Dealing with Dry Mouth

Mouthwash/Fluoride Rinse

If you have a very dry mouth you are highly prone to tooth decay. Purchase a daily strength pH buffered fluoride rinse like CariFree Maintenance Rinse and place it in your bathroom, where you can rinse with it frequently.  It is important to only use an anti-bacterial mouthwash which does not contain alcohol or phenol if there are symptoms of dry mouth or sore mouth as alcohol has a drying effect on oral tissues. Biotene mouthwash is anti-bacterial, alcohol-free and like the ‘Dry Mouth Toothpaste’ contains salivary enzymes. If during treatment your mouth still becomes very sore and you feel that the mouthwash is too strong try diluting it with warm water. You can find more info on these here.

There is a maintenance fluoride rinse called Carifree Rinse that helps keep the bad bacteria down. Unlike other fluoride rinses, this one neutralizes acid and contains Xylitol for extra protection.

There is also extra strong 2-part rinse to “shock” the bad bacteria, which is used for 1 minute a day for 2 weeks in extreme cases.

They make a spray too for oral moisturizing. More information

Other products that can help:

- X-Pur OptiRinse

Xyli-Melts are lozenges that stick to your cheek and slow-release xylitol to help moisten your mouth overnight.

X-Pur Remin Toothpaste is non-dairy and Fluoride Free.

Lubricity Spray is long lasting and hydrating.

Cari0 Toothpaste (gluten free, SLS free, xylitol, fluoride free, neutral pH, stimulates saliva)

There are also some slow-releasing sugar-free Salese Lozenges that can help greatly.

Anti-cavity Chewing Gum

Chewing sugarless gum can moisten your mouth.  We recommend only sugarless gum sweetened with Xylitol. It is the safest artificial sweetener, and has been shown to actually reduce decay if used after meals or sugar-containing snacks 3 times per day.

Prevora anti-cavity varnish

Prevora is very effective for preventing the type of decay typical with dry mouth. It slow-releases an antibacterial compound on to the roots. It is bonded on to your teeth in a 15-minute visit. It needs to be bonded on once a week for 3 weeks, then again in 6 months and 1 year for a “booster” treatment. The good thing about Prevora is that it is applied by us, not you. Prevora Web Site

Toothpaste

Most toothpastes contain the foaming agent sodium lauryl sulphate, or SLS, which has been found to cause irritation in sensitive mouths. Toothpastes containing SLS should be avoided if you have sore mouth (mucositis), oral ulcers or dry mouth. Biotene ‘Dry Mouth Toothpaste’is SLS free, contains fluoride and important salivary enzymes. Rembrandt ‘Natural’ is also SLS free, as is MI Paste and CariFree Gel.

Extra strong toothpastes

3M Clinpro 5000 or CTX Gel 5000 are extra strong fluoride toothpastes good for severe decay due to dry mouth. They should be applied nightly to teeth after regular brushing, immediately before going to bed. Dry the toothbrush and cover the bristles with the extra strong paste or use cotton buds if gums are sore. Brush on to all tooth surfaces for one minute, then vigorously swish for one minute forcing the gel into the spaces between the teeth. Spit out and rinse after. You should not have anything to eat or drink for at least 20 minutes afterwards. 

A fluoride-free option is MI paste, which contains calcium ingredients derived from milk.  It can be applied as above, but is actually edible. It is very good for sensitive teeth and patients that get many canker sores, and rebuilds the calcium in your teeth. Apply a small quantity as above, but swishing or rinsing is not needed. It’s best if you leave it on overnight.

There is also an anti-acid tooth powder called Common Sense Teeth Cleaning Powder that is good to use for dry mouth. It is fluoride-free. 

You can obtain all of these from our office in Palgrave.

Diet

Should you have significant oral discomfort, small regular meals and snacks may help you obtain adequate nutrients and prevent weight loss. Carry a toothbrush with you and if you have your own teeth you can reduce the impact of tooth decay by limiting sweet, sticky, sugary foods or anything with a high acid level such as grapefruit, tomato or orange. Always brush immediately after eating. If it is not possible to brush, swish and swallow with water as soon as possible.

Warning: DO NOT suck on lozenges such as Halls, Tic-Tacs or hard candies that contain sugar to help moisten your mouth or throat! These are very dangerous for patients with a dry mouth. You can obtain sugar-free candies, PUR or Spry mints sweetened with Xylitol. 

Flossing

Use dental floss or dental tape between teeth at least once daily.

Denture Care

The acrylic resin from which dentures are fabricated has microscopic holes or pores. It is essential that dentures are cleaned thoroughly at least daily with a toothbrush or denture brush. They should not be worn at night and always left to soak in warm water or a denture cleaner such as Steradent from Reckitt and Colman when not being worn. They should also be left out as often as possible during the day, whenever a mouthwash is used and during radiation therapy sessions.

The gums and areas under a denture should also be brushed on a regular basis and the mouth rinsed after all meals. Brushing stimulates the gums and helps keep them firm and less likely to harbour the microorganisms which may lead to irritation or infection. Removing accumulated food debris limits irritation, staining and bad breath. Oralbalance moisturising gel can be used on the tissue fitting surface of the denture to minimise irritation and may also improve retention. At first sign of discomfort, the denture should be removed and checked by a dentist as adjustment or relining may be required.

Saliva Substitutes

Saliva substitutes may help keep the mouth moist and allow for easier eating, swallowing, talking and sleeping. Many patients have reported significant relief from the effects of dryness by using ‘Oralbalance’ moisturising gel. It is also suitable to place under dentures.

Maintenance

You should see a dentist at least four times a year for cleaning, fluoride treatment and early treatment of cavities. If there is decreased saliva there is likely to be an increase in the amount of tooth decay.

Suggestions to relieve dryness and preserve soft tissue:

• Take frequent sips of water

• Use a water spray bottle to wet your mouth

• Chewing sugarless chewing gum helps stimulate salivary flow

• Use sugarless mints like Spry Mints, which helps stimulate salivary flow

• Suck hard sugarless candies, eg ‘Sugar Free Lozenges’ or ‘Sugar Free Drops’ by Ricci, or PUR mints 

• Suck on ice blocks

• Keep a glass or carafe of water by your bed for sipping during the night or on awakening

• Drink frequently while eating. This will make chewing and swallowing easier and may improve taste

• Use bland, non-spicy sauces and gravies as accompaniments to meat dishes

• Moisten foods with butter

• Pasta dishes with creamy sauces may be easier to swallow

• Limit caffeine-containing coffee and tea. Many patients report increased dryness after drinking beverages containing caffeine.

Where to buy the mentioned products

The products mentioned here are mostly available from pharmacies or health food stores, although they may have to be ordered. We can provide most of them to you at cost in our office. The web page for some of these products is here for Biotene and here for Carifree.

With thanks to:

Dr. Peter Foltyn 
Dental Department 
St Vincent’s Hospital 
pfoltyn@stvincents.com.au