Ask The Gentle Dentist: Enamel Erosion and Dry Mouth

Enamel erosion and the irritating problem of dry mouth syndrome and oral sedation for our high fear patients.

Enamel Erosion and Dry Mouth:

The following question was asked by a reader Sandy. I would like to thank her for the question as this is what helps me out immensely since I want to be engaged with the readership.

Question: What do we do to build up eroded enamel and is there a tooth paste that can help eroded enamel? What ingredients must that tooth paste have? What do we do that erodes enamel?

At the same time my wife saw an article online from WebMD and passed this along to me. The following is an excerpt from Web MD.

Because a dry mouth is not only a dental issue it is a medical issue and I appreciate this article from a medical site supporting the dentist’s involvement in overall systemic health. There is so much more evidence and research showing the association of oral diseases being related to systemic diseases. This only makes sense since our body is one unit. The following article also addresses the question posted by Sandy.

What Saliva Does: Dry mouth (xerostomia) is more than just feeling thirsty. You get it when your mouth makes very little saliva. Sometimes the saliva can be thick and stringy caused by a change in the glands themselves. Saliva helps you taste food and helps you digest food. It flushes food particles away from your teeth and prevents tooth decay. When you don’t have enough saliva the skin in and around your mouth gets dry and tight. You may get cracks and sores in the corners of your mouth, dry tongue and you may have trouble speaking or swallowing. When saliva is reduced it can lead to bad breath caused by food particles sticking between your teeth. Enamel erosion takes place when the acid levels of the mouth increase thereby dissolving the minerals out of the enamel. Over time this softened tooth structure turns into a cavity where it can only be repaired by your dentist with a filling.

Causes: There are over 400 medications that can lead to xerostomia, including non-prescription drugs. Allergy, cold, high blood pressure and many other medications can cause this irritating side effect. Radiation treatment for cancer can affect the saliva glands and significantly reduce saliva flow. Autoimmune diseases, such as Sjogren’s syndrome, where the body’s immune system attacks the saliva glands and tear glands leave the patient extremely dry and prone to dental decay. Diabetes is a common disease that can leave the patient dry.

Habits that contribute to a dry mouth: smoking can dry out the mouth because of the nicotine and heat from the cigarette shrinks the minor saliva ducts in the roof of the mouth. Alcohol and caffeine can also reduce and change the saliva quantity and quality.

Age: As we get older not only is there the reduced function of our saliva glands but with the need of so many medications to keep us healthy a dry mouth is possibly inevitable.

Treatment Recommendations

  • Hydration is a critical factor in preventing problems with xerostomia. It is important to at least 8 glasses of water daily and to drink it frequently. This keeps the mouth moist and prevents dehydration. The moist mouth dislodges the food particles from packing between the teeth and reduces the acidity in the mouth. Cavities form frequently when food gets caught between the teeth and at the gum line.
  • To rebuild minor enamel erosion frequent brushing and flossing are critical using prescription level fluoridated toothpaste. This should be done a minimum of twice per day.
  • Use of xylitol sweetener and products like MI paste which help to re-mineralize the tooth structure can be helpful.
  • To answer Sandy: Toothpastes that contain not only fluoride but those specifically designed to re-mineralize by building up the enamel. I usually recommend Sensodyne toothpastes.

Living a healthy lifestyle with plenty of exercise and eating ample fresh fruits and vegetables are important to long term health.

Sedation Dentistry

Question: I have gone to your web site and noted that you perform sedation dentistry. What is this exactly? How does this vary from IV Sedation and will it work on me? I have such a high fear of the dentist and don’t know if this program will sedate me enough to take care of my anxiety. Could you please answer me?

Thank You, Sharon P.

Answer: Sedation dentistry is safe and painless. Anxiety is controlled using what is called oral conscious sedation or a simple, safe sleeping pill before and during your treatment. You will become drowsy to the point of falling asleep during treatment and have virtually no memory of the visit. Can you imagine yourself sleeping through your dental visit? Sedation dentistry is ideal for patients who are fearful of going to the dentist, would like to get extensive treatment done in one long visit rather than making several trips to the dentist, and for those with a strong gag reflex.

Intravenous sedation usually involves a deeper level of sedation. Because a sleeping pill is used for the oral sedation it is a safer technique if used with a proper protocol. Both techniques monitor the blood pressure, heart rate and oxygen saturation in the blood to make certain the utmost safety is accomplished.

We are able to treat 95% of patients with this technique. We have only had a few patients who are minimally responsive to the medication. These patients usually need to be sedated using the IV approach which would require a referral to a specialist. Most cases we find that the patient remembers very little after the oral sedation procedure so this is very effective in treating those who hate coming to the dentist.

Ask The Gentle Dentist: Enamel Erosion and Dry Mouth

If you have any questions about sedation dentistry or enamel erosion and dry mouth, please contact us by email or by mail at 15055 22 Mile Shelby Township, MI 48315.

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