Sunday, June 07, 2009

Bacteria, bad breath, and oil pulling

I've been thinking about bad breath and mouth hygiene lately (and as soon as I get the big "L" off my forehead, perhaps I'll think about something fun). First of all, I wonder what to do about patients with bad breath--not the ones who complain of it who frankly never have bad breath on examination, but rather the clueless ones who have bad breath and don't know it. Should I say something to them? Perhaps I could include "Do you have bad breath?" in my review of systems during the annual physical, and if they answer "No," tell them "Not so fast on the negative buster!"

My latest foray into alternative medicine includes a month-long experiment in the Ayurvedic practice of oil-pulling. I'm not quite sure where I came across it, but it seemed like an intriguing way to use up a bottle of organic sesame oil sitting in my 'frig. First of an a.m. on an empty stomach, I sip but don't swallow a tablespoonful of sesame oil. As I bring in the paper, make coffee, empty the dishwasher, and do the little morning chores, I 'pull' the oil through my teeth or poke at the mouthful with tongue against teeth for (theoretically) 20 minutes or until my mouth is too full and I'm too grossed-out to go on which got up to 14 whole minutes today. Spit and rinse follows, then on to breakfast.

Testimonials abound on the Internet in support of the practice which, among other things, is supposed to enhance oral hygiene, and lessen tooth decay, bad breath, and dry lips. So far, one week into it, it only dampens my enthusiasm for breakfast and seems to make me less prone to eating the crap that drug reps bring in to the office (despite new Pharma regulations against the practice!).

An article in the Journal of the Indian Society of Pedodontics and Preventive Dentistry reported a study wherein 10 adolescent boys were somehow convinced to oil-pull in the a.m. for 10 minutes, and then their levels of streptococcus mutans (a bacteria associated with tooth decay) were compared with another group of 10 who swished instead of a morning with chlorhexidine mouth wash. Both groups experienced the same drop in levels of those s mutans bad boys.

But...I dare you to find a bunch of health nuts waxing poetic over the morning use of chlorhexidine mouthwash! Consider this on oil pulling from Molly of SanFrancisco: The really bad stuff that forms plague [sic], is very attracted to the acids in the oil. So it melts this bad stuff and then you spit it out. That's why your teeth get much cleaner than by conventional means, like alcohol based rinses. And so, when you melt this bad stuff, you simply spit it out..buh bye.

On now to my real story here which is breaking news from the first ever symposium on the microbiology of odors held last month in Philadelphia. Israeli microbiologists have developed a new saliva test called OkayToKiss that tests for the presence of certain enzymes produced by gram-positive bacteria (such as s mutans) that make it easier for gram-negative bacteria in the mouth to break protein into malodorous compounds.

The doc-in-charge of the research, Dr. Mel Rosenberg, is described as an "international authority on the diagnosis and treatment of bad breath." He invented a two-phase mouthwash (containing saline and oil) based on his studies of petroleum microbiology wherein he discovered that oral microorganisms from dental plaque when mixed with nontoxic oils became bound to the oil. Voila! Does that not sound like a variation on oil-pulling to you? Check out melrosenberg.com if you want a ton of technical on the process. And the 1-2 mouthwash known as Assuta bested Listerine with respect to longterm control of halitosis.

So back to this OkayToKiss test. Due out next year, this pocket-sized test I gather is a treated piece of paper that you lick and check. If it turns blue, keep your mouth to yourself. This Dr. Rosenberg is a kick--don't miss his smellwell site for more ideas on keeping fresh as a daisy.

September, 2009 update: Still oil-pulling. I can last 15 or more minutes at it, no problem. Teeth so white that my 20-something year old daughter who commented below about how gaggingly gross this sounded is now doing it herself. My first visit with the dental hygienist post oil-pulling is next month; I'll let you know how I fare.

11 comments:

Reality Man said...

Mindful pulling? Seems like the "L" word, or something like it, works for most who are concerned about it. It would be interesting to know some hard figures on actual decrease in tooth decay.

kenju said...

I have been plagued with bad breath for years and in spite of the fact that I brush well, floss, use the interdental brush & use mouthwash, it comes back rapidly.

Your last link doesn't work.

femail doc said...

RM: My mouth is so full of fillings courtesy of Kletsky, DDS that I won't be able to know if oil pulling stops decay. If people start commenting on my sparkly whites, however, I'll let you know.

KJ: Give oil pulling a try and let me know? It certainly is different. Thanks for heads up on bad link; it's fixed now.

Armouris: Speaking of bad links, your Mind Your Breath didn't work so I'm rejecting your comment. Please come back with a working link!

Anonymous said...

You say the L on your forehead???I dont get it....maybe mine is D for dense...idk
Anyway, the asians are best known for their interpretation of smells, especially bad breath , and are very adept at interpreting the illnesses associated with breath.... they also check the poop regularly and urine....It is part of their training and the experts practicing are as good or better than cancer sniffing dogs.... (I saw one doctor on a special quite awhile back who had his patients breath into a tube which he sat there and smelled to diagnose.....ha, and you complain!) I am sure a google could turn up someone... or a few well placed inquiries in CAM or acupuncture,TCM, hang outs...
I am sorry , i dont see anything new with this mel rosenberg.... the same ole, to me....
I recently did see where some people get some kind of smelly deposits on the back of their throats on the tonsils that really are killers....

I have never heard of using seseme oil for this purpose... it is used in asian medicine as a calming sedative in aroma and internally.....
The asians highly recommend alkalizing the body, which herbal formulas tend to do, as a means to health...
Ive noticed people with chronic bad breath have digestive problems, , sometimes pancreatic indicators....but most certainly in need of reexamining their eating habits etc....

judycolby said...

Did you know that Cushing's patients quite often have weird smelling breath at times? I've always presumed it was when the cortisol was the highest.

Erica said...

I feel like maybe the first part of this blog (about the patients who have bad breath who do not seem to be aware of it) could have been about me. You wrote it just a few days after I had come in to see you about something else, and I KNOW I have bad breath, at least quite a bit of the time. It is a side effect of being in Ketosis after bariatic surgery. I carry mints and mouth spray around with me, but so often it doesn't help. Any suggestions would be greatly appreciated. P.S. I'm also curious about the "L" on your forehead????

femail doc said...

Hi Erica, Well actually it wasn't about you. I remember that visit and the problem you had but I didn't note anything about your breath (that post-bypass ketone breath must be a real bummer after all that work to improve your weight, your health, and your overall appearance!). I should think it would be improving now that the rapid weight loss phase is over. Try this oil-pulling thing--it sure has made my teeth brighter although I don't think it will ever do all the extraordinary things that some claim on internet sites. It would not improve a ketosis situation, but again, hopefully you're past that.

L on the forehead is for loser--was a popular saying for awhile but one is probably a loser for using that expression now that it's no longer in vogue.

Anonymous said...

Mom, the thought of pulling a tablespoon of oil through my mouth for twenty minutes honestly makes me want to barf.

Anonymous said...

I have chronic halitosis and I am quite isolated, and a social outcast. I brush, toongue scrape, and floss. people talk about me really bad and I'm greatly depressed, just short of suicidal. No Dr. Or dentist cares to follow through in helping me. I'm on my second day of trying this. I will say my tongue seems less coated. I used coconut oil because I routinely battle with yeast. I even suspect that could be part of the problem. My bad breath is not an occassional nuisance. It is a personal hell. So far certain kinds of alcohol is the only thing that stops on for a little while. This has caused a new major problem. We really need some sort of doctor that specializes in cures for odors and such. I'm sure people have killed the self over the alienation. This is not to be taken as lightly as many "normal" people jest. With "regular" disease you get sympathy. With this you get disgust and socially stoned with cutting remarks and giggles of misunderstanding.

Anonymous said...

U r not alone I have suffered since age 15 just woke up with offensive breath out of the blue. I can relate to the comments lack of understanding and isolation. Since I have been holistic for the past couple of years and stopped using Fluoride it is much better. There are a few days that the offensive breath has returned. Been doing the oil pulling for about a week and it seems my breath has gotten worst, to top it off I went to a job interview today. Have had tonsils stones since 15 yrs old did not know what they were till 14 yrs ago. No boyfriend I do not even flirt with guys when they are clearly flirtin w/me. I do not want to smell my own breath let alone some man w/smelly breath so I will probably never marry. Havn children is out of the question for fear that i might pass this breath to a child is just mean and evil

Anonymous said...

I am in the same breath boat. Yuk! I, however, have decided to start oil pulling. Also I seem to be getting benefits in the odor and health departments by drinking Bragg's Organic apple cider vinegar, I add two tablespoons an about a quarter teaspoon of baking soda to an eight ounce glass, then add mineral water and mix. The ACV and it has to be the one with the 'mother' in it is acidic but turns to alkaline in your system. Most people don't have enough alkaline in their body naturally, so the baking soda sort of gives it a jump start. It also helps in not bothering your tooth enamel as straight vinegar would. This organic apple cider vinegar has good bacteria in it and it helps to detoxify your system. It can also lower blood pressure and help with blood sugar and has many, many health benefits. Talk to your doctor about it. I feel and smell much better since just using my first bottle this month. Good Health and Good Luck!