Dry Mouth

05/06/2010

Long before toothbrushes, dental floss and oral rinses, evolution created protective mechanisms in the mouth as defense against the bacteria that cause decay. This defense is saliva.

The simplest way to explain the role of saliva is to describe what happens when it is in short supply. A patient may complain that his mouth or throat is dry, rough, sticky or sore. See accompanying article on dental health.

Dentists may hear complaints of “I’m hoarse—it’s so hard to talk,” or “I can’t wear my denture—my mouth is always sore,” or “My tongue is sticking to the roof of my mouth.” Eating may be difficult and, with certain foods, impossible. With too little saliva, a patient may not be able to tell the position of food in the mouth. Patients may complain that fillings are falling out, or that they’ve had an unusual number of new cavities.

Xerostomia (dry mouth) may result from a disease process, treatment of a disease, drug therapy side effects, or a generalized decrease in saliva associated with aging. In Parkinson’s, dry mouth is frequently the side effect of taking an anticholinergic medication (Cogentin, Artane, Akineton or Kemadrin).

It has been found that patients with dry mouth are not only more prone to cavities but may have tooth sensitivity. Additionally, the tissues in the mouth may become dry and painful.

These are just a few suggestions to help deal with dry mouth. Discuss these suggestions with your dentist, who can help you implement a program to maintain a healthy smile.

Note: Many people with Parkinson’s complain of an excess of saliva (causing drooling) and believe that Parkinson’s actually causes more saliva to be produced. There is not actually an excess of saliva in Parkinson’s. The cause is a reduction of the times per minute that the person swallows. In Parkinson’s, the involuntary act of swallowing is slowed as well as the number of swallows per minute, allowing more saliva to accumulate.

Medication can cause dry mouth

Some medicines can worsen dry mouth. Examples include:

Antihistamines such as Benedryl
Anticholinergic medicines used for tremor- Artane, Benztropine, Parsitan, Akineton
Amantadine
Amitriptyline
Botulinum toxin

So why is xerostomia such a big concern? Saliva is part of the initial process of digestion. Prolonged periods of xerostomia can contribute to malnourishment. Secondly, xerostomia can lead to painful chewing, speaking, and swallowing. Patients with painful xerostomia may not chew their food properly, and when you combine this in a person with PD who may already have difficulty swallowing, there is an amplified risk for choking. Improper chewing can also add to malnutrition problems. Finally, saliva helps protect against tooth decay and periodontal (gum) disease. Saliva does this both by neutralizing the destructive acids produced by plaque, and by washing away the sugars on your teeth that can feed the plaque bacteria. Some people with PD who have long standing dry mouth require extensive dental work due to tooth decay caused by xerostomia.

Steps you can try to reduce dry mouth

Avoid alcohol and tobocco that can dry mouth
Talk to your doctor about your medicines
Chew gum or sugarless candies
For dry lips, try K-Y Jelly, Surgi- Lube or hydrous lanolin (ask your pharmacist). Avoid vaseline and products make your lips even dryer by pulling water out of the tissues.
Humidifying your sleeping area.
Add Papaine or papya to diet to thin thick secretions
Request a referral to a speech therapist if speech or swallowing is affected
See your dentist at least twice a year
An electric toothbrush improves dental hygiene over a standard toothbrush
substitutes like Xero- Lube, Salivart, Moi-Stir and Orex, or a solution of sodium carboxymethyl cellulose prepared by your pharmacist, can be used as an oral rinse several times a day.
For sensitive teeth, ask your dentist about a topical fluoride gel. Your dentist or his staff can teach you oral hygiene techniques (flossing, water pick, and special brushes) most effective in removing plaque, controlling cavities and keeping gums healthy.

Some people with PD report excellent relief of dry mouth with Myntz or Sqyntz, sorbitol based products available in the candy section of grocery stores. Click here for more information on products used to improve dry mouth. Always remember that the best defenses against xerostomia and tooth decay are good oral hygiene and regular check-ups with your dentist.

Author: James DeLapp, DDS, This article is reprinted in part with the author’s permission. James DeLapp practices dentistry at the Cottonwood Dental Group in Highlands Ranch, CO.

Medical Information Disclaimer and Legal Agreement

Please read this agreement entirely and carefully before using the Northwest Parkinson’s Foundation website (nwpf.org).By using www.nwpf.org site, you agree to be bound by the terms and conditions below and in the www.nwpf.org Privacy Policy.

Disclaimer About Medical Information:
The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient's own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care. The information contained herein is neither intended to dictate what constitutes reasonable, appropriate or best care for any given health issue, nor is it intended to be used as a substitute for the independent judgment of a physician for any given health issue. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only. The major limitation of informational resources like www.nwpf.org is the inability to take into account the unique circumstances that define the health issues of the patient. If you have persistent health problems or if you have further questions, please consult your health care provider. All visitors to this and other www.nwpf.org associated web sites agree to read and abide by the complete terms of this agreement.

Legal Disclaimers

Summary:
 * www.nwpf.org web site does not constitute an attempt to practice medicine.
 * The use of the site does not establish a doctor-patient relationship.
 * Individuals should consult a qualified health care provider for medical advice and answers to personal health questions.
 * While the site attempts to be as accurate as possible, it should not be relied upon as being comprehensive or error-free.
 * www.nwpf.org is under constant development and changes may be made in the articles and programs at any time.
 * The web site reserves the right to change its disclaimer or privacy policy, so users should review these periodically.

No Medical Advice.
The information posted here by www.nwpf.org is not to be considered medical advice and is not intended to replace consultation with a qualified medical professional. We may answer and post medical questions solely on our own discretion. We do not have the resources or the capability to answer all visitor questions. In general, the questions we choose to answer are (in our opinion) of value to other readers. The answers to these questions should in no way be considered specific medical advice or a plan for disease management. Our goal is to provide sufficient information so that www.nwpf.org visitors are able to become knowledgeable participants in their disease management plan. The primary responsibility of your disease management plan is with your treating physicians and you should only follow your treating physicians advice. DO NOT change/modify your disease management plan on your own without consulting your treating physicians.

No Warranties.
This web site is provided on an "as is," "as available" basis without warranties of any kind, express or implied, including, but not limited to, those of TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE or NON-INFRINGEMENT or any warranty as to accuracy, timeliness, completeness or arising from a course of dealing, usage, or trade practice. No oral advice or written information provided by the www.nwpf.org shall create a warranty; nor shall members or visitors to the site rely on any such information or advice.

Disclaimer of Liability.
The user assumes all responsibility and risk for the use of this web site. Under no circumstances shall www.nwpf.org or its contributors/employees or its affiliated organizations such as the University of Illinois at Chicago or its employees or anyone else involved in creating or maintaining this web site be liable for any DIRECT, INDIRECT, INCIDENTAL, SPECIAL or CONSEQUENTIAL DAMAGES, or LOST PROFITS that result directly or indirectly from the use or inability to use the web site and/or any other web sites which are linked to this site - or that result directly or indirectly from mistakes, omissions, interruptions, deletion of files, viruses, errors, defects, or any failure of performance, communications failure, theft, destruction or unauthorized access.

In states which do not allow some or all of the above limitations of liability, liability shall be limited to the greatest extent allowed by law.

Online Conduct.
Visitors agree to use the web site only for lawful purposes and are prohibited from posting on the web site any unlawful, harmful, threatening, abusive, harassing, defamatory or obscene material of any kind, including, but not limited to, any material which encourages conduct that would constitute a criminal offense, give rise to civil liability or otherwise violate any applicable local, state, national or international law. This applies to any posting that could be termed as Sexual Harassment and or Discrimination. Although in the absence of a specific complaint the postings are not monitored for compliance with this provision, in an effort to discourage such conduct, please note that all postings in the Comments area will list the author's name--no anonymous postings are permitted!

Disclaimer of Endorsement.
Reference to any products, services, hypertext link to the third parties or other information by trade name, trademark, supplier or otherwise does not constitute or imply its endorsement, sponsorship or recommendation by www.nwpf.org or its contributors/employees. They are for convenience only.

Link Disclaimer.
Links are provided only as an informational resource. Please note that many of the links provided are not on our servers and are not maintained by us or affiliated with any services provided by us. These links are provided simply as a service, and it should not be implied that we recommend, endorse or approve of any of the content at the linked site(s), nor are we responsible for their availability, accuracy or content.

Have a nice day.