Sunday, August 26, 2007

In our culture, it's a difficult thing to talk about.
--Patricia Lenton, University of Minnesota's School of Dentistry, on bad breath

And this is one of my dilemmas--do I, and how do I, talk to people about body odors?

I spend a lot of time with people in the closed quarters of a small exam room. Cigarette smokers who smoke in their cars reek of old smoke. I don't have any trouble discussing their habit with them. People who drink alcohol before their appointment smell strongly of that, and I always initiate discussions with them--especially if they're my first visit of the morning!

But people with B.O. so bad that I have to abandon the room for an hour or two lest future patients think that I smell of old sweat, well I just can't bring myself to mention that. Likewise bad breath.

I feel like it's my duty to do so, but mentioning another person's odor is so taboo, I still can't point this out to my patients.


Mauigirl said...

What always amazes me about situations like this (especially the BO) is, can't the person smell themselves? If I go one day without a shower, I notice it! Why can't they?

Femail doc said...

If you didn't know that you had BO, would you want your doc to tell you?

Apparently, these people can't detect their own odor. I can think of several patients whose sour sweat smell has gone on for years.

Jean said...

I feel if it can be in relationship to the visit, bring it up. Otherwise, I feel the pt. would be too embarrassed to return - although maybe that's the solution:)
As a retired dental assistant,we had many with BO and economics seemed to not always be a factor! "Uh, next time you brush and floss, do it in the shower, OK?"

Dr. Smak said...

I routinely bring it up to teenagers (particularly the clueless boys) but I have to admit, I usually cop out on the adults too.

In all honesty, sometimes with adults it's hard to identify the odor. Is it BO? Foot? That pervasive yeast scent that you can't identify the source of?

rlbates said...

I've never had the nerve to address it with anyone. Nor do I have the nerve to tell anyone they put on too much perfume.

Femail doc said...

Yes! The perfume thing. I have one older woman patient whose perfume smells like the ghastly cheap cologne that used to come in little girls' dress-up kits. I can hardly bear to be in the room with her. Ironically, I suspect she puts it on specially to 'dress-up' when coming to see me.

Mauigirl said...

A BO problem can be a hint of another incipient problem. So perhaps a doctor is really the only person who could have a legitimate reason for bringing it up. For instance, my husband's grandmother started having BO (not eye watering BO but noticeable) around when she was developing Alzheimer's Disease. (I think my mother-in-law had not yet started to go over there to bathe her as they hadn't yet realized she was not herself. But she probably had stopped bathing herself and this was a symptom of that.) But I know being a physician doesn't make it any easier to bring it up with somebody.