 Hello everybody. Let's talk about oral mal odor or otherwise known as bad breath. So what causes it, how does it happen, and how can we help our patients. So there are two separate things that you should know about this topic, and that is it could actually be a systemic issue so they might have the cleanest mouth ever, but if there's something going on that they're not happy with. It could be a systemic issue so either acid systemically or just something's going on that needs to be looked at by a doctor. Or of course there is something about the mouth that they're either not brushing twice a day their oral hygiene isn't impeccable, maybe they're using the wrong mouthwash there are a couple different things and that's what I'm going to talk to you guys about. So I'm just pulling up my notes here so I don't forget anything. So basically, if your patient is bringing this up to you they're concerned about it so you don't just want to say, well brush better and you'll be fine. Let them know this is such a common problem, and actually 90% of the time it is coming from the mouth so it's not a systemic issue. It's basically micro organisms on the tongue and the teeth, often people forget about the tongue. If they're not cleaning the tongue if they're not doing that then this is how oral mal odor can happen. But to be honest, I don't clean my tongue and I don't have any any issues with that. But some people just need to go the extra step right you just never know. And it could also be caused by somebody who has a lack of saliva. Either because they're taking a lot of medications or that's just the way they are, or they have some other condition that causes them to have a lack of saliva, which can cause oral mal odor. Those are kind of the main things. So how do you talk to your patients about improving that. Make sure they are using their toothbrush every day twice a day, and they're cleaning in between the teeth as well with something, whether it be a water pick anything just as long as they're cleaning in between the teeth every day that will help and take it a step above and use a mouthwash that will also make a big difference, but then also tell them if you are a smoker, you got to stop smoking you can't. You're not going to have very good breath if you're a smoker so that could be part of it. They typically want to stop smoking but let them know even if they reduce their smoking habit that could help. Maybe they drank a lot of coffee. Caffeine can also cause that, but make sure to tell them going back to oral hygiene, they might need to be cleaning their tongue twice a day. They can use their tongue cleaners or they can even use their toothbrush. They could have a toothbrush specific for their tongue and then a toothbrush specific for their teeth, or they can use the toothbrush for their teeth and their tongue it doesn't matter they're all being cleaned the same way in my opinion, but let them forget their tongue to forget their tongue. If lack of saliva is the issue then that needs to be taken care of, either by using special melt wash, melt washes, toothpaste, xylitol products, all of that can help. If it's something that has to do with allergy so it could be a nose and throat issue then the allergies need to be taken care of but that can also play a big effect. So let them know there is hope for them, but you might have to try certain things before you try other things. It's very simple have them clean their mouth as much as possible. Tell them it's not going to solve the problem overnight, especially if let's say you're seeing a patient with severe perio. You can let them know you have bad breath because you have severe perio, you have a lot of gum issues happening that's causing the bad breath. After we clean the teeth and get things maintained the bad breath is going to go away if that's the cause of it. It's not going to happen overnight if they start to brush twice a day is not going to magically stop if they still have severe perio but try things first. Have them maintain their oral hygiene if that for some reason isn't working they're doing everything they can, then maybe you need to incorporate a xylitol product. Maybe it's the foods they're eating so kind of looking into things for them because the patients bring it up they are concerned about it. They might have to kind of say okay well brush better we'll talk about it next time. They're probably embarrassed to bring it up. So just a couple things to help you and help them, and let them know you might have to try different things before you find something that works for them, because everybody's different. So let me know you guys have any questions, and I'll see you in the next one.