cigarettes, cigars, cigarillos, pipes, hookahs or shishas. Some companies make them to look like ordinary pens, or USB memory sticks to make them more discrete. (The World Health Organization http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/)

Why do people use electronic cigarettes?

Electronic cigarettes are on the rise throughout the world and in the United States. Here are some “commonly reported reasons for use: to quit smoking, to avoid relapse, to reduce urge to smoke, or as a perceived lower-risk alternative to smoking. Few studies, however, have explored whether electronic cigarettes (e-cigarettes) deliver measurable levels of nicotine to the blood. ” (Carcoran O., Dawkins L, 2013) This means that without measurable levels of nicotine in the blood it may not be an effective tool to quit smoking.

According to the US Centers for Disease Control and Prevention (CDC) the percentage of highschool and middle school students who have used electronic cigarettes has doubled from 2011 to 2012. Highschool increased from 4.7% in 2011 to 10% in 2012 and middle school increased from  1.4% to 2.7%. The National Youth Tobacco Study found that by 2012 more than 1.78 million middle and high school students in the US had tried e-cigarettes. (CDC, 2013)

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“ENDS use is expanding rapidly despite experts’ concerns about safety, dual use and possible ‘gateway’ effects. More research is needed on effective public health messages, perceived health risks, validity of self-reports of smoking cessation and the use of different kinds of ENDS.” (Pepper JK, Brewer NT http://www.ncbi.nlm.nih.gov/pubmed/24259045) This statement is from a study completed in 2013. It is saying that even though experts are worried that it ENDS may not be safe and can lead to drug abuse of other substances the sales of E-cigs are increasing.

“The primary concern is whether e-cigarettes have the capability of introducing nonsmoking youth to cigarette smoking,” said Thomas J. Glynn, PhD, American Cancer Society’s director of cancer science and trends and international cancer control. “Will we have new cigarette smokers out of this? A very clear message is that we are very much in need of FDA (US Food and Drug Administration) regulations that will limit access to e-cigarettes to youth.”(Simon, 2013)

Acting through the Family Prevention and Tobacco Control Act of 2009 the FDA is working on creating regulations for the ENDS products. The FDA will require that electronic cigarettes label what is in the product, and how they can market and sell the ENDS. A few states have set regulations on selling and promoting e-cigarettes to ages 18 and younger, however, it is not illegal to sell ENDS to youth in most states. (Simon 2013) The producers of e-cigs are marketing to children, creating products that are meant to taste like candy.

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Are Electronic Cigarettes Safe?

“The safety of ENDS has not been scientifically demonstrated.

The potential risks they pose for the health of users remain undetermined. Furthermore, scientific testing indicates that the products vary widely in the amount of nicotine and other chemicals they deliver and there is no way for consumers to find out what is actually delivered by the product they have purchased.

Most ENDS contain large concentrations of propylene glycol, which is a known irritant when inhaled. The testing of some of these products also suggests the presence of other toxic chemicals, aside from nicotine. In addition, use of these products -when they contain nicotine can pose a risk for nicotine poisoning (i.e. if a child of 30 Kilos of weight swallows the contents of a nicotine cartridge of 24 mg this could cause acute nicotine poisoning that most likely would cause its death) and a risk for addiction to nonsmokers of tobacco products. Nicotine, either inhaled, ingested or in direct contact with the skin, can be particularly hazardous to the health and safety of certain segments of the population, such as children, young people, pregnant women, nursing mothers, people with heart conditions and the elderly. ENDS and their nicotine cartridges and refill accessories must be kept out of the reach of young children at all times in view of the risk of choking or nicotine poisoning.

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As ENDS do not generate the smoke that is associated with the combustion of tobacco, their use is commonly believed by consumers to be safer than smoking tobacco. This illusive ‘safety’ of ENDS can be enticing to consumers; however, the chemicals used in electronic cigarettes have not been fully disclosed, and there are no adequate data on their emissions.”

http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/

A study done by the FDA found cancer-causing substances in half the e-cigarette samples tested. Other impurities were also found, including one sample with diethylene glycol, a toxic ingredient found in antifreeze.

Studies have shown that e-cigarettes can cause short-term lung changes that are much like those caused by regular cigarettes. But long-term health effects are still unclear. This is an active area of research, and the safety of these products is currently unknown. (http://www.cancer.org/cancer/cancercauses/tobaccocancer/questionsaboutsmokingtobaccoandhealth/questions-about-smoking-tobacco-and-health-e-cigarettes)

 

Conflicting View Points

Dr. Thomas J. Glynn MA, MS, PhD, who is the director of Cancer Science and Trends and director of International Cancer Control for the American Cancer Society from the American Cancer Society created list of reasons why people favor e-cigarettes and why they oppose to their use.

Those who favor e-cigarettes list as benefits:

  • Their ability to deliver nicotine to the user without many of the other 7,000+ chemicals in a regular, burned cigarette;
  • Their absence of secondhand cigarette smoke;
  • Their resemblance to regular cigarettes, which provide the tactile and visual sensations – holding them in a certain way, a glowing tip, blowing smoke, etc. – that many cigarette smokers have become used to, or even psychologically dependent upon; and
  • Their potential for aiding cigarette smokers to who wish to quit to do so.

 Choice between cigarette and e-cigarette

Those with concerns about e-cigarettes warn of:

  • Lack of scientific data about their safety. Simply put, e-cigarette users cannot be sure of what they are inhaling, since e-cigarettes have not been subjected to thorough, independent testing and, due to their manufacture by many different companies, there are no quality assurances in their production processes;
  • Lack of scientific data about their effectiveness as quit-smoking aides;
  • Lack of scientific data regarding their ability to deliver enough nicotine to satisfy withdrawal effects;
  • Lack of scientific data about the effect of secondhand vapor from e-cigarettes;
  • Lack of scientific data about whether the use of e-cigarettes encourages smokers who might have otherwise quit to continue smoking and only use e-cigarettes when they are in no-smoking environments; and
  • Lack of scientific data about whether youth may use e-cigarettes as an introduction to smoking regular cigarettes.

In the end one can clearly see the controversy over wether or not ENDS are good or bad.

Can I use ENDS to help me quit smoking?

“The efficacy of ENDS for helping people to quit smoking has not been scientifically demonstrated.

ENDS are often touted as tobacco replacements, smoking alternatives or smoking cessation aids. But we know that for smoking cessation products to be most effectively and safely used, they need to be used according to instructions developed for each product through scientific testing. There are no scientifically proven instructions for using ENDS as replacements or to quit smoking. The implied health benefits associated with these claims are unsubstantiated or may be based on inaccurate or misleading information. When ENDS are used as cessation aids, they are intended to deliver nicotine directly to the lungs. None of the approved, regulated cessation aids, such as nicotine patches and chewing-gum, delivers nicotine to the lungs. Therefore, the biological mechanism by which smoking cessation might be achieved by delivery of nicotine to the lungs and its effects are unknown. Delivery to the lung might be dangerous. Therefore, independently of the effects of nicotine, it is of global importance to study lung delivery scientifically.

The dose of delivered nicotine is also unknown. It is suspected that the delivered dose varies notably by product, which contain nicotine in various quantities and concentrations.”

http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/

 

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In Conclusion-

An article found on the US National Library of MedicineNational Institutes of Health looked at how ENDS awareness increased from 16% to 58% from 2009 to 2011, and use increased from 1% to 6%. The article included data gathered from 49 other studies. The majority of users were current or former smokers. Many users found ENDS satisfying, and some engaged in dual use of ENDS and other tobacco.

No longitudinal studies examined whether ENDS serve as ‘gateways’ to future tobacco use. Meaning no studies have been completed that extend long periods of time. Some longitudinal studies are decades of gathered data. ENDS are a new product. There is no way to tell the long term effects of electronic cigarettes on the human body until one of these studies is completed. Self-reported survey data has been completed. Meaning people using the product filled out a questionnaire which includes their feelings and beliefs. These studies have validity problems. Prospective trials  and self-reported surveys suggest that ENDS might help cigarette smokers quit, but no randomized controlled trials with probability samples compared ENDS with other cessation(quitting smoking) tools. Randomized controlled trials are the only reliable research worthy of trusting.  (Pepper JK, Brewer NT http://www.ncbi.nlm.nih.gov/pubmed/24259045)

The World Health Organization states “Until such time as a given ENDS is deemed safe and effective and of acceptable quality by a competent national regulatory body, consumers should be strongly advised not to use any of these products, including electronic cigarettes.”

In conclusion reliable, independent, randomized controlled research needs to be conducted to solidify the pros and cons of electronic cigarettes. There is simply not enough information as to whether vaping is safe to use or a good tool to decrease or end smoking. Our public health choices and policies need to be decided upon fact. As for my health and the health of our patients I will wait or advise a patient to wait to use an electronic cigarette.

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Want more info?

Want to learn more? Visit us at http://www.northstapleydentalcare.com/

Sources:

Carcoran O., Dawkins L, Acute electronic cigarette use: nicotine delivery and subjective effects in regular users. Psychopharmacology (Berl). 2014 Jan;231(2):401-7. doi: 10.1007/s00213-013-3249-8. Epub 2013 Aug 27. http://www.ncbi.nlm.nih.gov/pubmed/23978909

Centers for Disease Control and Prevention. Electronic Cigarette Use Among Middle and High School Students—United States, 2011-2012. Morbidity and Mortality Weekly Report. September 6, 2013
*(Etter, JF, Bullen, C, Flouris, AD, Laugesen, M, and Eissenberg, T “Electronic Nicotine Delivery Systems: A Research Agenda, Tobacco Control Online First, March 17, 2011 as 10/1136/tc.2010.042168).
http://www.cancer.org/cancer/news/expertvoices/post/2011/05/03/electronic-cigarettes-e28093-boon-bane-blessing-or-boondoggle.aspx

Glynn T. MA, MS, PhD, Electronic Cigarettes – Boon, Bane, Blessing, or Boondoggle?, (May 6, 2011), http://www.cancer.org/cancer/news/expertvoices/post/2011/05/03/electronic-cigarettes-e28093-boon-bane-blessing-or-boondoggle.aspx

Pepper JK, Brewer NT, Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review. (2013 Nov 20). Gillings School of Global Public Health, University of North Carolina, , Chapel Hill, , North Carolina, USA. doi: 10.1136/tobaccocontrol-2013-051122.  http://www.ncbi.nlm.nih.gov/pubmed/24259045

Questions and answers on electronic cigarettes or electronic nicotine delivery systems (ENDS) (9 July 2013) http://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/

Simon S. Electronic Cigarette Use Doubles Among Teenagers. (9-9-2013) http://www.cancer.org/cancer/news/news/electronic-cigarette-use-doubles-among-teenagers

Image Sources:
#2  https://student.societyforscience.org/article/dangerous-rise-electronic-cigarettes

#3 http://www.drugfree.org/join-together/tobacco/use-of-e-cigarettes-among-middle-and-high-school-students-doubles

#4  https://student.societyforscience.org/article/dangerous-rise-electronic-cigarettes

#5 http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm

#6 https://student.societyforscience.org/article/dangerous-rise-electronic-cigarettes

#7 http://ehealthmd.com/content/want-learn-how-quit-smoking-webquit-study-offers-free-online-smoking-cessation-help#axzz2xHfAcGUy

#8 http://www.nih.gov/health/clinicaltrials/basics.htm

 

Want to learn more? Visit us at http://www.northstapleydentalcare.com/