Dry mouth can make patient’s feel very uncomfortable like they’re in a desert with no relief. In fact places the patient at a higher susceptibility for dental caries. Saliva is needed to help moisten and cleanse our mouths while also aiding in digestion. Dry mouth is a very serious condition which can not only have an effect on oral health, but also on the patient’s overall health.
Dry Mouth Symptoms
Patients may express the following symptoms which are all associated with having dry mouth.
- Feeling thirsty or parched often
- Tissues feeling dry
- Dry throat
- Mouth burning or a tingling sensation
- Tongue red (might be a vitamin deficiency) and dry
- Bad breath
- Cracked lips (a vitamin B definciency)
- Corners of the mouth cracked (is also known as a vitamin B deficiency)
Dental professionals should obtain an accurate but current medical history. It is important to determine what diagnosed medical conditions and what medications patients are taking for these conditions. The Surgeon General estimtaes that there are over 500 medications that can cause dry mouth. If the dentist is going to be treating dry mouth or chronic dry mouth it is important to determine the true underlying cause. If the dentist can determine which medication has a side effect for dry mouth the doctor may need to dicuss the findings wwith the patients’ medical doctor and come up with a plan of action. The patient’s physician may determine that there may need to be a change in the type of medication.
If it is determined that the patient is undergoing radiation therapy there are precautions that should be taken while patient is undergoing radiation therapy to the head/neck. Radiation therapy to the head and neck can make it very difficult and uncomfortable to talk, eat and swallow. It makes the patient more susceptible to get an infection. If some of these side effects are too great, the patient may not be able to continue with the radiation therapy. As a result the physician may need to cut back or even stop the radiation treatment. As dental professional this is important as it has been proven that radiation treatment to the head and neck can effect each patient differently. Some patients will experience dry mouth, lots of dental cavities, change or loss in taste, jaw stiffness or changes in the jaw, infections or mouth and sore gums. Our jobs as dental professionals are to check and clean their teeth. Take dental x-rays to evaluate and the patient’s oral health and susceptibility for dental caries. Patients that are scheduled for head and neck radiation treatment should see a dentist at least one month before starting the radiation treatment. It is during this evaluation where we can educate our patients on how to prevent side effects from radiation treatment and how to prevent the jaw from being stiff by performing jaw exercises at least three times per day. To help reduce patient’s chances of pain and jaw pain and soreness give the patient some exercises to complete at home. The patient will open and close the mouth without causing pain twenty times as far as the patient can do so successfully without being in any discomfort. Radiation therapy in the head and neck can be a problem for children too. It has been proven that if patient’s undergoing head and neck radiation therapy have the patient rinse several times a day with a solution of ¼ teaspoon of baking soda and salt in one quart of warm water. Then have patient rinse with plain water. Patients have received great relief from this great practice that can be done anywhere. Before children start head and neck radiation treatment the child should be seen by a dentist for evaluation of primary teeth, loose teeth or teeth that may become loose during treatment. It has been proven that permanent teeth maybe slow to erupt and may look different than normal teeth.
Tips to reduce Dry Mouth
Here are some tips to help reduce Xerostomia also known as dry mouth.
- Decrease or limit caffeine consumption because the caffeine will make your tissues in the mouth feel drier.
- Drink water regularly throughout the day. Water helps to keep the PH in your mouth more stable and reduce an acidic environment for bacteria to thrive.
- Suck on ice chips. Sometimes patient’s will have difficulty swallowing but the ice chips make it more manageable.
- Chew sugar free gum as it contains Xylitol which is a natural sugar found in tree bark
- Avoid oral health products that contain alcohol (ie. Mouthrinse, toothpaste) as the alcohol will aide in drying tissues out.
- Include over the counter saliva substitutes in your homecare regimen (Oasis, Biotene Oral Balance, Mouth Kote) as these products aid in salivary production.
- Use a humidifier to add moisture in your air at night at bedtime (especially if you’re a mouth breather).
- Concentrate on breathing through your nose and not your mouth.
- Avoid using store bought or over the counter decongestants and antihistamines as this will often make dry mouth symptoms worse.
Xerostomia is a condition that should be taken very seriously as it can effect a patient’s quality of life. Since it is very uncomfortable patients will often choose not to eat as it can be very uncomfortable. If the patient wears dentures it may not fit properly or not feel very good on the tissues and as a result the patient will not wear them which so the patient will not eat. Saliva is very important in maintaining great health of both your teeth and mouth. It is best to avoid sugary foods or acidic foods or sweets as this will increase the risk of dental caries (cavities). Incorporate brushing with a fluoride toothpaste or a prescription fluoride toothpaste as it has a higher fluoride content in the toothpaste which will reduce the susceptibility of caries. Dental providers can also recommend patient’s to use a fluoride mouth rinse at night (ie. Act mouth rinse with Fluoride). It is also recommended that patient’s with dry mouth don’t skip out on dental visit’s and exams. The ADA recommends that patient’s should have cleanings and exams twice per year and x-rays once per year to detect for tooth decay or other dental problems and treat them accordingly. After trying all of these steps and the xerostomia does not subside or decrease it may be determined that you need to be seen by a specialist that can evaluate your condition further. There may be an unforeseen condition not detected. It has been proven that patient’s taking at least one medication has a higher susceptibility for xerostomia. Medications are probably the most common cause of dry mouth. Some side effects of medical conditions from xerostomia are the following conditions: hypertension (high blood pressure), stroke, mumps, rheumatoid arthritis, diabetes and anemia to name a few. A patient’s lifestyle can increase the likelihood of xerostomia if they partake in smoking and chewing tobacco. It may be determined from your medical physician that the only way to obtain long term relief may mean changing the dosage, medication or determining and addressing the underlying health issues. The patient should be informed that they should communicate on a regular basis with the cancer physician and dentist about any mouth problems that occur during and after the head and neck radiation treatment.