Xerostomia – Dry Mouth protocols
Most common causes of dry mouth and xerostomia;
1. Autoimmune diseases.
2. Head and neck radiotherapy.
3. Adverse effects of numerous medications, most medications that are anti-something will cause this as examples; antidepressants, antihypertensives, antihistamines, anti-epileptic, anti-inflammatory, anticholinergic, others also like analgesics, anxiolytic, diuretics and muscle relaxants. In a recent article I was reading there was a list of more than 300 medications. Make sure you ask your doctor prescribing them.
4. Even excessive exercise and dehydration
5. Excessive caffeine consumption as caffeine is a diuretic.
Signs & Symptoms
Sticky, stringy saliva & soft tissues
- Root surface demineralisation or decay
- Medications – especially those with “anti” eg anti-depressant, anti-hypertensive & smokers
- Red mucosa/tongue, fissured tongue
- Always thirsty – wakes at night with dry mouth
- Burning mouth / tongue
- Difficulty eating/swallowing
- Cracked, sore lips
- Dentures no longer fit or difficult to wear
- Bad breath
- **** ask !!!! ****
Treatment
Mild
- Increase water consumption. Sipping throughout day
- Chew sugar free gum (extra) or losengers
- Limit caffeine drinks. Teas, coffees, soft drinks & alcohol
- Stop smoking
- Use fluoride toothpaste – spit and no rinsing
- Use fluoride mouthrinse – oral B tooth & gum (alcohol free)
Moderate & Severe
- AS ABOVE & more
- Medicament trays & GC tooth mousse plus once a week for 20-30 mins
- Biotene mouth rinse
- Nightly, before sleeping, use oral balance dry mouth gel
- More frequent BW x-rays? As per dentist prescription
- Duraphate application on root surfaces at hygiene visits
- For relief of mucocitis/denture stomotitis use curasept gel or MR (chlorhex)