Xerostomia
Lack of saliva is a common problem, but a dry mouth can affect both your enjoyment of food and the health of your teeth. The medical term for dry mouth is xerostomia (zeer-o-STO-me-uh).

Dry mouth can cause problems because saliva helps prevent tooth decay by limiting bacterial growth and washing away food and plaque. Saliva enhances your ability to taste and makes it easier to swallow. In addition, enzymes in saliva aid in digestion. Although the treatment depends on the cause, dry mouth is often a side effect of medication. Dry mouth may improve with an adjusted dosage or a new prescription.

Signs and symptoms that you have xerostomia:

• Dryness in your mouth
• Saliva that seems thick, stringy
• Sores or split skin at the corners of your mouth
• Cracked lips
• Bad breath
• Difficulty speaking, swallowing
• Sore throat
• An altered sense of taste
• A fungal infection in your mouth
• Increased plaque, tooth decay and gum disease
• In women, dry mouth may result in lipstick adhering to the teeth.

When to see a doctor
If you've noticed persistent dry mouth signs and symptoms, make an appointment with your family doctor or your dentist.
Dry mouth has numerous causes, including:

• Medications. Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, decongestants, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson's disease medications.
• Aging. Getting older isn't a risk factor for dry mouth on its own; however, older people are more likely to be taking medications that may cause dry mouth. Also, older people are more likely to have other health conditions that may cause dry mouth.
• Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount
• produced. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production.
• Nerve damage. An injury or surgery that causes nerve damage to your head and neck area also can result in xerostomia.

• Other health conditions. Dry mouth can be a consequence of certain health conditions — or their treatments — including the autoimmune disease Sjogren's syndrome, diabetes, Parkinson's disease, HIV/AIDS, anxiety disorders and depression. Stroke and Alzheimer's disease may cause a perception of dry mouth, even though the salivary glands are functioning normally. Snoring and breathing with your mouth open also can contribute to the problem.
• Tobacco use. Smoking or chewing tobacco can increase dry mouth symptoms.
What can be done

• Write down any symptoms you're experiencing, including any that initially may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all prescribed medications, vitamins, supplements and over-the-counter medications that you're taking.
What to expect from your doctor

Your doctor or dentist is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor or dentist may ask:
• When did you first begin experiencing symptoms?
• Have your symptoms been continuous, or occasional?
• Have you started taking any new medications recently?
• Do you smoke or chew tobacco?
• Does anything improve your symptoms or stimulate your saliva flow?
• What, if anything, appears to worsen your symptoms?
What you can do in the meantime
Try frequently sipping water or chewing sugar-free gum to increase your saliva. Also, be sure to brush your teeth regularly to help prevent cavities. If you use tobacco, quitting will likely improve your signs and symptoms.

To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you'll need blood tests and imaging scans of your salivary glands to identify the cause
If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn't cause a dry mouth. Your doctor may also consider prescribing pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.
When the cause of the problem either can't be determined or can't be resolved, the following tips may help improve your dry mouth symptoms and keep your teeth healthy:
• Chew sugar-free gum or suck on sugar-free hard candies.
• Limit your caffeine intake. Caffeine can make your mouth drier.
• Avoid sugary or acidic foods and candies because they increase the risk of tooth decay.
• Brush with a fluoride toothpaste. (Ask your dentist if you might benefit from prescription fluoride toothpaste.)
• Use a fluoride rinse or brush-on fluoride gel before bedtime.
• Don't use a mouthwash that contains alcohol because these can be drying.
• Stop all tobacco use if you smoke or chew tobacco.
• Sip water regularly.
• Try over-the-counter saliva substitutes. Look for ones containing carboxymethylcellulose or hydroxyethyl cellulose, such as Biotene Oralbalance.
• Avoid using over-the-counter antihistamines and decongestants because they can make your symptoms worse.
• Breathe through your nose, not your mouth.
• Add moisture to the air at night with a room humidifier

Dental Health and Fluoride Treatment

Fluoride is a mineral that occurs naturally in many foods and water. Every day, minerals are added to and lost from a tooth's enamel layer through two processes, demineralization and remineralisation. Minerals are lost (demineralization) from a tooth's enamel layer when acids -- formed from plaque bacteria and sugars in the mouth -- attack the enamel. Minerals such as fluoride, calcium, and phosphate are redeposited (remineralisation) to the enamel layer from the foods and waters consumed. Too much demineralisation without enough remineralisation to repair the enamel layer leads to tooth decay.

Fluoride helps prevent tooth decay by making the tooth more resistant to acid attacks from plaque bacteria and sugars in the mouth. It also reverses early decay. In children under six years of age, fluoride becomes incorporated into the development of permanent teeth, making it difficult for acids to demineralise the teeth. Fluoride also helps speed remineralisation as well as disrupts acid production in already erupted teeth of both children and adults.

In What Forms Is Fluoride Available?

As mentioned, fluoride is found in foods and water. It can also be directly applied to the teeth through fluoridated toothpastes and mouth rinses. Mouth rinses containing fluoride in lower strengths are available over-the-counter; stronger concentrations require a dentist prescription.

A dentist in his or her office can also apply fluoride to the teeth as a gel, foam, or varnish. These treatments contain a much higher level of fluoride than the amount found in toothpastes and mouth rinses. Varnishes are painted on the teeth; foams are put into a tray, which is applied to the teeth for 1 to 4 minutes; gels can be painted on or applied via a tray. Fluoride supplements are also available as liquids and tablets and must be prescribed by your dentist, pediatrician, or family doctor.

When Is Flouride Intake Most Critical?

It is important for infants and children between the ages of 6 months and 16 years to be exposed to fluoride. This is the time frame during which the primary and permanent develop and erupt. However, adults benefit from fluoride too. New research indicates that topical fluoride -- from toothpastes, mouth rinses, and fluoride treatments -- are as important in fighting tooth decay as in strengthening developing teeth.

In addition, people with certain conditions may be at increased risk of tooth decay and would therefore benefit from additional fluoride treatment. They include people with:

• Dry mouth conditions : Dry mouth caused by diseases such as Sjögren's syndrome, certain (medications such as allergy medications, antihistamines, anti-anxiety drugs, and high blood pressure drugs), and head and neck radiation treatment makes an individual more prone to tooth decay. The lack of saliva makes it harder for food particles to be washed away and acids to be neutralized.

• Gum disease: Also called gingivitis, gum disease can expose more of your tooth and tooth roots to bacteria increasing the chance of tooth decay.

• History of frequent cavities : If you have one cavity every year or every other year, you might benefit from additional fluoride.

• Presence of crowns and/or bridges or braces : These treatments can put teeth at risk for decay at the point where the crown meets the underlying tooth structure or around the brackets of orthodontic appliances.

Ask your dentist if you could benefit from additional fluoride.

Significance Of Bad Breath

Bad breath, medically called halitosis, can result from poor oral hygiene habits and may be a sign of other health problems. Bad breath can also be made worse by the types of foods you eat and other unhealthy lifestyle habits.

How Does What You Eat Affect Breath?

Basically, all the food you eat begins to be broken down in your mouth. As foods are digested and absorbed into your bloodstream, they are eventually carried to your lungs and given off in your breath. If you eat foods with strong odors, brushing and flossing merely covers up the odor temporarily.

Why Do Poor Habits Cause Bad Breath?

If you don't brush and floss your teeth daily, food particles can remain in your mouth, which promotes bacteria growth between teeth, around the gums, and on the tongue. This causes bad breath. In addition, odor-causing bacteria and food particles can cause bad breath if dentures are not properly cleaned.

Alcohol consumption, insufficient intake of water, smoking or chewing tobacco-based products can also cause bad breath, stain teeth, reduce your ability to taste foods, and irritate gum tissues.

What Health Problems Are Associated With Bad Breath?

Persistent bad breath or a bad taste in your mouth may be warning signs of gum disease. Gum disease is caused by the buildup of plaque on teeth. The bacteria cause toxins to form in the mouth, which irritate the gums. If periodontal disease continues untreated, it can damage the gums and jawbone.

Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth and dental caries.

The medical condition dry mouth (also called xerostomia) can also cause bad breath. Saliva is necessary to moisten and cleanse the mouth by neutralizing acids produced by plaque and washing away dead cells that accumulate on the tongue, gums, and cheeks. If not removed, these cells decompose and can cause bad breath. Dry mouth may be caused by the side effects of various medications, salivary gland problems, or continuous breathing through the mouth.

Many other diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, liver or kidney problems.

Diabetes come with the problem of dry mouth. Dry mouth means less saliva. Saliva is important part of oral health to provide enzymes to help with the digestion of food. Less saliva means insufficient oxygen and that causes bad breath.

How would I know if I have bad breath

To find out if you have bad breath, you may check it out from your dentist with a test perform by the halimeter. If diagnosed with bad breath, ask your dentist about which product is best for you.

Stress Causing Periodontal Disease

Do you know?

Chronic stress can lead to a host of health problem including weakened immune system, increase in blood pressure and also periodontal problem (gum disease).

Periodontal disease if left untreated, can present in more serious and potentially expensive overall health complications.

According to David Coohran, DDS, PhD, president of the America Academy of Periodontology and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio, stress can make an individual more susceptible to harmful habits that negatively impact oral health. “ Stress may lead an individual to abuse alcohol or tobacco, and to possibly even neglect his or her oral hygiene. These lifestyle choices are known risk factor for the development of periodontal disease, which has been connected to several other chronic diseases, including heart disease and diabetes.”

Therefore, during periods of high stress, one should not only maintain a healthy diet, regular rest and exercise but to also maintain a healthy mouth by visiting his/her dentist regularly.

Periodontal Disease can cause Diabetes

Periodontal disease is a chronic inflammatory disease that affects the gum and the bone that supports the teeth. This disease has been associated with the progression of diabetes. In periodontal disease, body reacts to bacteria causing gum infection by producing proteins or chemical called inflammatory radiator. Ulcers and open sores in the gum can also become a passageway for these proteins and bacteria to enter the body's circulation.

Inflammatory radiator as well as some part of the bacteria prevents the body from efficiently removing glucose or sugar level from the blood. High level of sugar is known as poor diabetes control. Poor diabetes control can lead to serious complications, such as vision disorders, cardiovascular and kidney disease and even amputation.

Cleaning and other non- surgical periodontal treatment removes the harmful bacteria. It is believed that this helps to prevent the body from producing harmful chemicals that can enter the systemic circulation and contribute to poorer diabetes control. Patient with Type II diabetes and periodontal disease who receives periodontal therapy see level of oxidative stress reduced to the same level as non diabetic patient. In summary, to prevent diabetic condition from worsening, one should visit his/her dentist for regularly check- ups and cleaning.