Dental Implants

 

Dental Implants: Are They Safe?

Medically Reviewed by Zilpah Sheikh, MD on February 01, 2024

 Written by Lori M. King, PhD

• What Are Dental Implants?
• Types of Dental Implants
• Dental Implant Benefits
• Who Needs Dental Implants?

10 min read

What Are Dental Implants?

Dental implants are titanium or ceramic posts inserted into your jawbone to hold artificial teeth. They act like the roots of your natural teeth to provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

Dental implants are replacement roots for missing teeth. They're often more comfortable and help maintain your jaw and face shape better than dentures. (Photo Credit: E+/Getty Images)

Dental implants vs. dentures

Dental implants are usually titanium posts that are permanently inserted into your jaw. They're like artificial roots that make a base onto which your dentist can attach a replacement tooth. On the other hand, dentures are substitutes for your teeth instead of replacements. Dentures are usually made of metal, acrylic, or nylon plates and porcelain teeth. They're removable and generally sit on top of your gums.

Types of Dental Implants

There are a couple of different types of implants that differ in how they are attached to your jawbone.

The two types are:

• Endosteal implant. This is the most common type. It usually looks like a screw, cylinder, or blade that is implanted in your jawbone during surgery. Each of these implants can hold one or more prosthetic teeth. This is a good option for people who already have bridges or removable dentures.
• Subperiosteal implant. This is placed on top of the jaw, with posts from a metal framework sticking out through your gum to hold your prosthetic teeth. This is a good option for people who can't wear removable dentures or don't have enough bone in their jaw to hold an endosteal implant.

Dental Implant Benefits

Dental implants have many advantages over dentures, including:

• Better ability to chew. Dentures can slide around inside your mouth, which may make chewing difficult. Dental implants are fixed in your jaw, like your own natural teeth, which allows you to eat your favorite foods with confidence and without pain.
• Better ability to talk. Dentures that slip in your mouth may cause you to mumble or slur your words. Dental implants allow you to speak without your teeth slipping around.
• More comfort. Your gums change shape to fill holes where you had teeth, and they continue to change shape over time, so dentures tend to become loose and shift around. Dentists recommend you get your dentures realigned every once in a while and completely replace your dentures every 5-8 years because of the way your gums change shape over time. Because they become part of you, implants can be more comfortable than dentures that slip around on top of your gums.
• Improved oral health. Dentures that slip and slide in your mouth can make your gums sore or even make your gums infected. Bacteria and fungi can live in any cracks and crevices of your dentures, which raises your risk of getting an infection. On the other hand, implants allow easier access between your teeth, so you can continue to floss for good gum health. Also, you may need to have some of your teeth shaved down to wear a tooth-supported bridge. With implants, you don't need to have nearby teeth altered, which can improve your long-term oral health.
• Better appearance. The crown that fits over your implant is made to look like your own teeth. They can give you back your smile and help you feel good about yourself.
• Durability. With good dental hygiene, your implants can last a lifetime.
• Protection against bone loss. The roots of your natural teeth are anchored in your jawbone. This stabilizes your jawbone, as a load-bearing wall does inside your house. When you have teeth removed without replacing them, your jawbone can get worse over time. This can change the shape of your face and mouth. Since implants are fixed in your jaw like your natural teeth, they stabilize your jawbone and prevent bone loss.
• Who Needs Dental Implants?

Most people who are missing one, several, or all of their teeth are candidates for dental implants. In general, if you're healthy enough to have a tooth removed or have a root canal, you can be considered for a dental implant.

The ideal candidate for dental implant

You're an ideal candidate if you:

• Have good general and oral health
• Have a fully grown jawbone
• Have enough bone in your jaw to hold the implant or are able to have a bone graft
• Have healthy gum tissue with no periodontal disease
• Don't have a health condition that affects your body's ability to heal bone
• Don't smoke
• Are willing to commit several months to the process

Reasons Not to Get Dental Implants

Dental implants may not be right for you if you:

• Are younger than 18
• Smoke or use other tobacco products
• Have a lot of bone loss in your jaw
• Have poor oral hygiene
• Have a lot of cavities
• Have gum disease
• Have some medical conditions, such as bone disorders or some autoimmune conditions (such as diabetes)
• Does Insurance Cover the Cost of Dental Implants?

Insurance coverage of dental implants often depends on whether your medical or dental insurance applies, or whether both apply. Talk to your oral surgeon's office staff about the extent of your surgery and what your insurance will cover.

Here are some things to keep in mind:

• If your dental insurance covers implants, make sure you review your annual spending limit because you could have extra out-of-pocket costs.
• Some insurance plans may cover the implant but not the prosthetic teeth attached to it.
• Your medical insurance may also cover some parts of the procedure, so ask about that.
• If you have lost a tooth or need a replacement because of an injury or accident, some insurance policies will cover dental implants as part of that coverage.
• Make sure you talk to your insurance provider if you don't understand your coverage.

 

Dental Implant Procedure

How to prepare for dental implant surgery

You will need one or more surgical procedures to get an implant, so it's important that you have a thorough medical evaluation before you start the procedure. You want to make sure you haven't developed any conditions that may prevent you from healing well after the surgery. You will usually have a comprehensive dental exam. Your dentist will take X-rays of your teeth and jaw and make models of them.

You may meet with all the specialists who will be involved in your surgery, such as:

• An oral and maxillofacial surgeon (a surgeon who specializes in conditions of the jaw, mouth, and face)
• A periodontist (a dentist who specializes in gums and bones that support the teeth)
• A prosthodontist (a dentist who designs and fits artificial teeth)
• An otolaryngologist (an ear, nose, and throat doctor)

In addition:

• Make sure your dentist has a list of all your medical conditions, medications, and supplements. Your dentist especially needs to know if you are taking a blood thinner. You may need to stop taking some of your medicines before your surgery, but your dentist will talk about this with your primary care doctor. Don't stop taking any medicines without talking to your dentist and doctor about it.
• Take any medicines your dentist prescribes. People with some conditions or orthopedic implants (such as a hip replacement) may need to take antibiotics before surgery to avoid getting an infection.
• Talk to your dentist about what kind of sedation you will have during the surgery. You can usually choose between nitrous oxide (laughing gas), oral conscious sedation (sometimes called "twilight sleep"), and IV sedation. 
• Arrange for a ride after your surgery. If you have oral conscious sedation or IV sedation, you'll need a trusted friend or family member to drive you home afterward.

What to expect during your dental implant procedure

Dental implant surgery is usually an outpatient procedure that's performed in stages to allow you to heal in between. The entire procedure can take months because the bone in your jaw needs to grow and heal around the implant before the dentist can attach your artificial tooth.

Stages of the procedure include:

• Removal of the damaged tooth, if needed.
• Bone graft, if needed. If your jawbone is too thin or soft, a bone graft can give you a more solid base to hold the implant. Your dentist may use natural bone from another location in your body or a synthetic bone-substitute material. It may take several months to grow enough new bone to support your implant. Sometimes, you may get a sinus augmentation instead, especially if you need to have a tooth replaced in the upper back of your mouth. A sinus augmentation raises your sinus floor to give you enough bone to place the implant. Many people don't have enough bone to hold an implant in this area because the maxillary sinuses (hollow spots in your head) are right above the back teeth.
• Placement of the implant. Your surgeon will open your gum to expose your bone. They will then drill holes just large enough to hold your implant deep in your bone and place the post there. They will then stitch your gum closed. If you can see the implant when you talk or smile, your dentist may give you a temporary, removable denture to cover it in the meantime.
• Healing and bone growth. Your jawbone grows into and around the surface of the implant post. This can take several months and gives you a solid new root for your artificial tooth.
• Placement of the connector for the artificial tooth. The piece where your artificial tooth will attach is called an abutment. Your surgeon may place this at the same time as they place the implant so you don't need a separate procedure. However, this depends on which tooth or teeth are being replaced. The abutment will be visible above your gum line, so if you can see it when you talk or smile, you may want to wait for a separate procedure.
• Healing your gums. You usually need to let your gums heal for about 2 weeks before your dentist can place the artificial tooth.
• Placement of your new tooth. You can generally choose between removable or fixed teeth. Removable teeth look similar to removable dentures, but they snap onto a metal frame attached to the implant abutment. Fixed teeth will be permanently screwed or cemented onto the abutment. Your dentist may be able to replace several teeth onto one implant and abutment using this method if they are all bridged together.
• How Successful Are Dental Implants?

Success rates of dental implants vary, depending on your overall health and habits. But, for people with good health and oral hygiene habits, implants are successful 90%-95% of the time.

How Painful Are Dental Implants?

Since getting implants involves having surgery, you should expect a bit of pain. But, according to several studies, most people say that they had less pain and swelling during and after their dental implant surgery than after having a tooth removed.

After the surgery, you can usually manage your pain and swelling with over-the-counter pain medications, such as Tylenol or Motrin.

Dental Implants Complications

The risk of complications is minimal if your surgeon has a lot of experience performing implant surgery. But, like all surgical procedures, dental implant surgery does have potential risks:

• Infection
• Sinus damage
• Nerve damage
• Implant placed in an area that doesn't work long-term
• Allergic reaction to the implant material (this is very rare)

Dental Implant Recovery

Recovery times vary after surgery, but most people can get back to their normal activities in about 3 days. Right after surgery, you may have the following:

• Swelling and bruising in your gums and face
• Pain where your implant was placed
• Minor bleeding

Your dentist or surgeon may prescribe you pain medicine and antibiotics. Make sure you take your medicine as prescribed by your doctor.

Any swelling or pain should get better over time, but if it doesn't, talk to your surgeon.

You may want to eat soft foods until your gums heal.

It can take several months for your jawbone to heal and grow around your implant. You'll need to go to your surgeon and dentist for follow-up visits so they can make sure you're healing well.

Long-term dental care

Dental implants require the same care as your real teeth, including brushing, flossing, and regular dental checkups.

Takeaways

Dental implants are permanent replacement roots inserted in your jaw. Your implant will be a base for a replacement tooth, which could be a crown, bridge, or denture. Getting implants can take several dental surgeries with a few months of healing in between. But, in most cases, they're a better option than dentures, as they tend to be more comfortable and can help you chew, speak, and look better.

Dental Implant FAQs

Is there a downside to dental implants?

The most notable downside is that the process takes some time and patience to complete. You will usually need several surgeries with several months of healing before you will have your replacement tooth or teeth. However, it's mostly better for your long-term health and self-esteem than dentures since the implants are more like your natural teeth.

What are the 3 stages of dental implants?

Depending on your situation, your dental implants may take more or fewer stages. Generally, you will have surgery to place the implant, followed by a period of healing to let your bone grow around it. Then, you will have another surgery to place a connector piece called an abutment. Once you have healed from that, your dentist will place your replacement tooth.

What is the best age for dental implants?

If your jaw has stopped growing (generally over age 18), you are at the best age for a dental implant.

Link Between Gum Disease & Alzheimer's Disease

Periodontitis May Initiate Alzheimer’s Disease

Long-term exposure to Porphyromonas gingivalis causes inflammation and degeneration of brain neurons in mice that is similar to the effects of Alzheimer’s disease in human beings, according to the University of Illinois at Chicago (UIC). These findings suggest that periodontal disease may be an initiator of Alzheimer’s disease, researchers there report. 

“Other studies have demonstrated a close association between periodontitis and cognitive impairment, but this is the first study to show that exposure to the periodontal bacteria results in the formation of senile plaques that accelerate the development of neuropathology found in Alzheimer’s patients,” said Keiko Watanabe, DDS, professor of periodontics at the UIC College of Dentistry and corresponding author of the study. 

“This was a big surprise,” Watanabe said. “We did not expect that the periodontal pathogen would have this much influence on the brain or that the effects would so thoroughly resemble Alzheimer’s disease.”

To study the impact of the bacteria on brain health, the researchers established chronic periodontitis in 10 wild-type mice. Another 10 mice served as the control group. After 22 weeks of repeated oral application of the bacteria to the study group, the researchers studied the brain tissue of the mice and compared brain health. 

The mice chronically exposed to the bacteria had significantly higher amounts of accumulated amyloid beta, a senile plaque found in the brain tissue of Alzheimer’s patients. The study group also had more brain inflammation and fewer intact neurons due to degeneration. 

These findings were further supported by amyloid beta protein analysis and RNA analysis that showed greater expression of genes associated with inflammation and degeneration in the study group. DNA from the periodontal bacteria was also found in the brain tissue of mice in the study group, and a bacterial protein was observed inside their neurons. 

“Our data not only demonstrate the movement of bacteria from the mouth to the brain, but also that chronic infection leads to neural effects similar to Alzheimer’s,” Watanabe said.

The researchers say these findings are powerful in part because they used a wild-type mouse model. Most model systems used to study Alzheimer’s rely on transgenic mice, which have been genetically altered to more strongly express genes associated with the senile plaque and enable Alzheimer’s development. 

“Using a wild-type mouse model added strength to our study because these mice were not primed to develop the disease, and use of this model gives additional weight to our findings that periodontal bacteria may kickstart the development of the Alzheimer’s,” Watanabe said. 

The researchers say that understanding causality and risk factors for the development of Alzheimer’s is critical to the development of treatments, particularly when it comes to sporadic or late-onset disease, which constitutes more than 95% of cases and has largely unknown causes and mechanisms. Watanabe also said the findings offer lessons for everyone.

“Oral hygiene is an important predictor of disease, including diseases that happen outside the mouth,” she said. “People can do so much more for their personal health by taking oral health seriously.” 

The study, “Chronic Oral Application of a Periodontal Pathogen Results in Brain Inflammation, Neurodegeneration and Amyloid Beta Production in Wild Type Mice,” was published by PLOS One.

E-Cigarettes Link to Increase Risk of Oral Cancer

E-Cigarettes Linked to Increased Risk of Oral Cancer

 02 Aug 2018  Dentistry Today 

 Industry News

 1978 times

Tobacco remains a leading cause of oral cancer. But the market is evolving with increased usage of non-cigarette tobacco products, which often are touted as safer alternatives, and the dual use of multiple product types. So, researchers at the University of California San Francisco School of Dentistry and School of Medicine are evaluating exposure to known carcinogens according to recent use of different tobacco product types, alone or in combination.  

The researchers analyzed data from the Population Assessment of Tobacco and Health, which includes a sample of adults in the United States who provided urine specimens for analysis of tobacco-specific nitrosamines (TSNAs) N’-nitrosonornicotine (NNN), a known oral and esophageal carcinogen, 4-(methynitrosamino)-1-(3)-pyridyle-1-butanol (NNAL), a metabolite of lung carcinogen (NNK), and total nicotine equivalents.

Participants were categorized according to the use of combustible, which includes cigarettes, cigars, water pipes, pipes, blunts or marijuana-containing cigars, and smokeless, which includes moist snuff, chewing tobacco and snus, e-cigarettes, and nicotine replacement products. For each product, recent use was defined as within the previous three days, and non-use was defined as none within 30 days.

All tobacco use categories demonstrated elevated nicotine and TSNA concentrations relative to non-users. TSNA exposures were highest among smokeless tobacco users, whether used alone or together with other product types. Exclusive e-cigarette users were exposed to lower NNN and NNAL levels than other product users despite comparable nicotine exposure. However, most e-cigarette users concurrently used combustible tobacco resulting in TSNA exposure similar to exclusive cigarette smokers.

According to the researchers, most non-cigarette tobacco users in vast numbers are exposed to carcinogen levels comparable to or exceeding exposure among exclusive cigarette smokers, levels that are likely to place users at substantial risk. The researchers presented their study, “Nicotine and Carcinogen Exposure by Tobacco Product Type and Dual Use,” at last week’s 96th General Session of the International Association for Dental Research in London.

BOTOX USE IN TREATMENT OF TMJ DISORDERS

BOTOX® Treatments for TMJ

American Academy of Facial Esthetics Trained Physicians, Dentists and Nurse

BOTOX® Treatment for Jaw Tension and TMJ

BOTOX® is used as an alternative treatment for TMJ (temporo-mandibular joint) disorders and associated jaw tension and pain. When injected into facial muscles afflicted with soreness and discomfort, BOTOX® relieves TMJ and jaw tension for many patients. The injections often eliminate headaches resulting from teeth grinding, and, in cases of severe stress, BOTOX® can even minimize lock jaw. Although BOTOX® treatment for these conditions is presently experimental; evidence indicates that it can be extremely effective.

How Does BOTOX® Treat Jaw Tension and TMJ Disorder?

Located on both sides of the head at the point where the jawbone meets the skull, the temporo-mandibular joint (TMJ) is used during talking, eating, swallowing, and other everyday activities. If this joint becomes displaced or is overworked through excessive teeth grinding, a person may suffer severe tension headaches, as well as sharp pain in the jaw. BOTOX® relieves jaw tension by making muscles unable to engage in the powerful, often unconscious movement of the jaw that produces headaches and pain.
The BOTOX® alternative treatment for TMJ disorders and jaw tension is usually quick, straightforward, and effective. A non-surgical procedure, BOTOX® injections are administered in a doctor’s office and treatment requires no hospital stay. Most patients experience noticeable improvement within one or two days of their first treatment, although relief can take up to a week.

Areas Affected by TMJ Botox Therapy

Only the areas injected with Botox will be “relaxed.” Botox treatment for TMJ therapy will not affect anywhere else in your body. The injections are mainly in the temporalis, frontalis and masseter (see picture below) additional sites may be injected with Botox depending on the severity of the headaches.

How long is the Botox Treatment Procedure?

The length of the Botox treatment procedure depends on the number of injections needed as determined by the doctor. Still, it is reasonable for the treatment procedure to be completed within 10-30 minutes.

Is the Botox Treatment Painful?

The pain associated with the Botox TMJ Treatment procedure is due to the injections, but it is generally minimal and brief. Some patients have likened the Botox injection pain unto a “bug bite” or “prick”. Pain from the injection can be reduced by numbing proposed injection sites with a cold pack or anesthetic cream. If you are scared of needles the doctor may offer you Happy Gas.

What to Expect After the Botox TMJ Treatment?

After the Botox TMJ Treatment muscle tenderness will start to disappear almost immediately. Wrinkles begin to disappear within 24 – 48 hours after the injections, and you may continue to see the wrinkles diminish up to one week after the Botox treatment procedure.

There may be mild temporary bruising, numbness, or redness around the injection sites. You will not look 20 years younger, but you may find that you look more natural and relaxed or less sad and angry. A small number of patients treated with Botox injections reported no noticeable difference in the reduction of their wrinkles.

What is the Recovery from Botox Therapy for TMJ Treatment Like?

Because the Botox Treatment procedure is non-surgical and non-invasive, it is highly likely that the patient can return to normal activities immediately. However, to avoid spreading the toxin to other muscles, patients should not rub or massage the area injected with Botox and remain upright for many hours. Physical activity should also be limited for a time.

Risks, Limitations & Possible Complications of Botox Injections for TMJ Treatment

As with any medical procedure there are possible risks and side effects when using Botox for TMJ treatment. Since this is a non-surgical treatment procedure, the risks and possible complications are infrequent, minimal and temporary.

The most common reported side-effects of Botox treatment are headaches, respiratory infection, flu syndrome, temporary eye-lid droop, and nausea. Less commonly reported effects of Botox are pain, redness at spot of injection, and muscle weakness. These symptoms are thought to be connected with the Botox injection and occur within the first week.

There could also be bruising at the injection site. The lips are used more than the forehead for common activities such as chewing, kissing, and talking. Therefore Botox injections around the mouth are less useful in TMJ treatment and can have more potential inconvenient effects. These every day activities may become more difficult and too much Botox® around the mouth can result in drooling. Another limitation to Botox® injection for TMJ treatments is that there is a possibility of developing antibodies that would render the TMJ treatments less and less effective over time. This resistance could be delayed by using the lowest effective dose possible over the longest intervals of time. Botox injection treatments should be avoided during pregnancy and lactation.

Disclaimer: botox, dysport, dermal fillers, facial injections, and other skin care information contained on this website is provided for educational purposes and should not be taken as medical advice. To consult with one of our AAFE trained members, please contact one of our trained members today.

Dental Sealants

What are dental sealants?
Dental sealants are plastic coatings that are usually placed on the chewing (occlusal) surface of the permanent back teeth — the molars and premolars — to help protect them from decay.
Why are dental sealants placed on teeth?
The chewing surfaces of the molar and premolar teeth have grooves — "fissures" — that make them vulnerable to decay. These fissures can be deep, are difficult to clean, and can be narrower than even a single bristle of a toothbrush. Plaqueaccumulates in these areas, and the acid from bacteria in the plaque attacks the enamel and cavities can develop. Fluoride helps prevent decay and helps protect all the surfaces of the teeth, dental sealants provide extra protection for the grooved and pitted areas by providing a smooth surface covering over the fissured area.
When are dental sealants placed?
The first dental sealant to be placed is usually on the fissure of the first permanent molar tooth, once the chewing surface of the tooth has erupted completely beyond the gum. This tooth grows in behind the baby teeth. If the chewing (occlusal) surfaces of these teeth are sealed, the dental sealant will help protect the tooth. Except for the wisdom teeth, which come through much later, the molars and premolars continue to erupt until eleven-thirteen years of age and the chewing surfaces of these teeth can be sealed after they have erupted beyond the gum.

Are dental sealants only placed on the chewing surface of molar and premolar permanent teeth?
Dental sealants are usually placed on the chewing surfaces of these teeth because these are the areas and teeth that typically have deep fissures. Dental sealants are sometimes also used on other permanent teeth if they have grooves or pits, to help protect these surfaces. In some children, the molars in the primary dentition (baby teeth) also have grooves that could benefit from dental sealants and in this situation your dentist or hygienist may recommend dental sealants on the chewing surfaces of these primary teeth.
Can dental sealants be place on the teeth of adults?
Yes — while less common, dental sealants are sometimes placed in adults at risk for caries, on deep grooves and fissures that do not already have fillings or dental sealants.
What do dental sealants look like?
Dental sealants can be clear, white or have a slight tint depending upon the dental sealant used.
How are dental sealants placed?
Firstly the tooth surface is thoroughly cleaned with a paste and rotating brush by your dentist or hygienist. Next the tooth is washed with water and dried. Then a solution that is acidic is placed on the fissured area of the tooth’s chewing surface for a number of seconds before being rinsed off. This creates small microscopic areas and a fine rougher surface than the surrounding tooth enamel, that can be seen with a microscope. The rough surface and microscopic areas enable the dental sealant to attach to the tooth. After the tooth is dried again, the liquid dental sealant is placed on the tooth and hardened. Dental sealants are hardened by using a light that hardens the dental sealant, or sometimes by using a two-component dental sealant that sets without using a light. Once the dental sealant has hardened it becomes a hard plastic varnish coating, and you can chew on the tooth again.
How long does a dental sealant last?
Dental sealants have been used and have been proven to be effective since the 1970s. Many studies have shown that they are effective in helping to prevent decay on chewing (occlusal) surfaces. Dental sealants can last many years. If necessary, it is also possible to place a new dental sealant on the tooth.
Do I still need to use fluoride if I have dental sealants?
Yes. Dental sealants only protect the surface area that they are placed on. Fluoride helps protect all the surfaces of the tooth from decay and cavities.
For more information on dental sealant treatments, please consult with your dentist or hygienist.


Information provided by Colgate

Xerostomia (Dry Mouth)

What is dry mouth (xerostomia)? What causes dry mouth?

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 Xerostomia is a medical term used for dry mouth due to lack of saliva - there is not enough saliva to keep the mouth wet; there is reduced or absent saliva flow. It is also informally known as pasties, cottonmouth, drooth, doughmouth or des (from desert). It is usually a subjective complaint - the patient complains about it and subsequently sees the doctor.

Experts say xerostomia is usually caused by the inadequate function of the salivary glands.

Xerostomia can lead to speech and eating difficulties, halitosis (bad breath), an increase in the number of dental cavities (saliva helps prevent tooth decay), and infections in the mouth, such as thrush. An individual with xerostomia typically finds it harder to enjoy food.

Xerostomia is a common problem. It is frequently a side effect of medication, which may improve with a new prescription or an adjustment of dosage.

We all get a dry mouth sometimes - when we are upset, under stress or extremely frightened. Xerostomia is different - the individual's mouth is dry most of the time.

Some patients may think dry mouth is a normal part of aging - it is not. It is, however, more commonly found among the elderly. Experts say the main reason is that elderly people take more medications compared to the rest of the population, and some of these medications cause xerostomia.

Xerostomia may be a symptom of a serious systemic disease, such as systemic lupus erythematosus, rheumatoid arthritis, scleroderma, sarcoidosis, amyloidosis, Sjogren's syndrome and hypothyroidism. A systemic disease is one that affects the entire body.

In fact, xerostomia is not a disease; it is a symptom, just like headache is a symptom and not a disease.

What are the signs and symptoms of Xerostomia (dry mouth)?

A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign. The signs and symptoms of xerostomia may include:

• Bad breath
• Cheilitis - inflammation and fissuring of the lips
• Cracked lips
• Cracking and fissuring of the oral mucosa (inner lining of the cheeks and lips)
• Dryness in the mouth
• Dysgeusia - taste disorders
• Fungal infections in the mouth, such as thrush
• Glossodynia - painful tongue
• Increased need to drink water, especially at night
• Inflammation of the tongue, tongue ulcers
• Lipstick sticking to teeth
• More frequent gum disease
• More tooth decay and plaque
• Problems speaking
• Problems swallowing and chewing - especially dry and crumbly foods, such as crackers or cereals.
• Problems wearing dentures - problems with denture retention, denture sores and the tongue sticking to the palate.
• Sialadenitis - salivary gland infection
• Sore throat
• Sticky saliva
• Stringy saliva
• The skin at the corners of the mouth may split, or be sore.

What are the causes of xerostomia (dry mouth)?

Medications - many prescription and OTC (over-the-counter, no prescription required) medications cause dry mouth, including antihistamines, hypertensive medications (for high blood pressure), anti-diarrheals, muscle relaxants, urinary continence drugs, some Parkinson's disease medications, as well as a number of antidepressants.

Age - even though old age is not a dry mouth risk factor, elderly individuals tend to take more medications than the rest of the population. Many of the medications taken by seniors cause dry mouth.

Cancer treatment - radiotherapy (radiation therapy) to the head and neck can damage the salivary glands, resulting in less saliva being produced. Chemotherapy can alter the nature of the saliva, as well as how much of it the body produces.

Injury or surgery - which results in nerve damage to the head and neck area, can result in dry mouth.

Tobacco - either chewing or smoking tobacco increases the risk of dry mouth symptoms.

Dehydration - caused by lack of sufficient fluids.

Exercising or playing in the heat - the salivary glands may become dry as the bodily fluids are concentrated elsewhere in the body. Dry mouth symptoms are more likely if the exercise or playing continues for a long time.

Some health conditions, illnesses and habits - such as:

• Anxiety disorders
• Depression
• HIV/AIDS
• Parkinson's disease
• Poorly controlled diabetes
• Sjogren's syndromes
• Sleeping with the mouth open
• Snoring
• Stroke and Alzheimer's disease - more likely to cause a perception of dry mouth.

Diagnosing xerostomia (dry mouth)

The doctor or dentist will probably examine the patient's mouth and review their medical history. Blood tests and imaging scans of the salivary glands may also be ordered.

Sialometry - this is a simple office procedure that measures the flow rate of saliva. Collection devices are placed over the parotid gland or the submandibular/sublingual gland duct orifices, and saliva is stimulated with citric acid.

Saliography - this is radiographic examination of the salivary glands and ducts after the introduction of a radiopaque material into the ducts. It may be useful in identifying salivary gland stones and masses.

Biopsy - a small sample of salivary gland tissue is taken. Often used in the diagnosis of Sjogren's syndrome. If malignancy (cancer) is suspected the doctor may also order a biopsy.

Many healthcare professionals report that often the visual condition of the oral mucosa (inner lining of the cheeks and lips) does not correlate to the subjective feeling of "dry mouth" by the patient - even though the patient complains of severe dry mouth, the oral mucosa appears to be moist. Less frequently, it may be the other way round; the oral mucosa appears dry but the patient does not complain of dry mouth symptoms.

What are the treatment options for xerostomia (dry mouth)?

Treatment for xerostomia depends on several factors, such as whether the patient has an underlying condition or disease, or is taking certain medications that may be causing dry mouth.

Ideally, the underlying cause is found. This does not always happen. If it is found steps need to be taken to minimize its effect.

Medications - if the dry mouth is thought to be caused by a medication, the doctor will either alter the dosage or prescribe another drug which is less likely to cause dry mouth.

Stimulating saliva production - a medication may be prescribed, such as pilocarpine (Salagen) or cevimeline (Evoxac), to stimulate the production of saliva.

Experts say that symptomatic treatment for dry mouth typically includes four areas:

• Increasing the flow of saliva
• Replacing lost secretions
• Controlling dental caries
• Some specific measures, such as treating infections.

A patient with xerostomia should pay special attention to oral/dental hygiene. This includes plaque removal and treatment of gingival infections, inflammation and dental caries. Brushing teeth and flossing regularly is important.

Sipping fluids (non-carbonated, sugarless), chewing xylitol-containing gum, and using a carboxymethyl cellulose saliva substitute as a mouthwash may help.

Mouthwashes which contain alcohol should be avoided, because they may worsen dry mouth symptoms.

The patient should conduct a daily mouth examination, looking out for unusually colored patches, tooth decay or ulcers. Anything unusual should be reported to their doctor or dentist.

The patient should not wear dentures during sleep. The dentures must be kept clean by overnight soaking.

Individuals with xerostomia should avoid:

• Sugary foods or drinks
• Acidic foods or drinks
• Dry foods
• Spicy foods
• Astringents
• Excessively hot or cold drinks.

Alcohol consumption should be kept to a minimum or avoided altogether.

Caffeine consumption should be kept to a minimum.

Chewing or smoking tobacco should be avoided.

Eating such foods as carrots or celery may help with residual salivary gland function.

Breathing - breathing through the nose does not dry the mouth, while breathing through the mouth does.

Humidity - a humidifier can add moisture to a bedroom. This may help reduce dry mouth symptoms that develop during sleep.

Written by Christian Nordqvist

Copyright: Medical News Today

WE CATER TO COWARDS!!!

Neglect of one's mouth will not only become a compounding future financial consequence but more importantly an overall health issue.  This day and age of implant dentistry or bridgework, nothing compares to your own natural teeth. Fear of the dentist is the leading cause of dental neglect and with my 15 year+ dental experience I have found that majority of these fears stem from going to a dentist as a child. Providing knowledge and establishing trust with my patients have alleviated their fears over time,  don't get me wrong those severe fears may never go away fully  but the trust you form with your doctor will help you overcome or manage these fears.   The oral cavity is a gateway and a sneak peak to your overall health, not only showing possible serious health issues but neglect of the oral cavity can lead to serious health issues. This blog has been created to provide  a forum about various topics related to all aspects of dentistry  and oral health issues. Knowledge from future articles, discussions   and my dental experiences will  answer many of your dental questions. Preventative care will avoid many serious health issues and waiting for dental pain is not the only indication of a serious problem. "We Cater To Cowards" is our office trademark/motto. We are here to help and since I perform all cosmetic general & Implant dentistry from start to finish you only build a relationship with one dentist. Our new dental building has all the comforts of being at home(fireplace, waterfall, TV's in every room, coffee/tea ) & modern technology(Dental  3D Cat- Scan Imaging, Soft tissue laser, digital xrays), this is not your grandfather's dentist  or the dentist you went to as a child. If there is any specific  oral health topics, dental questions or even tooth whitening, please let me know. I hope you follow my future posts and I look forward to our future discussions.

 

"We Cater To Cowards"

Dr. Michael Kampourakis DDS