Dry mouth – cause and effect

Less amount of saliva secretion cause dry mouth. It is a clinical manifestation of salivary gland dysfunction. There are various factors that causes dry mouth.

Various causes for dry mouth : 

Radiation induced 

Radiation therapy to head and neck region for cancer treatment affects the salivary gland cells (dose dependent) causing dry mouth.

Medicine/ drug induced

Certain drugs that are taken for vomiting, allergy, blood pressure, muscle spasm and convulsions can cause decreased salivary flow because of reduced activity of para-sympathetic action.

Local factors

Like smoking, mouth breathing and decreased chewing can lead to dry mouth

Developmental abnormality

When abnormality of salivary gland occurred during the formation of fetus, or tumor or autoimmune states can cause dry mouth

Systemic alternations

Nutritional deficiency like anemia, vitamin A deficiency and hormonal imbalance can cause dry mouth.

Fluid loss associated with hemorrage, sweating, diarrhea, vomiting and dehydration, Diseases like diabetes, certain syndromes and graft versus host resistances can  cause dry mouth.

Signs and symptoms of dry mouth:

Increased thirst, increased uptake of fluids, frequent use of means like chewing gums and sour candy, difficulties in swallowing, speech and eating dry foods.

Burning and tingling sensation in the mouth, frequent oral infection, intolerance to dental appliance, abnormal taste in mouth, tongue may adhere to soft palate, painful salivary gland enlargement, increased incidence of dental caries. Saliva consistency becomes thick, foamy and ropey.

Suggestions to the people have dry mouth :

Try sweet and tart food and beverages like lemonade, they may help to produce more saliva

chewing of sugar free candy and ice cubes

Use soft and liquid foods, which may be easier to swallow

Hydrate well and drink frequently

Avoid chewing vitamin c and acidic lozenges, dry, sticky and salty foods.

Report to your physician for taking proper medical management.

 

References

Textbook of oral medicine by Anil Govindrao Ghom, 2nd edition

 

 

 

 

 

 

Effect of tobacco on the oral cavity

A week after the world anti-tobacco day, it is good to write a blog on smoking and its adverse effects to the oral cavity.

Tobacco as such is a carcinogen (cancer causing agent). From inflammation till cancer, tobacco can cause anything and everything. A few notable effects that tobacco could cause to oral cavity are,

Tooth discoloration, increased plaque formation and bad breath :

Smoking increase tartar and plaque accumulation on the tooth structure which eventually weakens the tooth supporting structures like gums and periodontium.

Tobacco stains are extrinsic stains, yet are hard to remove completely which gives a poor aesthetic appearance. Halitosis (bad breath) is very common for tobacco users.

Weakening of gums and increased bone loss :

Smoking directly triggers the body inflammatory agents, causing swollened gums, prone for infection and increased risk of bone loss. Because smoking cause impaired collagen mechanism, the rate of repair of the lost structure will be extremely slow or nil.

Delayed healing or no healing after tooth removal :

Smoking have negative impact on healing of the tooth removed area called tooth socket. Heat from the smoke and the other tobacco contents directly disrupt the blood clot ( which is essential for the healing process ) on the socket, causing a condition called ‘dry socket’ ( very painful unhealed condition )

Lower sucess rate of implant :

Adequate bone height and bone density is required for a successful implant procedure. Due to chronic bone loss after smoking, success of implant treatment is questionable.

Inflammation of salivary gland opening and reduced salivary flow :

Saliva is an important component in the mouth which play a vital role in defense mechanism, digestion process, lubrication, etc. Reduction in its flow has a tremendous negative effect on the oral environment. Heat from the smoke cause inflammation of the salivary gland opening (condition called smokers palate) and gradually reduces the salivary flow causing dry mouthDry mouth – cause and effect.

Increased risk of leukoplakia and other keratotic lesions:

Leukoplakia is the pre cancerous lesion where the oral mucous membrane undergoes metaplastic changes. Pouching of tobacco is one of the main etiological factor for such conditions and when left untreated it becomes cancer.

Increased risk of oral cancer :

Tobacco as such have a direct influence on the oral mucosa to cause dysplastic changes and thereby causing oral cancer.

 

Nevertheless of its consequences, it is always better to stay away from tobacco for the healthy and happy life.

Tooth sensitivity

OMGGGG !!!!! What a shooting pain was this !!!! For cold and hot and sweet and sour….For everything and on everything i eat…was this pain or sensitivity !!!! My dentist calls this sensitvity and i say this as PAIN….

Had you ever visited your dentist for this reason !!!! Or on least case, had you ever encountered this problem ??? And you doesn’t know whether it is a pain or sensitivity but for a few moment it had banged your head?? And you had no idea why this was happening !!!

This is something called as “Dentin hypersensitivity “. Tooth has only one sensation and that is pain sensation…Any insult that happens to the tooth structure will be elicited as pain. Depending on the level and depth of insult, we categorize it as either pain or sensitivity…

So why this sensitivity happens and what is the reason behind this !!! The outermost covering in the crown of tooth is called enamel and it is devoid of nerve supply thus protects the tooth from any sort of sensation. When this enamel wears off ( causative factors are many – either due to decay or trauma causing enamel to chip out or excessive grinding of tooth or toomuch of abrasion/attrition, or excessive brushing of teeth or receding of gums or gastric esophageal reflux causing acid erosion or bleaching the tooth ) on such case, the underline structure called dentin which contains nerve endings are exposed to the outer environment… Any substances that comes in contact with that particular portion will elicit pain.

This is not bound with the age limit( though elderly people are more prone), anybody can get it and lifestyle is an influential factor as well.

Only way to escape from this sensitivity is to occlude the exposed nerve ending.  But how far it could be kept occluded is questionable.

There is no universally accepted gold standard treatment for dentin hypersensitivity which reliably relieves pain for long term.

Depending on the severity, at home and in office methods are used.

Desensitizing toothpastes or mouth wash or chewing gums which contains potassium nitrate/citrate/chloride, strontium chloride/acetate , Calcium carbonate/calcium sodium phosphosilicate, hydroxyapatite are believe to have role in nerve desensitization with various mechanisms.

When the pain is severe, in office methods are implemented… Which includes dental sealants, or restoring the defective portion with the filling materials preferably which has the flouride content or with the use of mouth guard if the problem is due to teeth grinding.

How to prevent tooth sensitivity???

  • avoid using tooth abrading toothpastes
  • brushing teeth with soft or medium bristles
  • gingival recession can be avoided by healthy dietary and proper oral hygiene practices
  • devoid of stress
  • taking food at proper time
  • Limiting consumption of acidic foods and drinks

Tooth sensitivity still can be controlled with our quality of life.