Dry Mouth and Associated Complications
Cesar Migliorati, Professor and Chair
Saliva is critical for maintenance of good oral health. Key actions of saliva include: buffering to prevent an acidic oral environment which predisposes to dental demineralization and supply of calcium and phosphate, key substrates for dental remineralization, and protein secretion that enhances the local defenses against infection. Dry mouth can develop due to salivary gland hypofunction or due to pathological dysfunction of the glands. In the general population there are about 10% of individuals with dry mouth. In individuals over 65 years of age, about 20-25% complain of dry mouth. In nursing homes up to 50% of individuals can have dry mouth.
Saliva is important for communication and nutrition and hyposalivation can significantly alter quality of life. In this presentation we will discuss causes that may lead to dry mouth and associated complications to oral and general health. Common conditions include diabetes and hormonal changes, depression and anxiety, radiation therapy of the head and neck that includes salivary glands in the radiation fields, and some autoimmune diseases like Sjögren’s Syndrome.
For instance, hyposalivation develops shortly after initiation of radiation therapy and persists long term when doses to the salivary glands exceeds 3000 cGy. Patients with chronic hyposalivation are at risk for oral cavity infections and dental caries. Depending on the extent of hyposalivation and the oral environment, a severe form of rapidly developing decay can lead to loss of dentition. Current concepts regarding the management of patients with dry mouth will complete the discussion.
Note: LIVE attendance is limited and will be issued on a first-come, first-serve basis. Nonetheless, all registrants will have access to the on-demand recoring of this lecture. Thanks for your understanding.
Presenter Disclosure: Dr. Caesar Migliorati received an honorarium from Colgate-Palmolive to compensate for the time involved preparing and giving this presentation.
Target audience: Dentists, Hygienists and Assistants.
Release date: Wednesday, July 11, 2012
Expiration date: Saturday, July 11, 2015
"Dry Mouth and Associated Complications" is co-sponsored by Dental Tribune America, LLC. Dental Tribune America LLC is a recognized ADA CERP provider.
The speaker will answer your questions
Thank you. Maite Moreno DDS, MS (Mexico)
http://www.ncbi.nlm.nih.gov/pubmed/22746063
I am recommending biotine products. The oral balance gel is the best for patients with dry mouth. Keeping good oral hygiene and using high fluoride content toothpaste is also importan to prevent caries.
Thanks for your interest!
I appreciate it.
I am so happy that you had the chance to atend the webinar. I hope all is well with you. Hope to have a chance to see you again soon. Best, Cesar
Linda Percell, RDH, MHSc
I think you will find that depression and the meds to treat it, and stress do actually make dry mouth worse. I've seen patient under major stress who never had dry mouth previously come in with all the issues we see in our Sjogren's and other dry mouth patients--heavier plaque build up, more calcium deposits, increased inflammation which is disproportional to the actual plaque volume.
I am a dental hygienist with Primary Sjogren's, so dealing with dry mouth is something I do on a daily basis. For me there is the option of sialogogues like Salagen/Pilocarpine and Evoxac to stimulate more saliva production. For patients who are dry from medications and other problems, increasing salivary output by stimulating saliva with sugar-free mints or gum is often helpful if they still can make reasonable amounts of saliva. For super dry folks, mineral paste can help neutralize the acidic saliva by using it every four hours during the day. I'm also a fan of mineral paste fluoride varnish treatments because they supply all the necessary building blocks to tooth repair instead of relying of inadequate ambient salivary minerals to work.
JoAnn RDH, BSDH, Primary Sjogren's Advocate
Post your comments & new ideas here
Cesar Migliorati , Professor and Chair
Cesar A. Migliorati, received a dental degree from the University of Sao Paulo (USP), Brazil in 1972 and a MS in Stomatology. He worked as a dentist in private practice and was a teacher at USP in the Stomatology Department. Between 1981 and 1984 he completed specialty training in Oral Medicine and a Master’s Degree in Oral Biology at UC San Francisco (UCSF). In 1988 he obtained board certification in Oral Medicine. Dr. Migliorati has held teaching positions at USP, UCSF, University of Florida, University of Zurich and Nova Southeastern University.
He completed a PhD in stomatology with emphasis in HIV/AIDS in 2002. Dr. Migliorati has worked in Oral Medicine for the past 25 years in teaching, research and patient care. He was one of the pioneering professionals to work with patients suffering from oral manifestations of HIV/AIDS. He has also worked with patients with oral mucosal inflammatory diseases, oral infections, oral precancer and cancer and the oral complications of cancer therapy.
His research in oral precancer and cancer, immunology, HIV infection and immunosuppression, oral mucositis and laser therapy is thought provoking. He is a member of the American Academy of Oral Medicine and the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. Dr. Migliorati’s letter to the editor of the Journal of Clinical Oncology in 2003 was the first report in the medical literature of bisphosphonate osteonecrosis. He has published extensively in medical and dental journals that include JCO, Lancet Oncology and Nature Reviews Endocrinology.
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