A Holistic Dentist's Approach to Dry Mouth
Michelle Janbakhsh DDS
Dry mouth, or xerostomia, is a condition usually associated with reduced salivary gland flow. It affects at least one in 10 adults. In adults older than 65 the prevalence is about 25%, while in institutionalized elders it can be as high as 50%.
Many oral and systemic conditions can cause a change in the flow and composition of saliva. Prescription medications are implicated in 64% of dry mouth cases. The major drug groups are antihypertensives, antidepressants, analgesics, statins, antihistamines and anticancer meds but other factors may be involved.
Risk Assessment for Dry Mouth
If you answer yes to any of the following questions you could be at risk of abnormal salivary gland function.
1- Does the amount of saliva in your mouth seem too little?
2- Do you have any difficulty swallowing?
3- Does your mouth feel dry when eating a meal?
4- Do you sip liquids to aid in swallowing dry food?
Symptoms of Dry Mouth
Dry cracked lips and corners of the mouth, thick or ropey saliva, dry thin pale oral mucosa, loss of moist or burning feeling in the mouth, impaired taste, bad smell of the mouth, impaired taste, difficulty wearing dentures, dental hypersensitivity.
Non-oral symptoms: Sleep disturbance, dry nose and changes in sense of smell, dry burning eyes, blurred vision, heart burn, constipation, vaginal itching or dryness or fungal infection.
Complications of dry mouth include cavities on roots and teeth, reddened, fissured or lobulated tongue, opportunistic infections such as viral infection or overgrowth of candida. Also gingivitis, canker sore, cracked and bleeding tissue.
• Hydration: If not contraindicated by medical condition increase water intake to 8-10 (eight ounce) glass per day, use a humidifier and keep water close by at night time.
• Stimulation of salivary flow: regular gum chewing (xylitol containing gum), sonic brushing, acupuncture and electric stimulation
• Prevent cavities: minimize sugar intake, use MI paste nightly, floss daily and use a gentle tongue scraper, uses of rinses that reduce bacteria causing cavities such as Tooth and gum tonic or alcohol free Peridex (daily one week per month for 6 months). One minute rinse with 10% Betadine reduces Lactobacillus for 3-4 months.
• Prevent soft tissue injury and infection (folic acid aids healing of trauma and canker sores)
• Improve comfort: eating moist food, moisturizing lips, using saliva stimulants and substitutes. Dry mouth gels can be used under dentures. Aloe vera, slippery elm bark and carrageenan add moisture and have a slippery feel and forms a protective coating on the oral mucosa.
. Smoking causes severe functional alterations in the salivary glands.
. Alcohol consumption reduces salivary flow
. Sodium Lauryl sulfate
. Alcohol based mouthwashes
. Hard, dry or salty foods
. Carbonated and caffeinated drinks
. Chewable vitamin C, sugared or acidic lozenges
Alternative Therapies for Dry Mouth
Acupuncture: Increases blood flow over the parotid gland, which in turn releases neurepinephrine that stimulates autonomic nervous system, which stimulates salivation.
Saliwell: Is an intraoral remote controlled electronic saliva stimulator. There is an option of a removable device and also a saliwell crown which is attached to a dental implant.
Generally a patient with dry mouth should have dental re-check visits every 3 months for continuing care and support. If there is any infection in the mouth it should be treated. If it is caused by medication, the physician might be able to change the drug or adjust the dose. The patient should maintain meticulous oral hygiene by brushing and flossing twice a day and use products that promote healthy saliva.
Michelle Janbakhsh, DDS, is a holistic dentist in Washington D.C., at National Integrated Health Associates, NIHA, a integrative medicine and dental center serving the Washington,DC, Maryland and Virginia region. Known as "Dr. Jan" to her patients, she practices biological holistic dentistry with cosmetic dentistry as her special focus. NIHA holistic dentists offer a complimentary "meet and greet" consultation to explain the impact of dental health on the whole body.