What are the Best Xerostomia Treatment Products for Denture-Wearers?

June 3, 2024 | Dry Mouth / Oral Health / SaliPen® / Xerostomia

Anyone who wears dentures knows that xerostomia, aka dry mouth, presents a serious challenge regarding oral health and comfort. Dry mouth treatments become even more crucial for people who wear complete dentures, as the effectiveness of the treatments significantly impacts the quality of life.

 

In this blog post, we’ll review a recent article that examined the relationship between saliva and complete dentures, including various xerostomia treatments, how they relate to denture management, and proper upkeep techniques to prevent further oral health complications.

 

This is a must-read for anyone who wears dentures and suffers from dry mouth, and for dentists and prosthodontists who treat patients with xerostomia. 

 

Background: The Role of Saliva in Xerostomia

Saliva plays a critical role in oral health. Its presence, or lack thereof, affects many aspects of oral health, which may be exaggerated in people wearing complete dentures. 

 

The daily average of saliva secretion ranges from 500 ml to 1500 ml. Xerostomia, the subjective feeling of dry mouth, typically occurs due to insufficient saliva secretion or changes in the consistency of saliva. 

 

Saliva and Dentures

In edentulous patients (those without teeth), saliva becomes even more critical due to its role in denture retention and lubrication. Saliva preserves denture integrity by keeping denture surfaces clean and maintaining oral hygiene. It physically washes away food and other debris. Saliva also makes denture surfaces more compatible with movements of the lips, cheeks, and tongue while talking, chewing, and swallowing. 

 

Sufficient saliva isn’t the only factor that affects dentures. Quality and consistency also play a role. For example, thin viscosity saliva assists in denture retention and prevents tissue damage. Thick saliva can make it hard to get accurate impressions, and once in, can lead to the dislodgement of dentures.

 

Xerostomia Symptoms

Xerostomia has many symptoms, and each person typically presents with a combination of some of them, not necessarily all of them. Xerostomia symptoms include:

  • The ability to chew, speak, and swallow food
  • Sore throat
  • Fissures or cracks in the surface of the tongue, or “bald tongue” which happens when  the filiform papillae on the dorsal surface of the tongue undergo atrophy and result in a smooth, glossy appearance
  • Halitosis (bad breath), which arises from the build-up of bacteria in the oral cavity
  • Cheilitis, inflammation of the lips, and the cracking and splitting of the skin at the corners of the mouth 
  • Dysgeusia, a lack of taste or taste disorders (a condition that gained infamy as one of the symptoms of COVID-19)
  • Fungal infections in the mouth, such as oral thrush
  • Glossodynia, aka Burning Mouth Syndrome 
  • Inflammation of the tongue or the development of tongue ulcers 
  • Periodontal disease
  • Increased tooth decay and plaque accumulation
  • Sleep disruptions due to oral discomfort
  • People with dentures may experience issues with denture retention and adhesion of the tongue to the roof of the mouth. They may also develop denture sores
  • Severe cases of xerostomia may lead to sialadenitis, a salivary gland infection, which can cause localized pain, swelling, and inflammation of the salivary gland

 

Xerostomia Causes

Infrequent dryness usually isn’t considered a big deal and can be solved by simple home remedies for dry mouth, like drinking more water. Persistent dry mouth, however, has several medical causes. Identifying the cause in each patient is important because treatment largely depends on the cause. 

 

Causes include:

  • Salivary gland damage, which can result from radiation targeting the head, neck, and face, or diseases affecting the salivary glands, such as Sjögren’s syndrome, endocrine conditions, thyroid disorders, and more. Systemic diseases like liver and kidney diseases and viral infections may indirectly affect salivary gland function, contributing to xerostomia.
  • Medications that interfere with the neural control of salivary glands, including age-related medication usage.  Phenothiazines and benzodiazepines, commonly used to treat psychiatric and neurological conditions, have been linked to xerostomia, as have opioids and certain cytotoxic drugs used in chemotherapy.
  • Tobacco use increases the risk of dry mouth by impacting saliva production and quality.
  • Lifestyle habits, such as mouth breathing, snoring, or not drinking enough.

 

Xerostomia: Best Treatment Options

While there are no miracle cures for dry mouth, there are several effective treatments. Usually, doctors and dentists opt for a multidisciplinary approach that doesn’t just choose one treatment but combines several.

 

There are two main categories of treatment: natural salivary stimulation and artificial salivary substitutes.


  • Natural Salivary Stimulation

Natural salivary stimulation increases the body’s natural ability to secrete saliva. This can be done in several ways:

  • Electrostimulation, a technique in which soft, painless electrical impulses are delivered to the mouth to stimulate the salivary glands. Electrical stimulation can enhance salivary gland function by increasing blood flow, promoting glandular cell proliferation, and stimulating neurotransmitter release. The SaliPen is based on this technique. 
  • Chemical stimulation: Sialogogues are medications that directly stimulate the salivary glands to increase saliva production. The most commonly used sialogogues include Pilocarpine, Bromhexine, Cevimeline, and Anethole trithione. 
  • Lifestyle changes, such as consuming more frequent meals, drinking more water, reducing nicotine, alcohol, and caffeine intake, and chewing sugar-free gum may stimulate saliva production by mechanically activating the salivary glands.


  • Salivary Substitutes

Salivary substitutes artificially introduce saliva into the mouth (as opposed to stimulants, which encourage the body’s natural production of saliva). Salivary substitutes include sprays, gels, mouth rinses, and lozenges. 

 

Denture Modifications for People with Xerostomia

Denture modifications can offer some degree of relief for people who wear dentures and suffer from xerostomia. Reservoir dentures, for example, feature compartments within the base that hold saliva substitutes or lubricants, which they gradually release throughout the day. 

 

Prosthodontists can also make surface modifications, such as special coatings or soft liners, which can be applied to the denture surface to reduce friction and pressure spots. They can also adjust the contour and fit of dentures to accommodate changes in oral anatomy that result from xerostomia. 

 

Denture adhesives are another viable option for people with xerostomia. These adhesives come in different forms (powders, pastes, strips) and aim to replace saliva’s natural wetting mechanism by enhancing adhesion between the denture and oral tissues. Patients must clean dentures thoroughly after every use of adhesives to prevent the growth of bacteria and fungi. 

 

Oral Health Maintenance Measures for Denture-Wearers with Xerostomia

People with dentures who suffer from dry mouth must take extra precautions so their symptoms don’t get worse and so they can wear their dentures comfortably. These precautions include:

  • Dental evaluations every 4-6 months
  • Annual radiographs to assess potential dental caries, bone loss, or other pathology
  • A low-guar diet to prevent dental caries
  • Proper oral hygiene practices, including regular brushing and flossing
  • The use of topical fluoride treatments to strengthen tooth enamel and prevent decay
  • For rampant caries due to hyposalivation, neutral pH sodium fluoride can be effective
  • Wetting dentures before placing them in the mouth, and spraying prostheses with artificial saliva before applying denture adhesives to reduce discomfort 
  • Increasing fluid intake during meals and wetting dentures before eating to help with chewing and swallowing

Conclusion

Dry mouth can cause discomfort and pain, especially for people who wear dentures. Fortunately, there are many effective treatments, ranging from electrostimulation to lifestyle changes, and more. Additionally, denture-wearers who get regular dental checkups and follow denture best practices can significantly minimize discomfort and oral health complications. 

 

FAQS

Why does dry mouth make it hard to wear dentures?

Saliva plays a crucial role in denture comfort due to its role in denture retention and lubrication. Saliva preserves denture integrity by keeping denture surfaces clean and maintaining oral hygiene. It washes away food and other debris and also makes denture surfaces more compatible with movements of the lips, cheeks, and tongue while talking, chewing, and swallowing. 

 

Can dentures be adjusted to minimize the discomfort caused by dry mouth?

Yes! Prosthodontists can make denture modifications, such as adding reservoirs 

within the base of the dentures that hold saliva substitutes. They can also make surface modifications, such as special coatings or soft liners, or adjust the contour and fit of dentures to accommodate changes in oral anatomy that result from xerostomia. Patients may also use denture adhesives to replace saliva’s natural wetting mechanism.

 

Does xerostomia require continual treatment?

People with xerostomia, especially those who wear dentures, must continually invest time and effort to ensure their oral health doesn’t deteriorate further. This includes visits to the dentist every 4-6 months, proper oral hygiene practices and denture care, and drinking more water, among other things.  

 

Is electrostimulation an effective dry mouth treatment?

Yes, electrostimulation is an effective treatment for dry mouth. It works by boosting the body’s natural ability to secrete saliva. The SaliPen, in particular, is FDA-approved. Learn more about it here.