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Dry Mouth And The Denture Patient - Xerostomia

Xerostomia (Dry Mouth) and Wearing Dentures

To a great extent, dentures stay in place comfortably and in a stabilized manner by development of an intimate interface between denture surfaces and the soft tissues they rest upon. Presence of adequate amounts of saliva within this denture/tissue interface is essential. Without enough saliva, a denture will inadequately adhere to tissues, partly through loss of suction. In addition, tissues contacting a denture will become chafed and irritated without the lubricating effects of saliva.

Some Common Causes of Dry Mouth

• Medications: There are approximately 500 commonly prescribed medications that have xerostomia as a possible side effect, and this is a frequent cause of dryness.
• Aging: The amount of saliva produced by salivary glands lessens as a person ages.
li>Illnesses: Xerostomia is sometimes associated with certain illnesses or conditions such as chronic diarrhea, liver dysfunction, or Sjogren's syndrome.
• Radiation therapy: Radiotherapy that is used to treat some cancers may have reduced salivary gland function as a side effect.
• Habits: Chronic mouth breathing and inadequate fluid consumption often will cause dry mouth.

Approaches to Managing Dry Mouth

Before managing a persistent dry mouth, it is essential to first become aware of the problem, and then attempt to determine causation for the xerostomia. Sometimes the cause is easily eliminated, but in many instances, that is not possible, and the condition is persistent and often progressive. There are several approaches to managing dry mouth.

• Modify medications: If a certain medication is suspected of causing xerostomia, consultation with a person's physician may make it possible to use a different, but equally effective, drug that no longer causes dry mouth or causes it to a lesser degree. However, there often are not suitable alternatives for a particular person's individual problem. Under no circumstances should someone discontinue or attempt to change a medication without the explicit knowledge and approval of their physician -- to do otherwise may result in serious illness or death.
• Sialagogues: These are substances that stimulate the production of saliva. There are two important types of sialagogues. 1) Gustatory sialagogues such as sugar-free hard candies frequently will cause some increase in salivation, and citrus flavors such as lemon are sometimes more effective than others. While sugar-free, low-sticking gum has been suggested, the process of chewing gum could more easily irritate already poorly lubricated tissues by increasing denture movement. 2) Pharmaceutical sialagogues (called parasympathomimetic agents) sometimes improve salivation and must be prescribed by a person's physician if their health status allows such a consideration.
• Salivary substitutes: Salivary substitutes are commercially available solutions that help keep the mouth moist and more lubricated. These compounds usually must be applied frequently and they generally necessitate having a container of the substance nearby.
li>Water: Water is a salivary substitute and often is used in place of commercial salivary substitutes. Regularly moistening the mouth, and drinking increased amounts of water may both hydrate tissues and facilitate some increase in production of saliva in certain individuals. While increased intake of water is generally healthful, persons with certain medical conditions such as, but not limited to, congestive heart failure should first check with their physicians before significantly increasing their routine consumption of fluids.

Alternative Denture Therapy for Patients Suffering From Dry Mouth

Those patients who are not able to comfortably wear conventional dentures due to severe xerostomia might consider implant-supported dentures. If this course of treatment is pursued, intense oral hygiene practices are necessary to maintain healthy implants and avoid periodontal disease in the presence of reduced salivary production. A person should always consult with their dentist to determine which treatment is best for them.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

When Should a Denture Be Replaced?

There is no specifically agreed-upon chronological answer by dentists to "When should a denture be replaced?" There are instances where dentures have been replaced after 1 year or less, and on the opposite side of the spectrum, there are people who have worn the same dentures for 25 or more years. These ranges obviously are extremes.

However, on average, dentists seem to be replacing dentures somewhere between four to eight years. This would seem to imply that the average denture fabricated from contemporary biomaterials will wear out and deteriorate within that time and/or the average denture patient's jaws have changed so much that a new denture must be redone.

Each individual's denture needs are different. There are some factors that a licensed dentist takes into consideration when evaluating the need to replace dentures.

Denture Longevity Considerations

Lost vertical dimension:

The proper linear distance relationship between the upper and lower jaws is called vertical dimension. This is unique for each individual.

As one's jaw changes and the ridges upon which dentures rest shrink, a denture becomes loose and vertical dimension begins to change (the vertical dimension is said to be lost by a certain linear measurement unit such as millimeters). Additional plastic (acrylic resin) is added to the inside of a loosening denture (called relining a denture) to stabilize it by reducing looseness caused from jaw shrinkage. However, relining does not restore vertical dimension in an accurate way.

The current position held by most dentists is that when vertical dimension has been lost by three millimeters or more, a new denture should be fabricated in order to restore vertical dimension and maintain functional health.

There are individuals who have worn the same denture for extended periods with considerable loss of vertical dimension over time. Since vertical dimension loss is a slow, but nevertheless progressive, process, they have gradually adapted to a continually increasing closed bite position. These individuals often have a sunken facial appearance and usually appear much older than their chronological age.

Functioning with an abnormal vertical dimension may eventually result in alterations of the temporomandibular joints (TMJ, the jaw joint located in front of the ears). This can lead to significant pain and difficulty with effective eating and even the jaw motions involved with speech. It frequently becomes quite difficult, if not impossible, to restore such individual's proper vertical dimension and chewing efficiency by relining and repairing this older denture.

Tooth wear:

Aside from impaired ability to chew effectively, excess tooth wear will adversely affect esthetics and cause other problems associated with lost vertical dimension, as described above. While porcelain denture teeth will wear at a slower rate than plastic teeth, they nevertheless will wear and are more susceptible to chipping and cracking. Multiple cracked teeth will need to be replaced.

Deterioration: While the biomaterials used by dentists to fabricate dentures today are quite durable, they still deteriorate and exhibit dimensional change over time -- no longer fitting properly, even after relining.

Aging plastic looses its natural appearance and texture, and coloration fades, making dentures look quite artificial.

Deteriorating plastic also makes it easier for dentures to become excessively contaminated with microorganisms. This contributes to mouth irritation and bad taste, and socially unacceptable odors will develop that no amount of denture cleaning will seem to eliminate.

Keeping regular dental check-ups with your dentist so that one's dentures, soft tissues, and jawbone may be checked is essential to extending the life of a denture and maintaining oral health.

by Joseph J. Massad, D.D.S.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.