As we get older, many changes occur throughout our bodies. We start to not heal as quickly, our immune systems tend to be weaker, our balance suffers and our joints start to become a little stiffer making it more difficult to stay mobile. These changes are but a few of the many things that happen to all of us, we can’t escape it! Another aspect of aging which is seldom considered is that which is seen in the oral cavity. One of these effects, and the focus of this article today, is called ‘Dry Mouth’ or the medical term is ‘Xerostomia’.
To begin with this rather large topic, lets look at saliva and its functions to illustrate the issues if saliva quality or quantity is compromised.
Saliva has the ability to maintain dissolved Calcium and Phosphate. As the saliva bathes the teeth, these ions will stop the teeth from dissolving when exposed to acids. Plaque bacteria release acid onto the teeth which will dissolve enamel. Bacteria then start to consume the tooth as they have dissolved through the protective, hard enamel covering. This is commonly known as Caries or ‘Decay’. So without saliva, decay starts and processes much more rapidly, hence the ‘cario-protective’ nature of saliva.
The oral environment is warm, moist and nutrient rich. This is a great environment for the propagation of fungal infections. Oral candidiasis (oral thrush) is seen regularly in immunocompromised people, those with poor saliva flow and patients that don’t remove dentures at night. Saliva has anti-fungal agents in it to protect against this condition so if saliva is unable to reach the mucosa (mucosa is covered by a denture) or if there is not a lot of it, this often painful condition can result.
Patients with a low saliva flow are often seen having a larger amount of bacteria due to saliva’s ability to kill plaque. Now this doesn’t mean that saliva will kill all plaque, it kills some of it. So before you throw away your floss and toothbrush, just remember that mechanical removal of plaque is the only way to kill all of it to prevent decay and gum disease.
Our tastebuds are basically little chemical receptors which shoot messages to the brain telling us what we taste. The chemicals in food that elicit particular responses such as sweet, bitter, sour etc need saliva to be able to do this. This means the lack of saliva can mean our taste is affected. A common way around this for a lot of people is to have more sweeteners in foods which increases incidence of decay in an already compromised mouth.
Another important function of saliva is to act as a lubricant. This helps us chew and swallow food, add to general daily comfort as well as helping with denture retention. Lack of saliva in patients affects their daily lives with mucosa often being swollen, sore and sticky. There are products on the market to help combat this and increase comfort. The most important method of improving comfort is to drink clean water only. Any additives (cordials, citrus etc) have a detrimental effect on teeth and should be avoided or risk rampant decay/erosion of teeth.
Xerostomia has many causes in addition to just the reduced function of salivary glands with age. Things like auto-immune conditions such as Sjogrens Syndrome as well as there being over 300 different medications on the market that are prescribed for other health issues that cause Xerostomia. This list is visible here amongst many other interesting topics.
Xerostomia is something that will affect us all to some degree at some point in our lives. We can’t do anything to increase the flow of saliva, nor can we change its quality. The best thing you can do is attend regular dental maintenance visits. At The Village Dentist we carry many professional products that are able to combat the effects of Dry Mouth to maintain the health of your teeth and gums. We understand making an appointment can sometimes be the hardest part, so for this reason we now have online booking on our website. Help us help you and make an appointment today.