Information for Patients: Dealing with Dry Mouth

A good link for info on dry mouth is located here.
Click here to download a very thorough Word document on dry mouth.

Mouthwash/Fluoride Rinse

If you have a very dry mouth you are highly prone to tooth decay. Purchase a daily strength pH buffered fluoride rinse like CariFree Maintenance Rinse and place it in your bathroom, where you can rinse with it frequently.  It is important to only use an anti-bacterial mouthwash which does not contain alcohol or phenol if there are symptoms of dry mouth or sore mouth as alcohol has a drying effect on oral tissues. Biotene mouthwash is anti-bacterial, alcohol-free and like the ‘Dry Mouth Toothpaste’ contains salivary enzymes. If during treatment your mouth still becomes very sore and you feel that the mouthwash is too strong try diluting it with warm water. You can find more info on these here.

New for 2007: We now have a special anti-cavity mouth rinse system that changes the entire environment of the mouth so “bad” bacteria cannot grow and “good” normal bacteria can take over.

There is a maintenance fluoride rinse called Carifree Rinse that helps keep the bad bacteria down. Unlike other fluoride rinses, this one neutralizes acid and contains Xylitol for extra protection.

There is also extra strong 2-part rinse to “shock” the bad bacteria, which is used for 1 minute a day for 2 weeks in extreme cases.

They make a Boost spray too for oral moisturizing. Boost Spray link

New for 2009: There are some new slow-releasing sugar-free Salese Lozenges that can help greatly.

Here is another gel for moisturizing dry mouth from Biotene:

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Anti-cavity Chewing Gum

Chewing sugarless gum can moisten your mouth.  We recommend only sugarless gum sweetened with Xylitol. It is the safest artificial sweetener, and has been shown to actually reduce decay if used after meals or sugar-containing snacks 3 times per day.


We carry this gum in our office. In addition to the Xylitol, it is pH balanced.

Spry gum is also available from us, or from natural/ health food stores and comes in a variety of flavours.


Xylichew has more xylitol than the other gums, and is available in health food stores.


Prevora anti-cavity varnish- new for 2009
Prevora is very effective for preventing the type of decay typical with dry mouth. It slow-releases an antibacterial compound on to the roots. It is bonded on to your teeth in a 15-minute visit.  It needs to be bonded on once a week for 3 weeks, then again in 6 months and 1 year for a “booster” treatment.  The good thing about Prevora is that it is applied by us, not you.
Prevora Web Site

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Toothpaste

Most toothpastes contain 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. Rembrandt ‘Natural’ is also SLS free, as is MI Paste and CariFree Gel.

Extra strong toothpastes

3M Clinpro 5000 is an extra strong fluoride toothpaste good for severe decay due to dry mouth. It should be applied nightly to teeth after regular brushing, immediately before going to bed. Dry the toothbrush and cover the bristles with Gel-Kam or MI Paste or use cotton buds if gums are sore. Brush on to all tooth surfaces for one minute, then vigorously swish for one minute forcing the gel into the spaces between the teeth. Spit out and rinse after. You should not have anything to eat or drink for at least 20 minutes afterwards.

A fluoride-free option is MI paste, which contains calcium ingredients derived from milk.  It can be applied as above, but is actually edible. It is very good for sensitive teeth and patients that get many canker sores, and rebuilds the calcium in your teeth. Apply a small quantity as above, but swishing or rinsing is not needed. It’s best if you leave it on overnight.

There is also an anti-acid tooth powder that is good to use for dry mouth. It is fluoride-free.

You can obtain all of these from our office in Palgrave.

Diet

Should you have significant oral discomfort, small regular meals and snacks may help you obtain adequate nutrients and prevent weight loss. Carry a toothbrush with you and if you have your own teeth you can reduce the impact of tooth decay by limiting sweet, sticky, sugary foods or anything with a high acid level such as grapefruit, tomato or orange. Always brush immediately after eating. If it is not possible to brush, swish and swallow with water as soon as possible.

Warning: DO NOT suck on lozenges such as Halls, Tic-Tacs or hard candies that contain sugar to help moisten your mouth or throat! These are very dangerous for patients with a dry mouth. You can obtain sugar-free candies, PUR or Spry mints sweetened with Xylitol.

Flossing

Use dental floss or dental tape between teeth at least once daily.

Denture Care

The acrylic resin from which dentures are fabricated has microscopic holes or pores. It is essential that dentures are cleaned thoroughly at least daily with a toothbrush or denture brush. They should not be worn at night and always left to soak in warm water or a denture cleaner such as Steradent from Reckitt and Colman when not being worn. They should also be left out as often as possible during the day, whenever a mouthwash is used and during radiation therapy sessions.

The gums and areas under a denture should also be brushed on a regular basis and the mouth rinsed after all meals. Brushing stimulates the gums and helps keep them firm and less likely to harbour the microorganisms which may lead to irritation or infection. Removing accumulated food debris limits irritation, staining and bad breath. Oralbalance moisturising gel can be used on the tissue fitting surface of the denture to minimise irritation and may also improve retention. At first sign of discomfort, the denture should be removed and checked by a dentist as adjustment or relining may be required.

Saliva Substitutes

Saliva substitutes may help keep the mouth moist and allow for easier eating, swallowing, talking and sleeping. Many patients have reported significant relief from the effects of dryness by using ‘Oralbalance’ moisturising gel. It is also suitable to place under dentures.

Maintenance

You should see a dentist at least four times a year for cleaning, fluoride treatment and early treatment of cavities. If there is decreased saliva there is likely to be an increase in the amount of tooth decay.

Suggestions to relieve dryness and preserve soft tissue:

Where to buy the mentioned products

The products mentioned here are mostly available from pharmacies or health food stores, although they may have to be ordered. We can provide most of them to you at cost in our office. The web page for some of these products is here for Biotene and here for Carifree.

With thanks to:

Dr. Peter Foltyn
Dental Department
St Vincent’s Hospital