In a world where texts and videos gone viral can embarrass and humiliate the unsuspecting victim, ratting out bad breath is still considered taboo.
"Telling a friend that he or she has bad breath is a tough thing," said Dr. Todd Marshall, a dentist at the Facial Pain Center in Edina. "That's why it goes untreated."
Marshall is one of only a few Twin Cities dentists who treat chronic oral malodor, aka bad breath. He performs tests to determine that the sinuses or the lungs aren't the source of the problem. His system, which costs about $200 for each of three visits and is not covered by insurance, involves a high-powered spray wash of the tongue, which he compares to deep-cleaning a shag carpet.
He describes his system as 95 percent effective but only when patients are willing to follow a strict regimen that involves brushing, flossing, rinsing with ProFresh, scraping the tongue thoroughly, rinsing again and gargling twice a day. As part of the treatment, Marshall requires patients to ask a friend or family member to smell their breath.
"I warn them that the friend won't say the breath is minty-fresh," he said. "Normal breath is not offensive, but it doesn't smell minty-fresh."
But what might be a cure for years of chronic halitosis for some is overkill for most of us. While 25 percent of the population has bad breath regularly despite good health and oral hygiene, nearly everyone has bad breath at some point, Marshall said.
Still, the frequent advertisements of mints, gum, pastes and mouthwashes to combat mouth odor have convinced a significant number of patients that they have bad breath when they really don't, said Dr. Bashar Bakdash, professor of periodontology at the University of Minnesota School of Dentistry.
"It's a cultural thing. Some people take it to the extreme," he said.