Guest post by Maria Eliopoulos, DMD, private practice family dentist
“Oh my, Dr. Maria, I haven’t had a cavity in 30 years, but now I have at least two or three every cleaning appointment. Why is this happening?”
I hear this question at least once a week from many of my older patients. These patients have good hygiene, watch their sugar intake and maintain regular cleanings and exams. So why now? Why do they seem to be prone to so many cavities along their gum lines?
The major culprit is dry mouth. The aging process alone doesn’t cause dry mouth, but common senior issues exasperate the dryness. One in three older adults suffer from xerostomia. This lack of saliva leads to many problems in the mouth. Without the wetness of saliva, food and plaque cannot be properly washed away along the gum line. So, bacteria can have a feast on the dry areas of the teeth, thus causing root caries. Also, due to the dryness of the root surface, teeth are unable to absorb minerals such as calcium and fluoride. Eventually, this causes significant tooth decay which can lead to tooth loss. Many patients experience cracks on their tongues, which can be very painful. It can also cause systemic problems such as infection and poor digestive health.
Many common medications frequently have this undesirable side effect. Common prescription drugs used to treat high blood pressure, depression, allergies and pain can increase dryness. Popular pills including Lisinopril and Norvasc (high blood pressure), Zocor (cholesterol), Metformin (diabetes), Xanax and Zoloft (depression), and Vicodin and Lorcet (pain) are all medications we are familiar with. I know my own parents take a number of these.
As if taking prescriptions are bad enough, even over the counter products can cause problems. Antihistamines, decongestants and some vitamins can dry our mouths. Always read the directions, before taking these seemingly innocent products.
Other factors include diseases such as diabetes, autoimmune diseases, nerve damage and cancer treatments. Snoring and tobacco use are also culprits.
So, what can we do?
As in all good medical care, the most important person is YOU! If you are waking up with “cotton mouth,” if you have thick and sticky saliva, if you have bad breath, trouble swallowing or mouth sores more than usual, please tell your doctor and your dentist. Don’t just assume that it’s another sign of our bodies getting old! This is a condition we can actually alleviate.
Medically, your physician might be able to adjust your prescriptions. He can review your medical history and diagnose underlying conditions. Medications, such as Salagen, can be prescribed to increase how much saliva is formed and how easily it flows in your mouth.
So, what can I, as your dentist, do? Most importantly, I can see the effects of dry mouth by a simple exam. I’m looking for root caries, red dry patches on your gums and cracked lip corners. I can treat decay while it is small, causing less damage to your teeth and your pocketbook. I can also give in-office fluoride treatments, and sometimes, prescribe a home fluoride therapy. But, once again, the most important item is a conversation about the symptoms you might have.
What can you do at home? Maintain good brushing and flossing habits. Use a mouthwash that contains fluoride but make sure the mouthwash rinse has no alcohol in it because that exasperates dryness. Drink plenty of water every day and avoid soft drinks and sugar drinks. Chew sugar-free gum (I bet you didn’t think a dentist would tell you to chew gum) and suck on sugar-free candy. Chewing gum will stimulate saliva flow. Use a humidifier at night. Try to avoid smoking, caffeine and tobacco. Limit sugary foods. I know, I might sound like a killjoy but you just need to try and curb the cookies and gummy bears in your diet, you don’t need to totally eliminate them.
Hopefully by working together we can diminish the amount of cavities that senior patients often experience. Knowing the causes of dry mouth, it becomes easier to counteract the negative effects. I would much rather hear about your grandchildren, your travels and how much better your garden is doing than mine than telling you that we have to restore five cavities!