A Dry Mouth Is Not a Normal Part of Aging

Few things are more uncomfortable than having a dry mouth. Dry mouth from a decrease in saliva or spit can lead to serious problems for your mouth. Saliva protects your teeth and mouth by helping to wash away harmful plaque and bacteria. A dry mouth can increase your risk for cavities and gum disease, give you bad breath, and make eating painful.

Signs and symptoms of dry mouth include:

  • Difficulty speaking, eating or swallowing

  • A burning or sore sensation in the mouth

  • Altered sense of taste

  • Increase in oral infections

  • Difficulty wearing dentures

The leading cause of dry mouth is medication. Over 400 commonly prescribed medications from the following categories can lead to a dry mouth: anti-depressants, decongestants and allergy medications, high blood pressure, diuretics, and pain killers.

Other causes of dry mouth are depression, stress, anxiety, cancer therapy, diabetes and other auto-immune diseases.

It may not be possible to change your medications. Speak to your dentist about ways to make your mouth more comfortable. More frequent cleanings may be necessary to keep your gums from deteriorating. Your dentist can prescribe some products such as fluoride rinses and saliva substitutes to help maintain your oral health.


Your Appetite Isn’t the Only Thing to Suffer from Acid Reflux

Severe Acid Reflux or GERD (Gastro-esophageal Reflux Disease) affects 25% of the population, most of whom are over the age of fifty. As we age, the closure at the top of the stomach relaxes allowing stomach acid to travel up our esophagus or throat and settle in the mouth. Many foods and beverages, medications, smoking and other lifestyle habits can exacerbate the relaxation of the closure. The acid causes a burning pain (heartburn) in the chest and throat and leaves an acid taste in your mouth. If the acid reflux is not controlled, it can begin to dissolve the enamel on your teeth as well. Without the hard protective layer of enamel, your teeth may become sensitive, weak, and prone to cavities and fractures. Individuals with untreated GERD often have flat, worn-looking teeth that appear more yellow. Individuals may appear older than their true age and many long-time GERD sufferers require dental work to re-build the teeth to their original size.

What can you do to protect yourself and your teeth? Talk to your dentist about the best options for preventing damage to your teeth. He/she may recommend fluoride trays to wear during sleep when GERD is most active. He/she can refer you to a medical doctor for treatment of the disease.

To Protect Your Teeth:

  • After a reflux occurrence, rinse your mouth with water and wait at least 30 minutes before brushing your teeth. Brushing immediately will accelerate wear of your teeth.
  • Drink plenty of water with fluoride. Avoid acidic foods and liquids, such as: citrus fruits and juice, wine, coffee, sodas, teas and energy drinks.
  • Floss and brush daily with a soft toothbrush.
  • Use Fluoride rinses and/or trays as prescribed by your dentist.
  • Have your teeth and gums professionally cleaned at least twice a year at your dentist’s office.
  • Chew sugar-free gum or mints to increase saliva excretion.

Symptoms of GERD:

  • Heartburn occurring two or more times a week-mostly at bedtime
  • Heartburn that lasts several hours and/or disrupts sleep

* Contact your medical doctor if you suspect that you have GERD . Some specialized tests may be needed to confirm the diagnosis. Untreated GERD can lead to ulcers, esophageal damage, and in rare instances, esophageal cancer.



What Should You Do When Your Child Knocks Out a Permanent Tooth?

Imagine this: You are at the park enjoying your morning coffee while your child is on the play structure. Suddenly, he comes running up to you with his hand over his mouth. He is crying and there is blood on his chin. You fear the worst. What do you do?

First, remain calm. Comfort your child and inspect his mouth. Apply pressure to stop the bleeding. Check for out of position teeth or missing teeth (most likely, a front tooth). If an adult or permanent tooth has been knocked out, make every effort to find the tooth and get to a dentist immediately to reposition the tooth. (A baby tooth is not usually reinserted, because an adult tooth will eventually grow in to replace it; however, you should still have your child examined by a dentist that day.) When you find the tooth, pick it up by the crown or top of the tooth – not the root, and rinse off any dirt with water. If possible, place the tooth back into the socket and hold it in position until you can get to the dentist. Again, arrive at your dentist’s office within 30 minutes - any longer than that and you risk non-attachment of the tooth. If you or your child is not capable of holding the tooth in position, place the tooth in a cup of milk or the child’s own saliva. The important thing is to keep the tooth from drying out.

What happens next? The dentist will take x-rays, splint the repositioned tooth with wire, and prescribe antibiotics and pain relievers. He or she may trim the tooth slightly to keep the other teeth from hitting it. The purpose of reinserting the tooth is to help your child’s mouth and face grow and develop properly. The presence of the tooth in the jawbone enables this to occur. It may seem like a lot of effort for one tooth, but your child will thank you later.


Does Drinking Bottled Water Give Your Family Cavities?

As a parent, I try to be a good role model for my two young children. I cook nutritious meals for them, take them to museums and art exhibits, exercise good manners around them and teach them to respect and appreciate other individuals and their surroundings. And, we brush and floss together nightly! (We are a dental family!) Am I doing all I can to be a good role model for my kids? Maybe not.

You see, my family is addicted to bottled water. My husband buys it by the case from Costco. It’s so convenient to grab one as I’m passing through the garage on my way to the car for our numerous outings to preschool, the park and play-dates. I’m never without my bottled water and neither are my two children. Because, as you are well aware, children usually want whatever Mom and Dad have!

Right now, you’re probably thinking, "What’s the big deal? It’s not like you’re giving them a Big Gulp from 7-11!"

True, but it has made me stop and think about my choice. Most of the brands of bottled water available do not contain fluoride in them. The ones that do have fluoride, have sub-optimal levels. If you and your family members are like mine, you are missing out on the cavity-preventive benefit of fluoride.

How does fluoride benefit our children? Systemic fluoride, or fluoride that is ingested, is especially important for children ages 0 to 14 years, because during this time their permanent teeth are developing. The ingested fluoride is incorporated into the surfaces of the teeth to strengthen the enamel and make it more resistant to breakdown. In contrast, topical fluoride in toothpastes and rinses only strengthen teeth already present in the mouth.* Once teeth are erupted, ingested fluoride from foods or water can also have topical benefits for teeth, because it is excreted by the body into saliva inhibiting bacteria’s ability to produce acid and cause decay. So, adults benefit from drinking fluoridated water as well. Luckily for us, most Bay Area communities contain the optimum level of fluoride in the tap water (0.7-1.1 parts per million).

Dentists and health advocate groups have known about the ability of fluoride to strengthen teeth for decades, which is why 60 % of cities nationwide support and participate in the addition of fluoride to community water supplies. Studies conducted in the 1950’s comparing communities with and without fluoridated tap water demonstrated a 50% reduction in the number of cavities in young children who received the fluoride-fortified water. In fact, the program was so successful in reducing early childhood cavities that it led some dentists in subsequent years to wonder if they would have to consider an alternative career.

Despite these proven benefits, cavity rates may again be on the rise. Currently, there aren’t any studies that link consuming bottled water to an increase in cavities, but it’s probably just a question of time as we know that fluoride prevents cavity formation. I saw this first-hand when I worked in a clinic for underserved families in Half Moon Bay – a community that still doesn’t have fluoridated public water. The number of children as young as two years old who came in with a mouth full of cavities was staggering. Sure, there are dietary factors that also contribute to this increase; however, as the consumption of bottled water by Americans escalates each year along with this increase in childhood cavities, it has caught the attention of the American Dental Association. The ADA’s campaign has resulted in an FDA-enforced labeling of bottled water containing fluoride and targeting those brands for children. Additionally, I now inquire about my patients’ sources of water and counsel them on the benefits of fluoridated tap water. Even in Palo Alto where I practice, there is still a need to urge my patients to drink their own community’s fluoridated tap water.

So, how have I resolved this matter within my own household? We made a trip to Whole Foods Market and purchased 4 stainless steel water bottles for each family member to carry along with them on family outings. Filling each one with tap water adds a little more time to my routine in the morning, but now I can feel good that I "practice what I preach". Plus think of all the money we’ve saved eliminating those cases of water from our shopping list!

*Please note that children should not use fluoride toothpastes until they have learned to spit it out completely!

Additional tips:

1. Water filtration systems are a viable alternative if you can’t bring yourself to drink water straight from the tap. Water filtration pitchers from Brita or Pur that have charcoal/carbon filters remove impurities yet leave fluoride behind. Household water treatment systems may be used as long as they do not use steam distillation or reverse osmosis, as those purification methods also remove fluoride.

2. Encourage your child to brush her own teeth but do a follow-up brushing so that teeth are completely clean. Continue to monitor brushing until age 10. Make sure teeth are well brushed at bedtime. Floss teeth that are close together or touching.

3. Limit the frequency of sugar, starchy and acidic foods throughout the day. The more often the teeth are exposed to these items, the more susceptible the teeth are to decay. Fruit juices and sodas are particularly detrimental to your oral health.

4. Take your child to her first dental check-up by her first birthday - earlier if you suspect tooth decay or delayed tooth eruption.


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