View Full Version : Dry Mouth and Sjogren's from the Sjogren's Conference

04-13-2010, 03:51 PM
Hi Everyone,
Here is report number 3. Some of us, like me, can have this problem for years without knowing it.

Dry Mouth & Sjogren’s Troy E. Daniels, DDS, MS

Dr. Daniels practices at The Univ. of Cal., San Francisco and studies Sjogren’s as a leader in the Sicca study and SJS Registry at UCSF. Dr. Daniels first explained to us the functions of normal saliva -

• Maintains normal PH
• Supports remineralization with calcium and phosphate ions
• Protects and lubricates oral mucosa
• Solvent for taste perception
• Controls the oral flora

Dry mouth can be caused by prescription drugs, viral infections, depression, diabetes, sarcoidosis, TB, radiation treatments and SJS. Symptoms of dry mouth in SJS –

• Difficulty chewing and swallowing dry foods
• Altered sense of taste
• Difficulty speaking
• Saliva becomes more viscous
• Change in oral flora (yeast infections or thrush)
• Significant risk of characteristic pattern of dental caries

He then explained that there are three kinds of dental caries – interstitial (between the teeth), occlusal (on the biting surface) and root caries (wrap around necks of teeth, with or without crowns). The last type is most common in SJS, and can lead to the loss of crowns if not properly addressed. He treats the root caries before crowns.

Chronic inflammatory periodontal disease is NOT more severe in patients with low saliva, and may be even less severe.
Oral Candidiasis (yeast infections, also called thrush) Can be caused by low saliva, antibiotics, immune suppression. Treatment – Systemic (fluconazole) only if there is visible saliva, ineffective otherwise. Topical – (nystatin, clotrimazole, amphotericin B)

Treatment: Reduce oral symptoms, improve oral function:
• Increase salivary secretion - sugar-free gum or candy, prescription drugs ( Pilocarpine and Cevimeline) both stimulate secretion, but don’t restore normal levels of saliva

Saliva Replacement/Substitution - frequent sips of water, OTC preparations ( these contain carboxymethylcellulose, mucopolysaccharide, Glycerine polymers, Xylitol (can inhibit strep), neutral PH is important, some have fluoride) Too much water can reduce oral mucus film lining, cause nocturia.

This dentist encourages patients to pay attention to a good diet, maintain good oral hygiene, use topical fluoride as needed and consult your dentist regarding dental restoration.

Marla’s notes: I didn’t realize that I had dry mouth until I realized that this is why dentists and hygienists have been blaming me for bad oral hygiene for years, when I DID take good care of my teeth. I’ve also always needed something to drink at hand to swallow my food for years. I’m now concerned, since I have many crowns, and did not know about root caries before they were done. It seems that we need to clue our dentists in on this.

I forgot to note that there was a product being demonstrated that Dr. Daniels was enthusiastic about. It is a rinse that claims to remineralize the teeth with calcium and phosphate in the correct amounts. We all brought home lots of packets of this powder to mix with water. I need to give it a try.

I hope that this helps if you are dealing with dry mouth and/or dental problems.

04-13-2010, 09:20 PM
That was very informative. I've never been diagnosed with Sjogren's, but I definitely have several of the symptoms:huh:

Peace and Blessings

04-14-2010, 12:53 AM
Treatment Systemic (fluconazole) only if there is visible saliva, ineffective otherwise.


I had no idea!!!

Keep us posted on the mouth rinse, okay? Do you know the name of the new product?

04-16-2010, 07:03 AM
like you, my dentists have always been on my case about my dental care. Now, i know more about why i keep having problems, and why i keep having to pay for the advanced cleaning....thanks.

04-16-2010, 01:45 PM
this is very eye opening. and it is something I need to speak with my dentist about at my next appointment. I didn't know what dental carries were so I looked it up and between this and the oral symptoms, you are ringing lots of bells in my head right now. Thank you for sharing!

04-20-2010, 01:04 PM
So that's why my crowns never lasted!! You know, what I think I'm going to do is print out a bunch of the information you shared with us from the conference, and send it to the dentist who kept yelling at me over the years, insisting I didn't brush and floss when I DID!!!!! Finally, proof that it wasn't my fault!!!!

Did they say anything at the conference about tongue problems associated with Sjogren's? I've had little growths on my tongue, a few I had removed, some just go away after a while, but I bet that has something to do with Sjogren's as well.

04-20-2010, 10:58 PM
Thank you Marla for sharing . . . we all learn more every day from each other.

I noticed several items on the list as well; now I know why I get laryngitis, etc.