The Challenges of Dentistry Part 6

Dry mouth is the fastest growing challenge for dentistry today. The main reason for this is medications.  Many medications have dry mouth as a side effect.  People are living longer and require more medications than ever.  This makes the occurrence of dry mouth more prevalent.  Often the combination of medications can make this situation worse.  As the population gets older and more medicines are developed, this trend will continue.

Making this problem even more difficult is the fact that many people do not realize they have a dry mouth. Studies have shown that a person can suffer a 40% reduction in saliva flow before they realize there is a problem.  This can mean some serious problems arise before the patient realizes what is happening.

These problems are usually in the form of tooth decay, especially on the root surfaces. Without adequate saliva, decay causing bacteria can set on the teeth longer increasing the rate of decay.  In an older patient with dry mouth we see gum recession which exposes root surface.  The root surface of the tooth is meant to be below the gum line and does not have enamel to cover it.  Thus it is a softer surface and very susceptible to decay.  Some of our older patients see a loss of dexterity making adequate brushing more difficult.  Add all these factors together and we have a big problem with root surface decay.

These cases are difficult to manage. We encourage the patient to keep hydrated by drinking plenty of water.  It is essential to rinse and preferably brush after any food intake.  Meticulous home care is needed.  A mechanical tooth brush is encouraged.  We recommend Sonicare because we see great results with this brush.  There are a variety of dry mouth products available.  Some of these that our patients find helpful are Basic Bites, Xylimelts and Biotene.  As with any problems with decay, the more fluoride you can get the better.  Fluoride treatments at every dental visit are encouraged as well as a fluoride mouth wash to use daily.

We do see a few older patients experiencing loss of saliva due to age. Most of these only see a decrease in resting saliva.  They usually have adequate saliva flow when chewing and eating.  These actions stimulate the salivary glands. For these patients we recommend chewing a sugar free gum to stimulate saliva flow.  We recommend Ice Breakers Ice Cube Gum because the xylitol helps re-mineralize teeth.

In severe cases of dry mouth we may need to work with your primary care physician to explore options. Sometimes a different medication can be used that causes less saliva loss.  Sometimes there is an underlying condition like Sjogren’s Syndrome causing the dry mouth.  Often times your doctor may be able to recommend a solution.

If you are experiencing a dryer that normal mouth, make sure you discuss this with your dentist before it becomes a problem.

Thanks for reading,

Dr. Bruce