Laser therapy improves bad breath for some

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Laser treatment of the tonsils appears to help some people with chronic bad breath, or halitosis, new research shows.

The technique appears to aid people with halitosis caused by bacteria that have accumulated in tiny crypts in the tonsils. When the researchers applied lasers to those crypts, they found that more than half of participants experienced an improvement in their breath after one session. Most people required only two additional sessions, at most, to relieve their halitosis.

After following patients for an average of 20 months, their bad breath did not return. No one reported any side effects or complications from the treatment.

This type of laser treatment “is an effective, safe, and well-tolerated procedure for the treatment of halitosis,” write Dr. Yehuda Finkelstein of the Sapir Medical Center in Israel and colleagues.

Halitosis is typically caused by the activity of bacteria in small cavities throughout the mouth, nose and sinuses. In most cases, the foul breath emanates from the mouth, due to bacteria that have gathered in the gum margins, leaky crowns and other oral nooks and crannies.

The tongue and tonsils can also harbor bad breath bacteria, and most people with bad breath they cannot explain have a chronic case of tonsillitis, or inflammation of the tonsils.

Some people with halitosis can become obsessed with their breath, the authors write in the journal Otolaryngology - Head and Neck Surgery, and “religiously use cosmetic breath freshening products such as mouthwashes, candies, chewing gums, and sprays.”

To make sure all of the 53 people with halitosis included in the study had bad breath that emanated from their tonsils, the researchers massaged the tonsils and smelled the discharge, to determine if it matched their usual breath. All participants were otherwise healthy.

More than one-third of participants said they had severe halitosis, meaning that their breath was “offensive” and had disturbed their family and social relationships.

During the laser procedure, doctors first applied topical anesthesia, then used a laser beam to vaporize the surface of the tonsils. Participants returned 4 to 6 weeks later to determine if their breath had improved, and were followed for between 3 and 36 months.

Only two people experienced mild, recurrent halitosis, and eventually had their tonsils removed.

Out of 53 participants, 28 needed only one laser treatment, 18 required a second, and five were cured after three treatments.

No patients experienced voice changes, bleeding or other complications, and most returned to work and their normal routines immediately after surgery.

SOURCE: Otolaryngology - Head and Neck Surgery, October 2004.

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