The elixir of life may well be saliva. As much as I like coffee, water and wine, it truly is saliva that, as Mary Poppins says, makes the medicine go down. Saliva is liquid gold, and vital to a healthy mouth and good quality of life. It helps us talk, starts digestion, taste, swallow, heals our teeth, protects our tissues, and gives our mouths lubrication. Minerals in saliva reverse early stages of tooth decay. Saliva keeps our mouths comfortable, and though small, our mouth affects our entire body. We need saliva.
Lack of saliva is called hyposalivation. The feeling of a dry mouth is called xerostomia. Most folks just call it “dry mouth”. Dry mouth is most often caused by the side effects of many medications. Head and neck radiation, or cancer therapy can also damage the salivary glands and reduce saliva flow. Other causes of dry mouth are due to bacterial or viral infections, lupus, cystic fibrosis, Sjogrens syndrome, rheumatoid arthritis, and hormone imbalance to name just a few.(#1) Mouth breathing and allergies may also result in dry mouth as well. Advancing age, contrary to some beliefs, is not a cause of dry mouth, however many older people do take two or more prescription medications and experience the side effects of xerostomia. When I have a patient that takes two or more prescription medications, I know that they probably have dry mouth and are at extreme risk of tooth decay. Healthy saliva works to prevent tooth decay, so it’s important to recognize symptoms and catch it early. Basically, people with dry mouth have an extreme risk of tooth decay.(#2)
Most people don’t even realize they have a dry mouth until their saliva production is 60% reduced. (#3) Do you get up in the middle of the night to drink water? Does your mouth become dry when you speak normally? Do you need to drink water with meals? Do your lips stick to your teeth at night? These are just some of the signs of dry mouth.
Dry mouth can take over your life because it can be very uncomfortable. Some symptoms include: painful burning sensations, bad breath, tooth decay, ulcerated tissue, abnormal taste, oral lesions, candidiasis-related infections, and problems speaking. My patients with xerostomia want relief from these many and varied symptoms. Unfortunately, most over the counter products that stimulate saliva or lubricate the mouth don’t really last long, taste bad, or just don’t work well. Too many commercial dry mouth products have a very low pH and could contribute to further tooth decay. Avoid lemon drops, hard candies or cough drops; they are all sweet and slow dissolving, and without normal saliva (the hero!) they will lead to cavities. I’ve been on the hunt for the best products I can find to provide relief- here’s what I’ve come up with so far:
Over the Counter Products Prescription Products
Rincinol mouth rinse (by Sunstar) Gelclair
Allday Dry Mouth Spray
ACT Dry Mouth rinse
GC America Dry Mouth Gel order from the company
Basic Bites– sugar free soft chews – yes, they taste great and are perfect for dry mouth
MI Paste, also called Tooth Mousse – available either from your dental office or Amazon.com. (Not prescription but not sold in drugstores.)
Xylitol products- such as Spry (more on xylitol) Be sure xylitol is the first ingredient listed. YES! add xylitol to your life!
Oral Probiotics- Evora Pro is the one with which I am most familiar.
Spilanthes – an herb that’ll make you salivate like crazy!
MedActive- A line of products with Spilanthes- no Rx needed
OraCoat makes two fabulous products-
H-B12 Melts to relieve temporary mouth sores, ulcers, and other mouth pain
Xylimelts – excellent dry mouth relief even when sleeping, helps reduce dryness at night and a new case study even says it reduces root decay and gingivitis.
New on the market is Lubricity – I have just ordered two to try out. The product claims long lasting comfort – up to eight hours! It’s a spray. I’ll let you know how it compares to other products. Try it and let me know your thoughts.
Bet you didn’t know there were so many product options!?! Try them out and let me know what works for you!
#1- Trushkowsky, Richard D, Xerostomia Management, Dimensions of Dental Hygiene, pp.34-39 March 2014
#2 Noble, W. H, et al, Xerostomia from A to Z, Dimensions of Dental Hygiene, pp.22- 28 January 2012
#3- Douglas, L.M.: Investigating the Relationship between Clinical Oral Dryness Scores and Xerostomia Screening Questionnaire Responses. OHU Action Research 11A-12, 2013
The Queen of Dental Hygiene’s Pearls of Dental Wisdom on Living with Xerostomia/Dry Mouth:
*Because there is no saliva to start the digestive process, do drink water with meals. This will also improve your taste perception.
*Increase your water consumption throughout the day. Suck on ice chips.
* Maintain a meticulous oral hygiene routine. In order to reduce the risk of cavities, gum disease and bad breath, your hygiene must be impeccable.
*See your favorite dental hygienist more often (at least every three months), and have fluoride varnish applications with each dental appointment.
*Stop using toothpaste with sodium lauryl sulfate- it’s hard on tender tissues.
*Close your mouth, breath through your nose.
*Clean your tongue twice daily.
* One hour before bed, start a humidifier running in the bedroom, and have it run all night.
* If your lips stick to your teeth, you can try lining your gums with a thin veil of olive oil before bed.
*Avoid taking medication just before bed.
*Work with your MD/health care provider to change any medications that may be causing your dryness.
CaMBRA- Caries management by risk assessment – work with your dental professionals to stop tooth decay before it starts. See my blog post: Tooth Decay is not Okay for tips on tooth decay prevention. Dental decay is a pH disease – another post – What’s pH got to do with it? Dry mouth creates a very acidic environment and tooth decay bacteria thrive.
Find the products that work best for you, manage your medications, work your your health care providers, breathe through your nose, and stay on top of your oral health!
Try the different products listed above and let me know how they work for you. I’d love to know your thoughts and other product suggestions.
A smile has the ability to change your fate!
Until next week,