A dry mouth, one without adequate saliva, has severe consequences for the teeth and gums. Technically called xerostomia, dry mouth can be caused by several things: damage to the saliva glands (from radiation treatment for head and neck cancer for example), or more commonly, side effects from medication. Saliva contains components of the immune system, enzymes that start to digest food, water for lubrication, minerals that help maintain tooth enamel and proteins that help to neutralize acid from the diet and acid produced by bacteria.
A dry mouth becomes more acidic and this increases the risk of tooth decay tremendously, especially on root surfaces because they decay at a lower acid level than enameled parts of the teeth. Teeth can become very sensitive. The lack of minerals and the high acidity open the “pores” on the root surface. The enamel of the teeth becomes more susceptible to acid erosion, which results in an overall loss of tooth enamel on top of that which is lost to decay.
What can be done? The first thing is to try to reduce acidity in the diet. That means, especially, restricting the amount and frequency of acidic foods and beverages including fruit and fruit juices. To reduce the acid effect of the bacteria, limit the number of snacks per day and the sugars and simple carbs. in those snacks. These are readily used by bacteria to produce acid. Avoid sucking on candies to stimulate saliva, use chewing gum instead.
Drink lots of water – without lemon flavouring. This is the only safe beverage to use for sipping; however, sipping all day long can wash away the remaining healthy saliva. A combination of water and lubricating products and stimulating saliva is currently recommended.
A toothpaste containing fluoride is essential and extra fluoride in the form of a rinse or therapeutic paste may be recommended. Replacing the lost minerals from saliva is a problem. Remineralizing toothpastes can help.
For lubrication: Biotene oral Lubricating Gel or Spray
For stimulating natural saliva: chewing gum or candies sweetened with xylitol (avoid sour flavours)
For decreasing risk of tooth decay: Colgate Prevident 5000 toothpaste or a mouth wash with fluoride such as Optirinse
For replacing missing minerals: remineralizing toothpaste such as Colgate Pro-Relief or MI paste
Xerostomia is a challenge for those suffering from it to speak and eat comfortably and a challenge for the dental professionals to help maintain the health of the gums and the teeth. Together, we can partner to help alleviate symptoms and minimize damage to the dentition.