Dry Mouth: Why is my dentist and dental hygienist so concerned?

by Dr. Julie Melbinger-Wagner
ORIGINALLY PUBLISHED IN THE MEQUON BEACON

As I sit here writing the Mequon Beacon quarterly article, I am reminded that Valentine’s Day is fast approaching. Kids are frantically looking for the right valentine, parents are looking for ways to tell their family members how much their loved, and some may be awaiting that first kiss. Did you remember that first kiss? Maybe it was amazing, terrible, or perhaps the other person’s breath smelt. Did you know that dry mouth is one of the leading causes of bad breath?

Dry mouth, otherwise known as xerostomia, causes a feeling of stickiness and patients may also say their saliva appears to be thick and stringy, or experience a bad taste. Difficulty chewing, speaking, and swallowing, is often reported; which you can imagine is very trying for a denture patient since saliva is a key component helping to keep it in.

The key contributors to xerostomia are medications and health conditions. There are very few medications out there on the market that do not report dry mouth as a side effect. Anti-depressants being the most common, followed by oral and I.V. chemotherapeutic and immunosuppressant agents, antihistamines, high blood pressure medications, and asthma inhalers, just to name a few. Autoimmune disorders, genetic conditions, and cancer treatments are some medical conditions commonly associated. Sjorgren’s, is an autoimmune disorder that attacks healthy cells that produce saliva and tears. An example of a genetic disorder that causes dry mouth is Cystic Fibrosis, which attacks the salivary glands and reduces the production of proteins needed for digestion. Cancer patients are the most significantly impacted, especially those receiving both chemotherapy and radiation. When directed to the head neck, radiation will cause hypertrophy of the salivary glands leading to decreased salivary production. Radiation, in combination with chemotherapy, causes mucositis which is a painful, inflammatory, and ulcerative condition known as mucositis.

Without treatment, long-term reduction of saliva will have a devastating impact on your teeth. Xerostomia changes the Ph in your mouth to become more acidic which allows anerobic bacteria to thrive and multiply. The acidity rampantly breaks down enamel and a cavity forms. Fortunately, xerostomia effects a large portion of the population so there are many products and medications out there in the market. These medicaments are categorized as saliva substitutes and saliva replacements. Biotene, is the most common saliva substitute which offers a myriad of moisturizing products. Gels, sprays, rinses, gum, and lozenges can be found readily down any oral health care isle. There are also other product lines that also contain xylitol or fluoride, which have been added to remineralize and prevent the decay process from even starting.

In short, the next time you go to lean in for a smooch from a loved one and your sense of smell tells you no, please feel free to take that time to ask when they have last visited the dentist. Bad breath can be far more complicated than that gyro they ate for lunch.