Thursday, May 29, 2014

Drugs and Dry Mouth (The Top Five Prescription Drugs)

Dry mouth (also called xerostomia,) can be very uncomfortable.  Your entire mouth including the lips, tongue and throat can become very dry if saliva production decreases.  Having dry mouth can making eating uncomfortable or painful and can cause bad breath.  It can lead to higher levels of plaque, tooth decay, and dentures that are ill-fitting.  It may even cause an outbreak of thrush, a yeast infection that can occur in the mouth.  Unfortunately, dry mouth is a common side effect of many medications.  While saliva levels can return to normal if a medication is discontinued, this is not an option for many people.  If a medication needs to be taken for a long period of time or permanently, dry mouth must be managed to maintain the health of the mouth and teeth.  The mouth, after all, is meant to be a wet place!  Dry mouth symptoms can be managed by sipping water frequently, chewing sugarless gum or sucking on sugarless candies, using lip balms and with products like Biotene.  Biotene is sold in drug stores without a prescription as a rinse, spray or gel.  It acts by lubricating the mouth and holding in moisture.  (For more information see There are also store brands available.  Since saliva production decreases during sleep, using this kind of product before going to bed may be very helpful.  It is also very important to continue to brush and floss regularly if you have dry mouth.  Below lists the five most commonly prescribed drugs. ( ) 

Three of them - Abilify, Nexium, and Advair Diskus - can cause dry mouth.

1-      Abilify (aripiprazole) – treats depression. 

2-      Nexium (esomeprazole) – treats GERD (gastroesophageal reflux disease) and reduces stomach acid.

3-      Humira (adalimumab) – treats rheumatoid arthritis, osteoarthritis, psoriasis; also may be used to treat Crohn’s disease and ulcerative colitis.

4-      Crestor (rosuvastatin) – lowers “bad” cholesterol

5-      Advair Diskus (fluticasone & salmeterol) – for treatment of asthma and COPD.  

Dry mouth can interfere with your quality of life and the health of your mouth so speak with your doctor, dentist, dental hygienist or other health professional about ways to manage it.

This information is not intended to treat or diagnose any dental or medical problem or illness.  Please visit your medical or dental health professional if you need medical or dental treatment!

Monday, May 19, 2014

Sweet Dreams Are Made of Teeth (apologies to Annie Lennox)

Have you ever dreamed about your teeth?  Dreams about your teeth or dreams that your teeth are falling out are surprisingly common.  You might not be surprised that I see teeth in my dreams, however, I had dreams about teeth long before becoming a dental hygienist.

So what do dreams about teeth mean?  Dream analysis has been around for a long time.  From Joseph’s prophetic dreams in the bible to the surreal dream paintings of Salvador Dali̒, dreams tantalize and fascinate people. Freud proposed that a person’s dreams hold deeper meaning that can be interpreted only by analyzing its details using (his) psychoanalytic methods.  In Freud’s “The Interpretation of Dreams” he illustrates this method using his own dreams.  He describes a dream about a patient he treated who was also his good friend.  Her treatment was not as successful as he would have hoped.  In the dream Freud attempts to give his friend an oral exam, which she resists and he imagines she must have false teeth!  After exploring all the details of his dream, Freud concludes his dream uncovers a desire to gain back the respect of a person who is very important to him.  Freud believed that all dreams are the “(disguised) fulfilment of a (suppressed, repressed) wish.”(1) 

Modern pop culture puts dream analysis squarely in the realm of entertainment like horoscopes or psychic readings.  Websites abound that make suggestions as to why we dream about particular subjects.  Although studies have been conducted to explore what happens to the brain while dreaming, there is little scientific basis to dream analysis.  It is very subjective.  It would be difficult to pinpoint what any dream means to any given person without understanding that person’s perspective, history and environment.  The physiology and anatomy of the brain, like any other organ, may not vary much from person to person but the experiences of each individual can vary greatly and will influence the brain's performance and reactions.   The structure and function of the heart is the same in all, but the heart of an athlete will be much more prepared to run a marathon than the heart of a person who smokes two packs a day.  So it is difficult to say what causes teeth dreams or what the meaning of teeth dreams would be to different individuals.  Still, dreaming about the teeth is a very common occurrence.  (Perhaps not so surprising if we consider that (almost) everyone has them!)  Analysis of teeth dreams offer a variety of interpretations including issues of self-esteem, concern about money, death, fear of death or loss of a loved one, and even lying and deception.

In the dental profession, it is generally accepted that the health of the teeth and self-esteem are linked.  There are thousands of advertisements and sites from cosmetic dentists to implant dentists and orthodontists touting various procedures as a way to improve the way we look and feel about ourselves.  A recent study in the U.K. revealed that tooth loss might affect the way people feel about themselves both socially and psychologically.  Some of the people in the study reported staying home because of the condition of their teeth and compared tooth loss to the loss of a limb.(2)  An Italian study confirmed that having misaligned teeth could affect the “psychosocial well-being” of adolescents.(3)

If the condition of the teeth is a contributing factor to how attractive a person feels, then teeth are an important element of self-esteem.  But this depends on individuals and the importance they place on their teeth, as well as cultural and other factors.  Dentists and dental hygienists know that some patients value their dental health much more highly than others.  So the reasons that people dream about their teeth must be as varied as people themselves!  And how could a dream about the teeth falling out or rotting be the fulfillment of any kind of wish as Freud proposed? Teeth dreams, generally, are pretty disturbing.  Perhaps the horror of the dream forces the person to realize that he or she wishes to do, wants to do, or should be doing something different.  Or maybe it’s just guilt over eating that last piece of chocolate cake!
I welcome your comments and thoughts!

(1) The Interpretation of Dreams, Sigmund Freud (1913) Third Edition, translated by A.A. Brill.  New York: The Macmillan Company, 1913.  New York:, 2010
(2) Rousseau, N., Steele, J., May, C. and Exley, C. (2014), ‘Your whole life is lived through your teeth’: biographical disruption and experiences of tooth loss and replacement. Sociology of Health & Illness, 36: 462476. doi: 10.1111/1467-9566.12080
(3) Perillo L, Esposito M, Caprioglio A, Attanasio S, Santini AC, Carotenuto M.Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept. Patient Prefer Adherence. 2014 Mar 19;8:353-9. doi: 10.2147/PPA.S58971. eCollection 2014. PubMed PMID: 24672229; PubMed Central PMCID: PMC3964173

This information is not intended to treat or diagnose any dental or medical condition.  If you have a medical or dental concern, please seek treatment from a medical or dental professional. 

Saturday, May 17, 2014

Less is more for healthy teeth

When it comes to nutrition for a healthy mouth, less is more.  Generally, the less ingredients something has, the healthier it is for you.  A package of cheese crackers, for example, contains: enriched flour, riboflavin, cheddar cheese, soybean oil, salt, corn syrup, baking soda, yeast, and soy lecithin (and this is a shortened list,) whereas an apple has one ingredient.  A banana is a banana, lettuce is lettuce, and nuts are nuts – well, you get the idea!  This rule doesn’t always apply, however, as orange juice has only one ingredient but contains lots of sugar (22 grams per serving.)  You’re better off just having the orange at about 9 grams of sugar per serving.  Less is also more when it comes to how frequently we eat sugary snacks or drinks as well as how long we take to eat them, too.  It is better to have dessert right after a meal or sweet drinks with a meal.  Constant snacking and sipping doesn’t allow the pH of the mouth to return to normal as fast as it could, putting one at greater risk for cavities.  So substitute in those “one ingredient” snacks and have snacks or beverages with meals for better tooth health.

My next post explores a surprisingly common phenomenon: Dreams about teeth!

This information is not intended to diagnose or treat any dental or medical condition.  If you need dental or medical attention please visit a dental or medical professional!

Monday, May 12, 2014

Sugar - just say "no"

In February the California State Senate introduced the "Sugar-Sweetened Beverages Safety Warning Act," the first legislation of its kind in the United States.  The bill calls for warning labels on beverages containing more than 75 calories per 12 ounce serving which read: "Drinking beverages with added sugar(s) contributes to obesity, diabetes and tooth decay."  Research has shown that the effects of sugar on the body are so dramatic and potentially damaging that the warning was suggested to inform consumers of the danger.  No matter where you come down on legislating about the ill effects of sugar, the dental profession has known for a long time that sugar is very harmful to the teeth, especially if you aren't brushing and flossing properly or regularly.  Plaque, a biofilm which forms on the teeth, is full of germs that love to eat sugar.  The germs form acid as a byproduct which sits on your teeth and can cause cavities.  In addition, taking a long time to drink a sugary beverage by sipping it over a long period of time prevents your mouth from returning to normal, neutral pH levels.  (Sorry all you latte, cappuccino and frappuccino lovers!)  So the next time you reach for that sugary drink, give some thought to the health of your teeth as well as the health of your body!  Here are some "rules" you can follow and, although I can't enforce them legislatively, I hope you'll consider them helpful: Drink water whenever, juice just once, milk with meals, and soda - skip it.

Have a great day and don't forget to brush your teeth 2 times a day for two minutes and floss each day.

This information is not intended to diagnose or treat any dental or medical condition.  If you need dental or medical attention please visit a dental or medical professional!