Dr. Richard Nagelberg says people have been using some form of "fuzzy stick" to clean the mouth for ages for a reason...because it works. However, while the basic methods of brushing and interdental cleaning have developed over time, there is still one aspect of oral health that has been largely overlooked for far too long—xerostomia.
Using some form of a fuzzy stick to clean the mouth has been around for many moons for a reason...because it works. The cornerstones of brushing and interdental cleaning still apply, but one aspect of oral health has been largely overlooked for too long—XEROSTOMIA.
One of the problems with xerostomia is its subjective nature. There is also the issue of the gradual nature of dry mouth development. Xerostomia is most commonly a condition that develops slowly over time, and affected individuals tend to adapt to their new normal. This is why many patients indicate that they do not have a dry mouth when clinical observations indicate otherwise. The protective properties of adequate salivary flow are extremely well-documented and available from a brief Google search.
Many dental clinicians do not have xerostomia in mind when patients are seated in the chair. Some patients think that if dry mouth were important enough, their dentist or hygienist would mention it to them. Similarly, some clinicians are thinking that if patients have dry mouth, they will bring up the subject. Everyone is sitting there waiting for the other one to speak up first. But it’s our responsibility as health-care providers.
Mild, transient cases of dry mouth can be adequately addressed with over-the-counter remedies. Chronic cases can be addressed with a variety of remedies, including OTC mouth rinses or supersaturated calcium phosphate rinses, which simulate (not stimulate) the inorganic protective properties of saliva, provide the proper pH level, and help with tooth remineralization and lubrication of the mouth.
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Just as using a notched stick to measure pocket depth has been employed far too long, overlooking the damaging effects of xerostomia has gone on too long as well. Let this blog post serve as a call to action to elevate our awareness of dry mouth and make appropriate recommendations for our patients. Once you make the decision to do so and act upon it, many clinicians will be surprised how pervasive the condition is, especially in our older patients. We just have to remember to ask our patients about the condition and look in their mouths for validation.
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