Dry Mouth (xerostomia)
http://www.drsklar.com/ptinfo/dry.htm

• what is xerostomia
• problems
• symptoms
• importance of saliva
• causes
• specific preventive actions and products
  • xerostomia
  • cavity prevention
  • general health and healing
  • regular dental visits

What is Xerostomia?
    Xerostomia (ZEER-oh-STOH-mee-ah) is the technical term for dry mouth.  Everyone has a dry mouth once in a while - if they are nervous, upset or under stress.  But if you have a dry mouth all or most of the time, it can be uncomfortable and can lead to serious health problems.  Dry mouth is the condition of not having enough saliva to keep your mouth wet.
Problems

• dry mouth can cause difficulties in tasting, chewing, swallowing, and speaking
• dry mouth can increase your chance of developing cavities and other infections in the mouth
• dry mouth can be a sign of certain diseases and conditions
• dry mouth can be caused by certain medications or medical treatments, such as radiation treatments

Symptoms

• a sticky, dry feeling in the mouth
• trouble chewing, swallowing, tasting, or speaking
• a burning feeling in the mouth
• a dry feeling in the throat
• cracked lips
• a dry, tough tongue
• mouth sores
• an infection in the mouth

Importance of Saliva

• It helps digest food
• It protects teeth from decay
• It prevents infection by controlling bacteria and fungi in the mouth
• It makes it possible for you to chew and swallow

    Without enough saliva you can develop tooth decay or other infections in the mouth. You also might not get the nutrients you need if you cannot chew and swallow certain foods.
    Some people feel a dry mouth even if their salivary glands are working correctly.  People with certain disorders, like Alzheimer's disease or those who have suffered a stroke, may not be able to feel wetness in their mouth and may think their mouth is dry even though it is not.

Causes

    People get dry mouth when the glands in the mouth that make saliva are not working properly. Because of this, there might not be enough saliva to keep your mouth wet. There are several reasons why these glands (called salivary glands) might not work right.

• Side effects of some medicines. More than 400 medicines can cause the salivary glands to make less saliva. Medicines for high blood pressure and depression often cause dry mouth.
• Disease. Some diseases affect the salivary glands. Sjögren's Syndrome, HIV/AIDS, diabetes, and Parkinson's disease can all cause dry mouth.
• Radiation therapy. The salivary glands can be damaged if they are exposed to radiation during cancer treatment.
• Chemotherapy. Drugs used to treat cancer can make saliva thicker, causing the mouth to feel dry.
• Nerve damage. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.

Specific Preventive Actions and Products

• xerostomia
  • special toothpaste and rinse, Biotene, available in drug stores
  • Smints, mints that contain xylitol and will not cause cavities (BEWARE: all sugarless gums and mints, with the exception of Smints contain sorbitol as the primary sweetener that bacteria do grow on and cause cavities, including even the Nutrasweet containing gum and mints.) - available in Target, CVS, Walmart, some 7-11's
  • drink lots of water (water popsicles work well)
  • avoid caffeine (tea, soda, coffee)
  • be aware that many medications cause dry mouth and may increase the dryness
  • if your salivary glands are not working effectively, but can still produce some saliva, there is a prescription medication to increase saliva flow,  Salagen 5 mg (pilocarpine HCl)
  • don't use tobacco or alcohol, they dry out the mouth
  • be aware that spicy or salty foods may cause pain in a dry mouth
  • use a humidifier at night
  • if your dry mouth is caused by medicine, perhaps your medication can be adjusted or changed
• cavity prevention (also keeps the gums healthy!)
  • custom fluoride trays and dental office strength fluoride (9,000 ppm), NuPro Neutral Sodium Topical Fluoride gel
  • extremely effective plaque removal (food gets off teeth easily, plaque is the main concern)
    • floss effectively to remove plaque every time you brush or eat
    • brush thoroughly and effectively
      • disclosing tablets/solution
      • dry brushing
  • Water-Pik to help rinse out, kill bacteria, and change the micro-environment to prevent plaque bacteria
  • keep mouth moist, stimulate saliva - see above to help with xerostomia
• general health and healing
  • eat nutritiously
  • supplement your diet with vitamins and minerals (even if you feel you eat well), especially water soluble vitamins [B complex, C] (since you are drinking more water) and antioxidants [E] - always take a multivitamin/multimineral, then add the others - you may require a liquid product if you have difficulty swallowing and/or feeling after surgery (see Ensure Plus HN)
  • exercise for health, circulation, mental well-being, improved sleep
• 
  regular dental visits
  • visit your dentist regularly to monitor the possible effects from having a dry mouth, as well as to learn effective ways to deal with it

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Andrew M. Sklar, DDS, PC http://www.drsklar.com Family and General Dentistry 4901 Seminary Road, Suite 120 Alexandria, VA 22311 Tel: 703-931-3141 Fax:703-845-1512 email: office@drsklar.com

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