One of the most debilitating circumstances to challenge anyone’s quality of life is dryness of the mouth (clinically known as Xerostomia). This condition is characterized by an inability to secrete sufficient saliva to maintain the moistness of the mouth. The lack of lubrication of the tissues, (the cheeks, the tongue, the gums, the floor of the mouth, the palate, soft palate and throat,) results in difficulty speaking, chewing food and swallowing.

The tissues can become sore and abraded – because of friction between tissues that would otherwise slide smoothly over each other or because the limited amount of saliva available may dry out and cause the tissues to stick together – such that efforts at separation cause the tissues to tear and bleed. Infections that would normally be prevented by saliva can now become established.

The unchecked infections also include the proliferation of bacteria that cause tooth decay and gum disease. The acid produced by some bacteria (“Streptococcus mutans” is one example) causes demineralization (loss of calcium and phosphate ions) of the tooth structure. As a result, the teeth become flexible and their protein matrix breaks down at the main sites of flexure, leading to the development of cavities and the failure of existing restorations.

There is no synthetic material that can perfectly replace saliva. Saliva is a highly sophisticated polysaccharide that has many properties, some of which we still understand imperfectly. The polysaccharide is a long chain molecule that provides excellent lubricating properties especially when it remains hydrated. So a regular supply of water, or water vapour, is important in trying to optimize the “wetness” of the mouth. A small aerosol spray bottle containing water may provide the ideal vehicle for wetting the mouth quickly and unobtrusively. Saliva also contains a supersaturated solution of calcium and phosphate ions – the same ions of which the mineral in tooth structure is constituted. In the presence of fluoride, the tooth can reabsorb these ions from appropriately constituted gels at a rate ten times greater than if fluoride is not present. Gels are available that can provide these components. They are generally best applied to the teeth using custom made gel carriers that are like mouth guards. Research shows that this is more efficient than using mouth rinses.

The ideal management is to prevent demineralization lesions occurring before damage to the tooth can occur. The back teeth may be more difficult to manage than the front teeth. Their complex contours can be more difficult to clean and the heavier loading when chewing may promote their breakdown. If preventive measures are not successful, tooth replacement may have to be considered.

If you are having a problem with dry mouth or have any questions, please don’t hesitate to contact our office.