dry mouth

[Drsumitra]

There may be a way to aid dry mouth condition.

A new battery-powered mouthguard was created to fix this problem. The mouthguard fits over the lower arch of the teeth and enables the production of saliva thanks to little electric shocks. This device is necessary because dry mouth impacts 20 percent of people older than 50.

This device could be extremely helpful because of the importance of saliva in digestion and fighting against bacteria. A healthy person can generate three pints of saliva per day but there are many people that don’t produce enough. The result is the condition of dry mouth, known as xerostomia. The condition usually stems from some kind of medication or cancer treatment.

This new mouthguard is custom designed for each person and triggers saliva production by way of electric shocks. Each patient controls the device and can be worn for up to 10 minutes every hour.

The device can be beneficial for people who developed dry mouth from Parkinson’s Disease and Sjogren’s Syndrome. More tests are on the way.

Scientists have also created mint disks with Xylitol in them, which are thought to aid dry mouth. The disks are applied at night. They melt while the person is asleep and studies from the University of Washington indicate a reduced impact of dry mouth symptoms with one week.

        

[Drsumitra]

 Dry mouth, also called xerostomia (ZEER-oh-STOH-mee-ah), is the condition of not having enough saliva, or spit, to keep the mouth wet.  Dry mouth can happen to anyone occasionally—for example, when nervous or stressed.  However, when dry mouth persists, it can make chewing, eating, swallowing and even talking difficult.  Dry mouth also increases the risk for tooth decay because saliva helps keep harmful germs that cause cavities and other oral infections in check.

Causes

Dry mouth occurs when the salivary glands that make saliva don’t work properly.  Many over-the-counter and prescription medicines, as well as diseases such as diabetes, Parkinson’s disease and Sjogren’s syndrome, can affect the salivary glands.  Other causes of dry mouth include certain cancer treatments and damage to the glands’ nerve system.  It’s important to see your dentist or physician to find out why your mouth is dry.

Treatment

Depending on the cause of your dry mouth, your health care provider can recommend appropriate treatment. There are also self-care steps you can take to help ease dry mouth, such as drinking plenty of water, chewing sugarless gum, and avoiding tobacco and alcohol.  Good oral care at home and regular dental check-ups will help keep your mouth healthy.

        

[Drsumitra]

 Sjogren’s syndrome is a disease that causes dryness in your mouth and eyes. It can also lead to dryness in other places that need moisture, such as your nose, throat and skin. Most people who get Sjogren’s syndrome are older than 40. Nine of 10 are women. Sjogren’s syndrome is sometimes linked to rheumatic problems such as rheumatoid arthritis.

Sjogren’s syndrome is an autoimmune disease If you have an autoimmune disease, your immune system, which is supposed to fight disease, mistakenly attacks parts of your own body. In Sjogren’s syndrome, your immune system attacks the glands that make tears and saliva. It may also affect your joints, lungs, kidneys, blood vessels, digestive organs and nerves. The main symptoms are:

• Dry eyes
• dry mouth

        

[Drsumitra]

 

What Causes Sjögren’s Syndrome?

Sjögren’s syndrome is an autoimmune disease. The immune system is supposed to fight disease by killing off harmful viruses and bacteria. But with autoimmune diseases, your immune system attacks parts of your own body by mistake.

In Sjögren’s syndrome, your immune system attacks the glands that make tears and saliva (spit). The damage keeps these glands from working right and causes dry eyes and dry mouth.

Doctors don’t know the exact cause of Sjögren’s syndrome. They think it may be caused by a combination of two things:

• Genes
• Exposure to something like a virus or bacteria.
• What Are the Symptoms of Sjögren’s Syndrome?

The main symptoms are:

• Dry eyes
• Dry mouth.

Sjögren’s syndrome also can affect other parts of the body, including the skin, joints, lungs, kidneys, blood vessels, digestive organs, and nerves. Symptoms can include:

• Dry skin
• Skin rashes
• Chronic dry cough
• Thyroid problems
• Joint and muscle pain
• Vaginal dryness
• Numbness and tingling in the arms and legs.

Sjögren’s can also make you very tired.

How Is Sjögren’s Syndrome Diagnosed?

Doctors use a few ways to diagnose Sjögren’s:

• Medical history
• Physical exam
• Certain eye and mouth tests
• Blood tests.

Doctors may also use:

• A urine test
• A chest x ray.
• How Is Sjögren’s Syndrome Treated?

Treatment differs for each person. It depends on what parts of the body are affected. Treatment will focus on getting rid of symptoms. Treatment may include:

• Medicines for joint or muscle pain (such as aspirin and ibuprofen)
• Medicines that help you make more saliva
• Medicines that suppress inflammation (such as corticosteroids)
• Medicines that suppress the immune system.

Treatment for dry eyes may include:

• Artificial tears that come in different thicknesses. You may have to try a few to find the right one.
• Eye ointments. These are thicker than artificial tears. They protect the eyes and keep them wet for several hours. They can blur your vision, so you may want to use them while you sleep.
• Medicines to reduce inflammation in the eye.
• A chemical that wets the surface of the eye and keeps the natural tears from drying out so fast. It comes in a small pellet that you put in your lower eyelid. When you add eye drops, the pellet melts. This forms a film over your own tears and traps the moisture.
• Surgery to shut the tear ducts that drain tears from the eye.

Treatment for dry mouth may include:

• Chewing gum or sucking on hard candy helps your glands make more saliva. However, gum and candymust be sugar-free.
• Sipping water or a sugar-free drink often to wet your mouth.
• Using oil or petroleum-based lip balm or lipstick to help dry, cracked lips feel better.
• Using a saliva substitute prescribed by a doctor to make the mouth feel wet.
• Using medicine to help your mouth make more saliva.

People with dry mouth can easily get mouth infections. Tell your doctor if you have white patches or red, burning areas in your mouth.

Medicines and Dryness

Some medicines can cause eye and mouth dryness. If you are taking one of the drugs listed below, ask your doctor whether you should stop.

Drugs that can cause dryness include:

• Those used for allergies and colds (antihistamines and decongestants)
• Those used to lower fluids (diuretics)
• Some used to treat diarrhea
• Some used to treat blood pressure
• Some antipsychotic medicines
• Tranquilizers
• Antidepressants.
• What Research Is Being Done on Sjögren’s Syndrome?

Studies are being done on:

• Genes and gene therapy
• Bacteria and viruses
• The immune system
• Hormones
• Predicting who may have lung problems
• Treating other skin problems
• Medicines that help the glands make moisture
• Medicines to help the immune system and reduce swelling.

        

[Drsumitra]

        

[drsushant]

Xerostomia (dry mouth) may be a side-effect of other medication. It is also caused by irradiation of the head and neck region or by damage to or disease of the salivary glands.

Patients with a persistently dry mouth may develop a burning or scalded sensation and have poor oral hygiene. They are prone to increased dental caries, periodontal disease, intolerance of dentures, and oral infections, particularly candidiasis. Where possible, treatment is directed at the underlying cause of dry mouth. If this is not possible, or is only partially successful, symptomatic treatment is used.

Treating the underlying cause
Drugs are a common cause of dry mouth. Reduce the dose or change the drug if possible. Morphine is a common, but often overlooked, cause of dry mouth. Other drugs that cause dry mouth include tricyclic antidepressants, antihistamines, antimuscarinic drugs, antiepileptic drugs, antipsychotics, betablockers, and diuretics.
Dehydration should be treated.
Simple measures will often relieve symptoms of dry mouth, even if rehydration is not undertaken.
Anxiety can also cause dry mouth.
Sjögren’s syndrome – check anti-nuclear antibody titre.

General measures

Simple measures should be used by all patients. Dry mouth may be relieved in many patients by:

Frequent sips of cool drinks.
Sucking pieces of ice.
Sucking sugar-free fruit pastilles.
Eating partly frozen melon or pineapple chunks.
Sugar-free chewing gum stimulates salivation in patients with residual salivary function.
Petroleum jelly can be applied to the lips to prevent drying and cracking.

        

[drsushant]

Available treatments
Artificial saliva
This can provide useful relief of dry mouth. A properly balanced artificial saliva should be of a neutral pH and contain electrolytes (including fluoride) to correspond approximately to the composition of saliva.

Artificial saliva offers little advantage compared with simple measures for most patients. The few available studies are of poor quality, but suggest that many patients find no additional benefit with carmellose-based preparations compared with frequent tea, coffee, milk, or fruit juice.1 In addition, some patients find carmellose-based products feel sticky.
The duration of action of mucin products is only 10 to 15 minutes.
Long-term use of acidic products may demineralise tooth enamel. Glandosane® spray, Salivix® pastilles, and SST® tablets are acidic products.
Sugar-free chewing gum is as effective as artificial salivas.2
Consider using an artificial saliva containing mucin or lactoperoxidase when simple measures have been tried, but symptoms remain troublesome. The pH of some artificial saliva products may be inappropriate.

Luborant® is licensed for any condition giving rise to a dry mouth.
Biotene Oralbalance® BioXtra®, Glandosane®, Saliva Orthana®, and Saliveze®, have Advisory Committee on Borderline Substances (ACBS) approval for dry mouth associated only with radiotherapy or Sjögren’s syndrome.
Salivix® pastilles, which act locally as salivary stimulants, are also available and have similar ACBS approval.
SST® tablets may be prescribed for dry mouth in patients with salivary gland impairment and patent salivary ducts.

Pilocarpine tablets
These are licensed for the treatment of xerostomia following:

Irradiation for head and neck cancer
Dry mouth and dry eyes (xerophthalmia) in Sjögren’s syndrome
It can be considered for difficult cases.

Most patients with drug-induced dry mouth usually respond to treatment after the first dose.3
Only about 50% of patients with radiotherapy-induced dry mouth respond to treatment, and it may take up to 3 months before a response is seen.3
Pilocarpine 5 mg three times a day is more effective than artificial saliva, but also has more adverse effects, e.g. sweating, dizziness, rhinitis, urinary frequency, and blurred vision.
Acupuncture may be a useful alternative to pilocarpine in resistant cases.4
They are effective only in patients who have some residual salivary gland function. If there is no response they should be discontinued.
There is a risk of increased urethral smooth muscle tone and renal colic.
Adequate fluid intake should be maintained to avoid dehydration associated with excessive sweating.
Patients should be counselled that blurred vision or dizziness may affect performance of skilled tasks, e.g. driving, particularly at night or in reduced lighting.

        

[Anonymous]

A comparison of artificial saliva and chewing gum in the management of xerostomia in patients with advanced cancer.

This was a prospective, randomized, open, crossover study comparing a mucin-based artificial saliva (Saliva Orthana) with a low-tack, sugar-free chewing gum (Freedent) in the management of xerostomia in patients with advanced cancer. The conclusions of this study were that both Saliva Orthana and Freedent are effective in the management of xerostomia in patients with advanced cancer, that both Saliva Orthana and Freedent cause some side-effects in this group of patients, and that patients with cancer think that chewing gum is an acceptable treatment. Sixty-nine per cent of the patients preferred the chewing gum to the artificial saliva. Furthermore, the chewing gum scored better than the artificial saliva on every measure of efficacy. However, none of these results reached statistical significance.

        

[Anonymous]

A clinical comparison between commercially available mucin- and CMC-containing saliva substitutes.

In this investigation, the subjective impressions of patients, suffering from severe xerostomia, have been recorded after symptomatic treatment with different CMC- and mucin-containing artificial saliva over 3 years. A total number of 137 patients divided into 3 groups participated. Group I (40 patients) used CMC-containing artificial saliva, group II (61 patients) alternately used CMC- and mucin-containing artificial saliva and group III (36 patients) used mucin-containing artificial saliva. From this study it is concluded that artificial saliva containing mucins proved to be of benefit to patients suffering from xerostomia.

        

[drsushant]

A comparison of artificial saliva and pilocarpine in the management of xerostomia in patients with advanced cancer.

This was a crossover study comparing a mucin-based artificial saliva (Saliva Orthana) and pilocarpine hydrochloride (Salagen) in the management of xerostomia in patients with advanced cancer. The pilocarpine was found to be more effective than the artificial saliva in terms of mean change in visual analogue scale scores for xerostomia (P = 0.003). Furthermore, more patients reported that it had helped their xerostomia, and more patients wanted to continue with it after the study. However, the pilocarpine was found to be associated with more side-effects than the artificial saliva (P < 0.001). These side-effects were usually reported as being mild. Of the patients who used both treatments, 50% preferred the artificial saliva, and 50% preferred the pilocarpine. The commonest reason for preferring the artificial saliva was the fact that it was a spray, rather than a tablet.

        

[drsushant]

Possible Solution to Dry Mouth Exists

There may be a way to aid dry mouth condition.

A new battery-powered mouthguard was created to fix this problem. The mouthguard fits over the lower arch of the teeth and enables the production of saliva thanks to little electric shocks. This device is necessary because dry mouth impacts 20 percent of people older than 50.

This device could be extremely helpful because of the importance of saliva in digestion and fighting against bacteria. A healthy person can generate three pints of saliva per day but there are many people that don’t produce enough. The result is the condition of dry mouth, known as xerostomia. The condition usually stems from some kind of medication or cancer treatment.

This new mouthguard is custom designed for each person and triggers saliva production by way of electric shocks. Each patient controls the device and can be worn for up to 10 minutes every hour.

The device can be beneficial for people who developed dry mouth from Parkinson’s Disease and Sjogren’s Syndrome. More tests are on the way.

Scientists have also created mint disks with Xylitol in them, which are thought to aid dry mouth. The disks are applied at night. They melt while the person is asleep and studies from the University of Washington indicate a reduced impact of dry mouth symptoms with one week.

        

[Drsumitra]

Sjögren’s syndrome (SS) is a chronic inflammatory disorder characterized by diminished lacrimal and salivary gland function. SS occurs in a primary form not associated with other diseases and in a secondary form that complicates other rheumatic conditions. The most common disease associated with secondary SS is rheumatoid arthritis.

In primary or secondary SS, decreased exocrine gland function leads to the sicca complex, a combination of dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) [1,2]. In addition, a variety of other disease manifestations can occur in SS. The clinical manifestations of SS are divided into the exocrine gland features and the extraglandular disease features [3].

An effective classification system for SS must accommodate the range of clinical manifestations of this disorder. The ends of the clinical spectrum of SS are diverse:

At the severe end are patients with florid salivary gland enlargement, adenopathy, antibodies to the Ro/SSA and La/SSB antigens, cryoglobulinemia, hypocomplementemia, a propensity to develop non-Hodgkin lymphoma, and other extraglandular disease manifestations.
At the mild end are patients with moderate symptoms of dry eyes, dry mouth, a low titer of antinuclear antibody, and vague symptoms of fatigue, myalgias, and cognitive dysfunction. In many patients with mild disease, distinguishing SS patients from individuals with fibromyalgia or depression who have ocular and/or oral dryness caused or exacerbated by medications with anticholinergic side effects is a major challenge.
Another group of patients with extraglandular manifestations may be found to have antinuclear antibody and Ro/SS-A antibody during evaluation, even though they lack dominant manifestations of dry eyes or dry mouth. These laboratory findings may be found during evaluation of neuropathies, nephropathies, hematologic abnormalities or lymphoproliferative involvement of other organs with a pattern suggestive of SS or systemic lupus erythematosus in the extraglandular organs

 

        

[Drsumitra]

 A salivary gland stone — also called salivary duct stone, salivary calculus, or sialolith — is a calcified structure that may form inside a salivary gland or duct and can block the flow of saliva into the mouth.

The majority of stones affect the submandibular glands located at the floor of the mouth. Less commonly, the stones affect the parotid glands, located on the sides of the face, or the sublingual glands, which are under the tongue. Many people with the condition have multiple stones.

Salivary Gland Stone Causes and Symptoms

Salivary stones form when chemicals in the saliva deposit. They mostly contain calcium. The exact cause is not known. But factors contributing to decreased saliva production and/or thickened saliva may be risk factors for salivary stones. These factors include: dehydration, poor eating, and use of certain medications, such as antihistamines, blood pressure drugs, psychiatric drugs, and bladder control drugs. Trauma to the salivary glands may also increase risk for salivary stones.

The stones cause no symptoms as they form, but if they reach a size that blocks the duct, saliva backs up into the gland causing pain and swelling. The pain, which is usually felt in a single gland, may be intermittent and get progressively worse. Inflammation and infection within the affected gland may follow.

Salivary Gland Stones Diagnosis and Treatments

If you experience symptoms of a salivary gland stone, your doctor will first check for stones with a physical exam. Sometimes tests may also be ordered, such as X-ray, CT scan, or ultrasound.

If a stone is detected, the goal of treatment is to remove it. For small stones, stimulating saliva production by sucking on a lemon or sour candies may cause the stone to pass spontaneously. In other cases where stones are small, the doctor or dentist may massage or manually push the stone out of the duct.

For larger, harder-to-remove stones, doctors usually make a small incision in the mouth to remove the stone.

Increasingly, doctors are using a newer and less invasive technique called sialendoscopy to remove salivary gland stones. Developed and used successfully in Europe for a decade, sialendoscopy uses tiny lighted scopes, inserted into the gland’s opening in the mouth, to visualize the salivary duct system and locate the stone. Then, using specially designed micro instruments, the surgeon can remove the stone to relieve the blockage. The procedure is performed under local or light general anesthesia, which allows the patient to go home right after the procedure.

For people with recurrent stones or irreversible damage to the salivary gland, surgical removal of the gland is necessary.

In addition, antibiotics are prescribed if salivary stones have caused infection.

        

[drmithila]

A dry mouth is not a diagnosis in itself. It is a symptom and there are various causes which include:

Medication. Various drugs can cause a dry mouth as a side-effect. For example, tricyclic antidepressants, antihistamines, antimuscarinic drugs, some antiepileptic drugs, some antipsychotics, betablockers, and diuretics (‘water tablets’). Many of these drugs cause a dry mouth by affecting the salivary glands which reduce the amount of saliva that these glands make.
Radiotherapy to the head or neck. The radiotherapy can damage the salivary glands.
Mouth breathing – which can be due to a blocked nose or other causes.
Anxiety.
Dehydration (low body fluid). This may occur for many reasons, but you will usually be quite ill with fever or other symptoms if you are dehydrated.
Sjögren’s syndrome. This is a condition which can affect various parts of the body, including the joints (which can cause arthritis), the salivary glands (which can cause a dry mouth), and the tear glands (which can cause dry eyes).
What are the treatments for a dry mouth?
If possible, treat any underlying cause
In some cases, it may be possible to treat the underlying cause. For example:

If a drug is causing the dry mouth as a side-effect, it may be possible to change to a different drug, or to reduce the dose.
Dehydration, a blocked nose, and anxiety can often be treated.
Practical measures
Whatever the cause, the following will often help:

Take frequent sips or sprays of cold water. Always have a glass of water next to you when you go to bed.
Suck ice-cubes.
Sugar-free chewing gum is often helpful.
Eating pineapple chunks or partly frozen melon is often soothing and helpful.
Some people find that it helps to suck boiled sweets. (But, sugary or acid sweets may not be good for your teeth.)
Consider reducing or cutting out caffeine and alcohol which have a diuretic effect. (This means that they can make you pass out more urine, which can be dehydrating.) Caffeine occurs in tea, coffee, cola and other drinks. It is also part of some drugs.
You can apply petroleum jelly to your lips to prevent drying and cracking.
Artificial saliva
If the above measures are not adequate, then your doctor may prescribe a spray, gel or lozenge which acts as a substitute for saliva. Each dose only lasts a short time and so they need to be used frequently. Some people find artificial saliva products more helpful than others.

Saliva stimulants
In some cases of dry mouth, the saliva glands are only partially affected and can be stimulated to make more saliva:

Chewing sugar-free gum can help to increase the production and flow of saliva.
Pilocarpine is a drug which can stimulate salivary glands to make more saliva. It may be prescribed if other measures have not helped much.
Pilocarpine usually works well and quickly in most people with a dry mouth caused by a medication side-effect.
About half of people with radiotherapy-induced dry mouth respond to treatment with pilocarpine. In these people it may take several weeks, even up to three months, before the drug starts to work. So, it is worth persevering with treatment if it does not seem to be working at first.
Pilocarpine can cause side-effects in some people, such as sweating, dizziness, runny nose, blurred vision and frequent trips to pass urine. Side-effects tend to become less troublesome in time as your body becomes used to to this drug. So, a doctor may suggest a low dose at first and to take this for a while until any side-effects have eased. The dose may then be gradually increased with the aim of getting maximum benefit but with minimum side-effects.
Pilocarpine should not normally be used if you have asthma, chronic obstructive pulmonary disease (COPD), bradycardia (slow heart rate), bowel obstruction, or angle-closure glaucoma

 

        

[Drsumitra]

A little-known fluid produced in tiny amounts in the gums, those tough pink tissues that hold the teeth in place, has become a hot topic for scientists trying to develop an early, non-invasive test for gum disease, the No. 1 cause of tooth loss in adults. It’s not saliva, a quart of which people produce each day, but gingival crevicular fluid (GCF), produced at the rate of millionths of a quart per tooth.
The study, the most comprehensive analysis of GCF to date, appears in ACS’ monthly Journal of Proteome Research.
Eric Reynolds and colleagues note that GCF accumulates at sites of inflammation in the crevice between teeth and gums. Since dental workers can easily collect the fluid from patients, GCF has become a prime candidate for a simple inexpensive test to distinguish mild gum disease from the serious form that leads to tooth loss. But researchers have little information about the chemical composition of GCF.
The scientists collected GCF samples from 12 patients with a history of gum disease. Using high-tech instruments, they identified 66 proteins, 43 of which they found in the fluid for the first time. The fluid contained proteins from several sources, including bacteria and the breakdown products of gum tissue and bone, they note. They also identified antibacterial substances involved in fighting infection.
The findings advance efforts to develop an early test for gum disease, they suggest.

 

        

[Author]

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