If you’re dealing with dry mouth, you’re not alone. According to a recent survey by the Sjögren’s Foundation, about 73 percent of respondents said dry mouth had a moderate to major impact on their lives. While dry mouth can make it harder to eat, swallow, or talk, it can also significantly affect your dental health. People who have Sjögren’s disease are more likely to have issues with cavities and losing their teeth. That’s why you must take a proactive approach to caring for your gums and teeth.
The reduction in saliva in your mouth isn’t just uncomfortable; it’s likely contributing to poor dental health. People with Sjögren’s disease have a higher risk of developing cavities, plaque accumulation, gingivitis, periodontitis, oral lesions, and oral infections like candidiasis.
Doctors have suggested that this increased risk is likely associated with low saliva levels in the mouth. Generally, saliva plays a vital role in maintaining good dental health. It can reduce the formation of harmful microorganisms, dilute foods that would affect the mouth’s pH, remove sugars and other components that can cause cavities, and balance the remineralization of your teeth.
If there’s an issue with producing saliva, it would make sense that your dental health wouldn’t be at its best. However, some researchers suggest that it’s not just the presence of saliva that matters. Healthy saliva also needs to contain specific organic and inorganic substances to function effectively.
According to one paper, Sjögren’s may alter the protein profile of your saliva, thereby changing its composition. When the saliva of people with the condition was assessed, researchers found an increase in the levels of lactoferrin, beta(2)-microglobulin, sodium, lysozyme C, and cystatin C, and a decrease in salivary amylase and carbonic anhydrase. While lactoferrin and lysozyme C are usually useful for their antimicrobial properties, elevated levels may indicate a serious infection.
High levels of cystatin C may also indicate that something is wrong. It acts as a protease inhibitor, which means it stops certain enzymes from breaking down proteins. Usually, its level in saliva is low. Amylase is important for breaking down starch into smaller molecules so they can be digested. Lower saliva levels may mean that starches stick around and cause cavities.
Of course, more research is needed to confirm that these changes are directly linked to a higher risk of dental issues. However, the results so far suggest that there may be more for health experts to explore in the management of Sjögren’s disease.
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You should see your dentist at least twice per year. Depending on your needs, your dentist may have a different schedule. During these visits, you must let your dentist know about your Sjögren’s diagnosis as well as any sensitivities you’re dealing with. Sometimes, people with this condition have such sensitive teeth and gums that the usual methods of cleaning may be difficult.
It’s important to brush your teeth regularly to prevent food buildup in your mouth. Since your enamel is already compromised, you need to ensure that you’re not brushing too often. The American Dental Association (ADA) recommends brushing your teeth twice a day for two minutes each time, typically in the morning and before bed. To ensure that you’re getting everything, dentists recommend focusing on each tooth and brushing thoroughly. The best method is to start at the base of the tooth on one side, hold the brush at a 45-degree angle, and brush 10 times upward in a circular motion. You should then repeat that method on the other side of the tooth. For the tops of the teeth, press the toothbrush against the surface and brush 10 times.
While it’s not always necessary, using a toothpaste with fluoride may help to strengthen your teeth. Toothpaste with abrasives, on the other hand, should be avoided as they may weaken your teeth. You can then follow up with alcohol-free mouthwash that’s fortified with fluoride. After swirling the mouthwash in your mouth, spit it out without rinsing with water.
Additionally, if you’ve eaten acidic foods, then you need to wait for at least 30 minutes before brushing. Some notable acidic foods include tomatoes and tomato-based products; citrus fruits such as oranges, lemons, and limes; grapes, plums, raspberries, strawberries, apples, and pineapples; peaches; carbonated drinks; flavored tea; yogurt; and pickled foods.
Along with brushing, flossing is another way for you to remove food particles from your mouth. This is especially important if you know that food will get lodged between certain teeth. When flossing, gently slide the floss between the teeth. Move the floss along the side of one tooth without troubling the gum. You should then move to the other tooth. Lift the floss out, then use a clean section of floss on the next set of teeth.
Fluoride is great for strengthening your teeth, so using toothpaste that’s been supplemented with fluoride can be a good idea. You should also ask your dentist and doctor about using other dental care products that contain fluoride. These can include mouthwash, daily rinses, or tooth gels.
You can’t forget about your tongue when it comes to dental health. Having less saliva means that people who are living with Sjögren’s are also at risk for developing yeast infections on the tongue. Each time you brush your teeth, brush your tongue as well, or use a tongue scraper.
Sugary, sticky foods may be fun to eat, but they’re an unnecessary risk for your dental health. These foods can stick to your teeth, making them hard to remove, even with thorough brushing. It’s even worse if they’re a mid-meal snack, so you’re not going to brush your teeth directly afterward.
If you’re going to snack, consider reaching for foods that are low in refined sugar and aren’t carbohydrate-rich. Fresh fruits and vegetables can be hydrating and provide a healthy snack.
If you wear dentures or other forms of removable dental prostheses, it’s best to remove them at night. Keeping them in may increase your risk of developing a fungal infection, so it’s recommended that you clean your dentures daily. After brushing your dentures thoroughly, place them in an antiseptic solution recommended by your doctor. If your dentures no longer fit well, don’t use denture adhesives, as this could encourage the growth of microorganisms. Talk to your dentist instead so they can recommend options.
Without a steady flow of saliva, you may deal with a poor remineralization balance. That means your teeth may be losing their protective coat–leaving you open to cavities. Remineralizing products may help with that, but you should talk to your doctor before choosing one.
Stimulating saliva production is a key part of your oral health, and you’ll likely be prescribed medication for that. However, another way to supplement your medication is to eat sugar-free gum or candies. Not all artificial sweeteners are good for you, though, so make sure they contain xylitol.
Interestingly, it’s not uncommon for your dentist to notice that something is wrong. Although you may have been prescribed medication to ease your dry mouth symptoms, their effectiveness may vary. Telling your dentist that you have Sjögren’s disease and which medications you’re taking to combat dry mouth can be helpful. That information can affect how often they recommend visits and how seriously they take any changes to your teeth or gums.
When visiting your dentist, you should discuss any issues you’ve had with your dental care as well as ask if they’ve noticed any differences between the last time they saw you and the current state of your mouth. Depending on what they say, you may have more to discuss with your primary physician. You can never be too careful when it comes to Sjogren’s.
Proper dental care is imperative when living with Sjogren’s disease. Your risk of developing serious infections and cavities or losing your teeth is higher than that of those who don’t have the condition, so you can’t rely on the regular type of dental care. It can also be helpful for you to speak with your dentist about your condition and relay any observations to your primary care physician.
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