By Lisa Stillman, RDH, BS
Let’s talk about saliva. Saliva is 99% water and 1% of the most amazing ingredients—secretory proteins, immunoglobulins, electrolytes, antibodies and wound healing components. Science cannot duplicate saliva. When healthy, we produce two to three pints of saliva per day, which equals almost 10,000 gallons in a lifetime.
However, many people are deprived of saliva.
Severe dry mouth is associated with over 700 medications, which correlate with almost all medical issues, as well as autoimmune diseases. The medical health practitioner treating these patients and writing these prescriptions are not as concerned with dry mouth as they are with getting these patients stabilized medically. Many times they automatically recommend their patients suffering from dry mouth to drink more water.
Is that the answer? How many of you have heard yourself recommending water to your dry mouth patients? Think about this: Would you put your dry, chapped hands in water to moisturize them? If you suffered from dry mouth, wouldn’t you already be drinking more water?
As dental health professionals we need to gain a higher understanding of what these patients need for comfort and healing from this life-changing malady.
We know that healthy saliva is the first step in digestion by breaking down the food, allowing for taste to occur and making swallowing more comfortable. It also contains proteins that keep the tissues slippery and enzymes that support healthy natural flora, which inhibits infection. Saliva also offers the buffering capacity to keep a balanced remineralization and demineralization cycle that protects the enamel. If we relied only on water for wetness, the mouth would become dry and chapped because any mucins formed would be constantly diluted, causing difficulty in creating a bolus. Taste is lost and teeth become porous. Additionally, without saliva, digestive juices are compromised, which contributes to constipation, GERD, imbalance of natural flora, and other problems.
Ideally what we want to do is produce more saliva, and xylitol does just that. The cooling effect that emanates from xylitol actually makes the mouth water. Isn’t that what we want to do? Increase saliva, not dilute it! When you see your next dry mouth patient, ask them to only drink water to hydrate their body and to include products that are going to increase the saliva flow. Xylitol products like gum, candies, mouth sprays, and tooth gels are the optimal choice for dry mouth patients.
Be mindful that dry mouth interferes with sleep. Some patients wake up every hour to sip water as their tongue sticks to the roof of their mouth. One remedy is to use the oral mist, tooth gel, and Xlear Nasal Spray, which moisturizes the nasal passages and pharyngeal area that are highly affected by a lack of secretions. I am told by several oral cancer survivors that these three products used together keep the tongue from sticking to the roof of the mouth for three hours. Stay away from peppermint and cinnamon flavored products, but spearmint is okay. Provide your patient with a list that offers an armature of products. They get tired of the same tastes and need variety. Your patient will treasure you for thinking about them in such a personal caring way like no other healthcare professional.