Xerostomia (Dry Mouth)

Zero what? Xerostomia (Zero-Sto-Mia). I have a good friend who true to the movie would break down the greek for us... :). Dry mouth is actually not so funny. I saw a patient this week who had photographs of her mouth just 5 years ago. She had a beautful smile. Since then she had been placed on anti-depressants. Since then she has been getting cavities and having teeth pulled. Presently she is in pain and honestly embarassed of her teeth. Sadly no one picked up that all this could have been prevented . HOW? Lets look at why this is happening, lets get to the root of the problem and build up from there. Xerostomia occurs when the saliva drys up. This can be for generally 3 reasons: Disease, stress/age and antidepressants (medications). Diseases can be for instance Sjogren's syndrome...it is an autoimmune disease that damages the saliva glands. Stress and age I place together because each will dry the mouth somewhat but may still be stimulated normally. Age will slow the saliva production as will occur in general with our bodies as we age. Stress is something that can change with time. It may be for a time and when over our saliva will return to normal. We all experience this when we get nervous and our mouth gets dry. Medication however as well as disease may not change for a long time. The devestation from lack of saliva occurs from day to day. The saliva contains antibodies, antifungals, and minerals we need to combat decay. If each day we lose a little ground to decay eventually as months pass and years pass we will find that tooth damage can be quite severe. It is important to recognize each of these reasons because each is treated differenly. Disease can be treated with medications and there is much information available for patients with Sjogren's syndrome. If saliva is dry due to age we can treat with topical methods. Toothpastes that have extra fluoride, (Prevident 5000) meticulous oral hygiene as well as certain rinses (Biotene products) and toothpastes (Colgate Sensitive with ProArgin technology) can be useful to help saliva flow and help prevent decay. Stress and depression can be treated in many ways: if medication is needed then physicians need to be mindful of the dry mouth that can follow anti-depressants. We can change the frequency and time of dosages to alter saliva flow. We can try different medications that may interact differently with certain genetics. The main point is that if diagnose the root cause we can treat and take proper action. Without a proper diagnosis all the dental dollars spent to spot treat symptoms of decay will be wasted and lost.

My comments to my new patient were, "This was not your fault! and it is not because you are a bad patient or neglectful person! This happened because you had an outside event cause damage to the balance of your oral health."

I am so happy to have asked the right questions and have seen Xerostomia and its affects and effects in my research at dental school. I can help our new patient get back in shape and smiling as good as new!