Oral Care Recommendations for a dry mouth

Xerostomia or dry mouth often occurs in many varied medical conditions such as Diabetes, Sjogren's Syndrome, Lupus, Arthritis, HIV infection, Hepatitis C and others.  It can occur when taking any one of 300+ over the counter or prescription medicines or following medical treatment such as radiation therapy for a cancer of the head or neck region and chemotherapy to any part of the body. Saliva is extremely important to the health of your mouth. A serious side effect of having a dry mouth is breakdown of fillings, rapid tooth decay and loss of teeth which can impact on function and appearance.

Without saliva to wash away food debris and buffer the acid levels in your mouth, tooth decay can develop quickly around the edges of your teeth and may lead to dental abscess formation and the need to have teeth extracted.  Having a dry mouth can also impact on getting a good night's sleep, which is important for you if you are unwell.

The following recommendations will help limit the problem.  If you have a dry mouth you should see your dentist regularly.  Looking after your teeth for life can be hard at the best of times - if you have a dry mouth it is even harder.

Care of a dry mouth

Dehydration is the most common cause of dry mouth. Drink at least 1.5 lires of water a day. This should be drunk a glass or half glass at a time. It should not be sipped. Sipping washes away the protective saliva  & makes the teeth more susceptible to decay & can paradoxically make the mouth feel more dry.

Regime.

On first waking:

Drink a glass of water

  1. Rinse mouth with Sodium Bicarbonate mouth wash. Spit this out at completion of rinse. Don’t swallow, spit out until comfortable. Don’t rinse with water afterwards.
  2. The Sodium Bicarbonate mouth wash is made by adding a half teaspoon of Baking Soda to a glass of water. If the taste is too strong dilute the baking soda further, but the more it is diluted, the less effective the solution will be.

Eat Breakfast

  1. Clean teeth (brushing, flossing interproximal brushes – whatever the appropriate brushing regime). Neutrafluor 5000 toothpaste should be used. After brushing rinse lightly. Vigorous rinsing reduces the benefits of the Neutrafluor 5000.

During the day

After eating throughout the day clean teeth Neutrafluor 5000.

  1. Drink a glass of water as required
  2. Chew sugar-free gum as required. Make sure the gum is sugar free and acid free. It should not contain lemon, or orange or citric flavoring. The recommendation is to use Recaldent gum.

Before Bed, after eating

  1. Use the Sodium Bicarbonate mouth rinse.
  2. Clean teeth, as per cleaning regime, using the Neutrafluor 5000 toothpaste. Spit out until comfortable. Only rinse lightly.
  3. Apply Tooth Mousse or Tooth Mousse Plus to the teeth. This is done my smearing it onto the teeth with a finger. Leave the mousse on the teeth. Don’t spit & don’t rinse.

If you feel thirsty during the night feel free to drink a glass of water, as frequently as necessary.

Toothbrush

Use a soft small-head toothbrush like Oral-B 30 or 35, Colgate Diamond Head or Sensodyne Search.  The Biotene Supersoft toothbrush has a large head; however, the reduced width of the individual fulaments within the bristles has created a very soft toothbrush which is ideal for sensitive mouths as is the 'Surgical' by Curaprox.  Braun 'Oral-B Plaque Remover' is an excellent electric toothbrush and easy to use.

Brushing

Brushing your teeth thoroughly at least twice a day using small circular strokes.  Avoid vigorous and in particular horizontal brushing at the gum line of your teeth as this may damage the gum and cause root surfaces to be exposed.  As tooth root surfaces are extremely vulnerable to accelerated dental decay, additional brushing is strongly recommended for anyone with reduced salivary flow.  Keep a spare toothbrush in your back pocket, at work or in the car. Thirty seconds or more several times a day will limit the build up of plaque and food acids around tooth root margins and reduce the potential for accelerated dental decay in these areas.

Toothpaste

Most toothpaste contains the foaming agent Sodium Lauryl Sulphate, or SLS, which has been found to cause irritation in sensitive mouths.  Toothpastes containing SLS should be avoided if you have sore mouth (mucositis), oral ulcers or dry mouth.  Biotene 'Dry Mouth Toothpaste' is SLS free, contains fluoride and important salivary enzymes.  Pronamel from GSK is also SLS free.  If it doesn't cause discomfort Colgate NeutraFluor 5000 plus, although not SLS free, is also recommended for dry mouths.  If you have gum disease use Curasept 'gel Toothpaste'.  It is SLS free contains .12% Chlorhexidine Gluconate which is effective against the wide range of oral microorganisms implicated in gum disease.

Mouthwash

A warm salt water or sodium bicarbonate mouth rinse may improve oral comfort if you have mild irritation or a sore mouth.  If you want to use an anti-bacterial mouthwash chose one which DOES NOT contain alcohol or phenol if there are symptoms of dry or sore mouth. 

A dry mouth caused by medications or medical conditions can be helped using special gels or rinses designed to hydrate the mouth. Ask your dentist or hygienist about these.