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Severe Mental Illness and Oral Health

Severe mental illness (SMI) is a life-altering disease that may be diagnosed with illnesses like schizophrenia, bipolar disorder, and/or severe depression. It usually strikes at the time a person is just beginning to discover the freedoms of adulthood, their dreams, and their chances of moving forward in life. Then, suddenly continuing as a member of their peer group changes dramatically.  For them life becomes a world of thought dissolution, paralyzing grief, endless fear, and a desperate attempt to “become normal” with life-changing medications and hospitalizations.  Families find they are in a pit of terrifying unknowing and panic. They worry for the loved one’s prognosis and recovery of life. I am a dental hygienist and was a caregiver for my nineteen year old son affected with SMI until his passing on June 18, 2008 at 24 years old.

Not only did SMI drastically change the overall quality of life and general health for my son, it had a detrimental impact on his oral health. Within one year of my son’s diagnosis and taking the prescribed medications, his teeth began to disintegrate, leading to over $15,000 in dental reconstruction.  He suffered tooth loss and severe generalized demineralization and sensitivity.  We were fortunate that we could provide dental treatment for him whereas many others with SMI are not that fortunate and consequently suffer greatly from pain, infections and loss of many teeth.  People with mental illness are the most dentally under-served population.

I learned about xylitol in my desperate attempt as a mom and a dental hygienist to help him. When I learned about the amazing dental benefits of xylitol, I advised my son to begin incorporating it into his daily routine between meals in the form of chewing gum. Initially it relieved my hovering over him to encourage good oral hygiene habits and within time we saw a decrease in  plaque buildup and tooth decay.

What are some of the dental and general health issues folks with SMI wrestle with and how does xylitol help?

  • Symptoms of SMI cause exhaustion, disorganization of thought process and demotivation, all of which affect oral hygiene.

    Using xylitol products such as Spry Gum, Mints, Toothpaste, and Gel five times a day (Spry Five) is the appropriate amount of exposure for satisfactory results to occur.  Because xylitol is a five carbon molecule, the bacteria in the mouth cannot digest it.  After the bacteria ingest the xylitol there is no replication of the bacteria and they lose their stickiness and wash away.  The pH of xylitol is neutral which helps keep the saliva in a neutral state.

  • Medications cause severe dry mouth.

    Xylitol has a cooling effect and draws moisture to the tissue surfaces. Salivation increases with Spry Gum, Mints, Oral Mist, thus relieving dry mouth.

  • Medications cause dry nasal passages.

    When used in a nasal wash, like Xlear nasal spray, xylitol moisturizes the nasal passages.

  • Medications cause an imbalance of natural flora.

    Xylitol products used in the form of Spry Gum, Mints, Rinses, Toothpaste and Tooth Gel reduces Candidiasis infections, Angular Chelitis, and canker sores that many patients on psychiatric medications experience.

  • Antipsychotic medication cause metabolic changes which lead to the addiction to sugar, severe weight gain, Type 2 Diabetes and high Cholesterol/triglycerides.

    Using xylitol in the form of XyloSweet to replace sugar helps curb the appetite for sugary carbs. It helps those with diabetes as it has a low Glycemic index of 7 and is 40% less calories than sugar. Xylitol is a natural sweetener recommended by Diabetic Educators for their diabetic patients. Since sugar drives the numbers up for triglycerides, using XyloSweet in place of sugar will help to reduce those numbers as well.

In summary, using 100% sweetened xylitol Spry dental products five times a day (Morning, after each meal and before bedtime) and XyloSweet as a sugar substitute will address many severe issues that plague this population from medication side effects.  Offering this population successful alternative for their oral health creates a comprehensive caring experience for the patient. Dental health and treatment play a very important role in a person’s recovery from an episode of SMI to feel confident in being able to re-enter their former life.  It is very important for a person to be free of dental pain, infection and feel confident about their smile. Prevention is the key that xylitol offers.  I readily share this pertinent information as the North East Xylitol Educator in hopes to reduce the frustration involved for the dental caregiver when attempting to help these folks with the impending tooth destruction that occurs with a SMI diagnosis and as a way of honoring my son.

Lisa E. Stillman RDH, BS