Thursday, April 22, 2010

Problems with Dentures Caused by Xerostomia, or Dry Mouth

Summarized from “Dry mouth and Dentures”
By Randy F. Huffines, DDS Ó 2009

Saliva and oral health:
Dry mouth (also called Xerostomia) in most people is usually a side-effect of medications. Chemotherapy, radiation therapy, and some diseases can also cause a decrease in saliva production. It is necessary to have your dentist find the cause of your dry mouth so you can be treated properly. Most people with Xerostomia do not even know they have the condition until they have lost 50 percent of their saliva.

Saliva may appear to be only water, but this is not the case. Saliva actually works as part of your body’s immune system and contains hundreds of chemicals that make it possible to speak, chew, and swallow your food more comfortably. It also helps inhibit the germs that cause oral infections.

Oral lubricants:
There are medical products you can take to replace saliva. Some pharmacists call them “artificial saliva,” but a better term for them is “oral lubricants.” However, science to date has not been able to produce a substance that can replace all of the functions of saliva. Nevertheless, many people feel that oral lubricants make their mouth feel more comfortable. Many of these lubricants can be purchased in spray bottles. Some people even use water. Let your dentist recommend which oral lubricant it best for you.

Eating with a dry mouth:
If you wear dentures, you may have a number of problems if you do not produce enough saliva. Due to inadequate lubrication, it will be difficult to chew and swallow foods—especially dry foods. You can alleviate some of this with gravies and sauces and taking frequent sips of water. You can also use take an oral lubricant a few minutes before you eat. You must remove your dentures prior to using the lubricant so it can coat the parts of the gums that support the dentures. Then place the dentures back in your mouth.

Dry mouth and denture "fit":
Saliva is needed to hold your dentures to your gums. Dentists call this retention. When your mouth is dry, your denture will feel loose. This gets worse when supporting tissues under your dentures continue to shrink through the rest of your life. The amount of shrinkage varies from person to person. As your gums shrink, the denture and the gums become mismatched. This happens a little at a time, but even a small change in denture fit becomes more noticeable when your mouth is dry.

Most people notice this more often with the lower denture. It is easier to wear dentures on the upper arch because of the size and shape of the gums. As shrinkage occurs, you many h ave to have your denture remade or relined more often than someone who has normal amounts of saliva. A relinement is a procedure where additional denture material is added to the part of the denture that contacts the gums. This makes the denture fit closely and conform to the shape of the mouth.

However, even if you have a “perfect fit,” you may still experience some looseness because you lack enough saliva to hold the denture in place. You may need a denture adhesive to help in this case. There are many types available. Your dentist can offer advice on which one will best fit your needs.

Not only may you feel an increasing sensation of looseness, but you may also have sore spots underneath your denture because you have less saliva. Without the natural lubrication it provides, there is an increase in friction between the dry denture and the gum, which results in a sore spot. Your dentist should check denture fit is as close as possible. Then, if no adjustment needs to be made to the denture, you can use an oral lubricant or a denture adhesive.

Continued problems will require additional consultation with your dentist. You may need dental implants. It has been shown that replacing dentures with implants has greatly improved the quality of life for thousands of people. Dental implants are almost identical to natural teeth in both function and appearance.

Dry mouth and oral infections:
Because saliva controls germs in your mouth, dry mouth will make you more prone to mouth infections. Candida, a yeast-like fungus, often infects the mouths of people who wear dentures. One such infection is denture stomatitis. It occurs more commonly under the upper denture, particularly in those who have dry mouth and wear their dentures while they sleep. Most cases do not cause enough pain for people to notice, and may go on for years before finally being detected.

When it is detected, it must be eliminated before new dentures are made. Your dentist may have to treat your mouth with both tissue conditioners and antifungal medications.

There is also angular cheilitis, another problem caused by Candida. It causes sores to form at the corners of the mouth. It is treated with antifungal medications. Be careful how you use these medicines because they are often used incorrectly. Talk to your dentist before use.

If you have some natural teeth, you are more likely to have tooth decay resulting in tooth loss if you have dry mouth. Without saliva to regulate germs that cause decay, bacteria can grow more and cause greater damage. Ask your dentist for ways to prevent and reduce tooth decay.

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