Clinic Deals With the Bad Breath of Life : Health: For those with chronic mouth odor, treatment can be a lifestyle-saver. A Pennsylvania periodontist claims a 96% cure rate.

You know you have bad breath when your wife won’t kiss you, your co-workers will communicate only through electronic mail and your best friend keeps asking if you’d like a stick of gum.

Mouthwash doesn’t help, brushing three times a day doesn’t help, and you’ve bought so many breath mints the manufacturer mails you a Christmas card each year.

So what do you do? You could check out the Pennsylvania Center, which says it’s the only dental clinic in the country that specializes in treating breath problems.

More than 500 people from around the country have been treated at the clinic since it opened in January, according to Dr. Jon L. Richter, the periodontist who founded and directs the clinic. Ten times more than that have called to inquire about appointments.

“Some of these poor souls have been asking their dentists and physicians for years for help but have essentially been told, ‘Go brush your teeth and leave me alone,’ ” said Richter, 48, a graduate of Yale and the University of Pennsylvania. “But the fact is, for some people, bad breath is ruining their lives.”

As a periodontist, Richter said he heard complaints from many patients troubled with bad breath. Many had been to ear-nose-and-throat doctors, gastroenterologists, dentists and general physicians, to no avail. “When I started to read up on the problem I found that there had been quite a bit of research done in the chemical area, but not in the clinical, which rather surprised me,” he said.

Treatment centers for patients with bad breath are long overdue, according to Dr. Richard H. Price, a spokesman for the American Dental Assn. and a monthly columnist in the Boston Herald.

“The problem is, dentists aren’t taught in dental school how to treat bad breath or even to consider it the major problem that it is,” said Price, who has a dental practice in Newton, Mass.

“After all, nobody dies from bad breath. But let’s face it, it’s the type of thing that can make neurotics out of all of us,” he said.

Price said he is not familiar with Richter or the Pennsylvania Center but said the diagnostic and treatment process the center follows aligns with American Dental Assn. recommendations.

Most patients must make three visits to the clinic for the treatment process. On the first visit, patients undergo diagnostic tests to determine if the odor stems from medical problems or oral anaerobic bacteria. Richter said bacteria are the cause of 90% of the cases he sees.

“A lot of people, for one reason or the other, have a particular germ in their mouth that produces a very bad odor, and if there are enough of those germs--an infestation--the odor can be quite powerful,” he said.

If the problem is a bacterial infestation, patients return for a second visit, and the soft tissue in their mouths is gently scaped and sprayed with a germicide.

The patients then are taught how to treat themselves using a germicide shipped to their homes each month. The third and final visit is made a few weeks after treatment has begun to make sure that the problem is under control.

The center, Richter said, has a 96% success rate. The cost of the diagnosis and treatment is about $300; the cost of the maintenance program is about $16 a month.

“The cost is ridiculously low considering what you get in return,” said an attorney who lives in the Rochester, N.Y., area and was treated in March. “Personally, I feel like I received a second life.”

The attorney, who spoke on the condition of anonymity, said he had been suffering with the problem for more than 15 years.

“It’s a very disturbing experience to know that people were shying away from you because of your breath,” he said. “I flew down there to the center in desperation, and I can’t tell you how happy I’ve been since.”