Up to 50 percent of the U.S. population reports that their own ?bad breath? has concerned them during some point in the course of their lifetime. Half of this group is indeed likely to have an ongoing sporadic or a chronic breath malodor problem. This report looks at the phenomenon of malodorous breath, which oddly persists in a society rife with scientific and medical advancements. Also reviewed are the primary causes, diagnoses, treatments and research frontiers.

This manuscript summarizes the findings of a literature review on the use of peroxide-based tooth whitening agents in children and adolescents. Safety considerations including localized adverse effects and toxicological concerns are described. Oral findings include: (1) one in every two to three patients may experience tooth sensitivity and/or gingival irritation after bleaching treatment, which may be more traumatic an experience for children than adults; (2) depending on dose, duration, frequency and route, studies indicate excessive exposure to peroxide can be potentially harmful; (3) degree of potential toxicity and harmful outcomes increases in those who overuse whiteners?a concern in teenagers; (4) careful case selection using stringent criteria is suggested for primary teeth whitening; (5) whitening in healthy adolescents is a case-by-case determination that must include the weighing of risks (oral health and age) vs. benefits (improved esthetic perception). It is hoped that the present review will lead to a better understanding of the health implications of tooth whitening in children and adolescents, and provide guidance for treatment that provides satisfactory outcomes externally (enamel and gingiva) and internally (endodontic tissues and systemic health

abstract Objective: Recently, a novel paint on liquid whitening gel Colgate'' Simply White Clear Whitening Gel which contains 18% carbamide peroxide, has been developed as a self administered tooth bleaching system. The put pose of the present study was to determine the efficacy. and safety of this product listing alternate exaggerated or simplified treatment regimens. Methodology: This was a three week clinical trial using a parallel, double blind, stratified protocol with three different Instructions for application: 1) twice daily, no air drying, and 15 minutes without eating/drinking, 2) three times daily, 30 second air drying and 30 Minutes without eating/drinking; or 3) four times daily, 30 second air drying and 30 minutes without eating,/drinking One hundred and twenty (120) healthy volunteers were balanced into three equal groups based on gender, age and shade scores (A3 or darker). Clinical evaluations (shade guide, oral tissue health, gingival index and visual analog sensitivity score) were performed on each group at baseline and weekly for the next 21 days. At the conclusion of the study, a survey of the subjects'' opinion on their assigned product regimen was also conducted. Results: Subjects who used Colgate Simply White Clear Whitening Gel three and four times daily achieved the greatest improvement (5.88 ±1.53 shades, and 5.57 ± 1.54, respectively). However, these values were only about one shade better than the value observed for the more convenient, twice daily, "no dry" regimen (4.5 1 ± 1.77 shades), though they were statistically significant (p < 0.05). The result for the four times daily protocol was not statistically different from the three times group. Also, no statistical differences were detected between the groups concerning oral tissue health, gingival index or tooth sensitivity, and no adverse effects were observed or reported regardless of the regimen used. Surveys completed by the subjects showed that those who used the twice daily, "no dry" regimen found the product to be the easiest to use, the most comfortable and the most pleasant tasting. Conclusion: It can be concluded from the clinical data that three or four applications of Colgate Simply White Clear Whitening" Gel per day provided better efficacy. In addition, the use of the whitening gel twice daily, even without "dry time" and only 15 minutes without eating/drinking, yielded results that were comparable to previously reported results using the original on label direction. The potential additional benefit to the "simplified regimen" is that it was perceived to be the most convenient and comfortable. The use of Colgate Simply White Clear Whitening Gel up to four times daily for up to three weeks is also safe, and the tendency of'' abusing the product with more frequent daily use may be deterred by the inconvenience reported by the study subjects. J Clin Dent 2004

Abstract Background. Natural herbal products are being used by increasing numbers of Americans for general and oral health care. A number of these products, however, have undergone little rigorous testing as evidenced by the relatively few scientific studies found in the literature evaluating their safety and efficacy. This in vitro study evaluated the antimicrobial potential of 14 natural herbal dentifrices. Methods. A diffusion method was used to evaluate the antimicrobial effectiveness of 14 natural herbal dentifrices on three oral bacteria (Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus) and one fungus (Candida albicans). A non-herbal dentifrice, Colgate Total, and sterile pyrogen-free water served as the positive and negative controls, respectively. The experiments were conducted in triplicate at full strength and at 1:1 dilution. The zones of inhibition were measured at 24 and 48 hours to evaluate the antimicrobial potential of the dentifrice. Results. Six of 14 herbal dentifrices evaluated were effective in inhibiting the growth of all four microorganisms tested. Colgate Total produced significant sizes of inhibiting zones for all four microorganisms, while no inhibiting effect was observed with the negative control. Six of the 14 herbal dentifrices produced larger inhibition zones than the positive control against A. viscosus. Six of 14 herbal dentifrices were inhibitory against C. albicans at full strength, but at 1:1 dilution, 11 of 14 had negligible effect on C. albicans. One dentifrice produced microbial growth around and over the samples, indicating possible microbial contamination of the toothpaste. One of the herbal dentifrices showed consistent antimicrobial activity against all four microorganisms. Conclusions. The variation in antimicrobial inhibition among the 14 herbal dentifrices tested indicates a need for more research to validate effectiveness claims of herbal oral health care products. Clinical Implications. This study, which investigated the antimicrobial potential of commonly available herbal dentifrices on the market, provides dental practitioners insight into the claims of antimicrobial effect of these herbal dentifrices in contrast to their detected antimicrobial effect.

People have been concerned about ?bad breath,? or halitosis, for a long time. More than 2,000 years ago, Hippocrates suggested a rinse using herbs and wine be used to sweeten the unpleasant odors of the breath.1 While up to half of the adult population is estimated to be affected by real or perceived halitosis at some time or another,2,3 one-quarter may have this problem chronically to the extent that others have ?trouble enjoying their company.?3,4 These estimates are difficult to validate, however, as many who readily admit breath malodor have none, while those who deny experiencing any significant breath problems are actually suffering from it5 We?ve all known the latter type, and putting oneself in the place of one who unknowingly inflicts others feeds our social paranoia. Thus it is no surprise that over the decades, the public?s concerns over their own potential oral odors have not decreased, even while dental health has improved. These concerns continue to spawn ingenuity in the breath-freshening industry. For example, in 2002, Time magazine hailed Listerine?s PocketPaks?the first breath strips that dissolved on the tongue?as one of their ?Products of the Year,? along with breakthroughs such as the birth-control patch.6 Meanwhile, diagnostic devices, usually used in dental offices and research studies, are available to measure odor-producing chemical compounds in the breath. In the United States, estimates are that we spend $1 to $3 billion a year for gum, mints, and breath fresheners,7,8 and there?s no sign of the popularity of these products dissipating any time soon. The joke is on the consumer, however, when a product (e.g., Altoids, etc.) contains sugar, as this feeds bacteria, furthering odor-production just as the mintiness dissipates. Also, alcohol-containing rinses can dry out the mouth, re-establishing an odor problem soon after their fragrance is gone. One report claims that even sugarless gum has been shown to slightly increase the production of methyl mercaptan (smells of feces).9 So when over-the-counter (OTC) fresheners fail, it is not uncommon for some to consult with or at least mention it to a doctor of dental medicine or surgery. Dentists get lots of education about treating teeth, but could probably learn more about malodor. In 2001 one dental conference established some best practices regarding oral malodor evaluation.3 A few years later, the ADA Council on Scientific Affairs released its 2003 ADA Seal Acceptance Program Guidelines for Products Used in the Management of Oral Malodors, in which an example of a scale for odor assessment is found.10 These guidelines will protect the public by assuring that ADA Seal products that make malodor control claims will meet strict criteria by mid-2005. Yet, some dentists still complain that the profession has yet to agree upon a standard assessment of halitosis.11 Before the dust settles on assessment protocols or the which products will end up bearing the ADA Seal, diagnostic and treatment products will continue to make their way into dental offices and the Home Shopping Channel. Halitosis is on the American consumer?s radar so fluorimetric sensor-based instruments?among other types of clinical gizmos?may be at a dental office near you, or in your own, for volatile sulfur compound (VSC) diagnostic assistance.12 This review article summarizes some of the current literature on halitosis to provide an overview of etiology and treatment. Suggestions for management and prevention are provided, along with research frontiers in halitosis.

This book presents, even though brief, an accumulation of knowledge in oral malodor from over the last 30 years.  It took the author over four years to culminate the  most information on the subject from its fundamental concepts to its latest practical knowledge in the field. The material presents the causes of the disease, oral malodor, various diagnostic methods and the essentials of the treatment process. This is an ideal resource for dentists, hygienists, medical and other health practitioners, and researchers alike. This is a practical guide which will satisfy the needs of clinicians in their daily management of patients. This book is a rare and vital ready reference on the topic.