When you have dry mouth most of the time, you are at risk of experiencing a number of oral health problems, such as

• tooth decay
• mouth sores
• chapped or cracked lips
• bad breath
• a sore tongue or throat
• trouble chewing, speaking, or swallowing.

Dry mouth also may affect how your dentures fit. Dentures are held in place by a thin layer of saliva. If you don’t make enough saliva, your dentures may not stay in place. Dentures that don’t fit well can slip and rub, causing mouth sores.

WHAT CAUSES DRY MOUTH?

Many things can cause dry mouth. Medications are a common reason a person may make less saliva than usual. As many as 500 medications both prescription and those you can buy over the counter (like allergy and cold medicines) can be factors. Radiation treatments for head and neck cancer often damage the salivary glands and result in chronic dry mouth. Saliva production also may be affected by diseases. Longterm diseases, such as Sjögren syndrome, diabetes, and rheumatoid arthritis, can be associated with dry mouth. It also may occur in people with conditions that develop with advancing age, such as Parkinson and Alzheimer diseases. Depression and anxiety also may be related to dry mouth.

Using tobacco or drinking alcohol or beverages with caffeine like coffee and tea and eating spicy foods also can trigger dry mouth.3 Breathing only through your mouth most of the time whether awake or sleeping also dries your mouth out.

WHAT CAN YOU DO TO HELP WITH DRY MOUTH?

You can try several things to help relieve dry mouth, including

• sipping water or sugarless drinks that don’t contain caffeine
• sucking (not chewing) on ice chips
• applying lanolin-based lip balm
• using sugar-free chewing gum or sugar-free candy to stimulate saliva production
• using a humidifier at night.

There also are several things you can avoid that might help; for example

• eating salty or spicy foods
• consuming alcoholic beverages, including alcohol containing mouth rinses
• drinking caffeine-containing beverages
• using tobacco products.

HOW CAN YOU HELP KEEP YOUR MOUTH HEALTHY?

Having low or no saliva can increase your risk of tooth decay. This makes good oral hygiene even more important. Some steps you can take to improve your oral hygiene include brushing your teeth twice a day with a soft-bristled brush and a toothpaste with fluoride in it and cleaning between your teeth once a day using floss or another interdental cleaner.

You should also visit the dentist regularly. Your dentist may be able to help determine the cause of your problem. He or she can examine you, measure your salivary flow, and talk with you about your general health, medications, or personal habits that may contribute to your dry mouth. Your dentist also may be able to help reduce your risk of tooth decay by applying a fluoride gel or varnish to your teeth or prescribing a mouth rinse or toothpaste that contains high levels of fluoride.1 He or she also may suggest that you use a rinse or gel to help keep your mouth moist.

If you wear dentures, your dentist can be alert to ensure they fit properly. If mouth sores develop, he or she may be able to adjust the dentures to help resolve the problem.

CONCLUSION

Dry mouth can lead to oral health problems like tooth decay or mouth sores. Talk to your dentist about ways to limit the effects of dry mouth.

Dental care is considered safe during pregnancy.1,2 Your dentist may work with your obstetrician when planning your treatments, but many decisions can be made without consultation. For example, many medications including some antibiotics and local anesthetics can be safely used during pregnancy. X-rays also are considered safe when a protective cover is used over your abdomen and throat.

In addition to regular visits to your dentist, you may need to see him or her for problems that might come up during pregnancy, like gum problems or dental erosion.

GUM PROBLEMS

Changes in your hormones during pregnancy may put you at increased risk of some gum problems. For example, your gums may swell or bleed when you are brushing. This form of gum disease is called gingivitis. Some extra effort in caring for your teeth at home may help prevent gingivitis

• brush twice a day for 2 minutes with a toothpaste that has fluoride
• clean between your teeth once a day with dental floss or another interdental cleaner.

Left untreated, gingivitis can lead to periodontitis. Periodontitis affects the tissues beneath the gumline that hold your teeth in place. Professional dental care is needed to treat periodontitis. Without treatment, periodontitis can get worse, and you can lose teeth.

Another gum problem that can occur during pregnancy concerns lumps along the gumline. These are generally harmless, but they can make it difficult to keep your teeth clean. They typically go away after the baby is born, but if they cause serious problems for you in taking care of your teeth, your dentist may suggest removing them.

DENTAL EROSION

Some pregnant women experience nausea. If this causes you to vomit, acid in the mouth can increase the risk of dental erosion. Constant exposure to this acid can soften and wear down enamel (the hard outside layer of your teeth). This is called dental erosion. To help reduce the loss of enamel, women should not brush their teeth immediately after vomiting. Instead, they should rinse with a diluted solution of 1 cup water and 1 teaspoon of baking soda to neutralize the acid.

WHEN TO SCHEDULE YOUR APPOINTMENT

Dental treatment is considered safe at any time during pregnancy, but you might be more comfortable during your second trimester. Nausea and vomiting are more common during the first trimester,4 which could make treatment difficult. During the third trimester, the weight of the baby may cause you to be uncomfortable or even lightheaded during treatment.5 If so, tell your dentist so he or she may see about making you more comfortable by helping you change positions.

CONCLUSION

Professional dental care is considered safe during pregnancy, can help you maintain good oral health, and manage any problems that may develop. Daily care at home is also an important part of keeping your teeth and gums healthy.

Your mouth can be affected by head and neck cancer treatment in a number of ways: oral sores, dry mouth, tooth decay, and infections such as thrush. Good home care, such as brushing twice a day with a fluoride toothpaste and cleaning between your teeth daily, will go a long way toward protecting your mouth. Here are some tips to try if you develop any of these side effects.

ORAL SORES

Oral sores are common during cancer therapy. They can range from redness to an actual open sore. Your dentist may help you manage this discomfort with a numbing cream or gel that you can apply to the affected area. This gel or cream can help numb the area or at least reduce the pain. Let your dentist know if you develop a sore.

DRY MOUTH

A dry mouth is also common during and after therapy for head and neck cancer. This is because the salivary glands, which produce saliva that keeps your mouth moist, can be damaged by the treatment. Here are some things you can try to make yourself more comfortable:

• chew sugar-free gum or suck on sugar-free candies, which may help increase the flow of saliva
• sip water at mealtime to aid in swallowing
• suck -do not chew on ice chips.

Alcohol, including alcohol-containing mouth rinses, can be drying to your mouth, so avoid it. Let your dentist know if dry mouth is becoming a problem for you. He or she might recommend the use of an artificial saliva.

TOOTH DECAY

The risk of developing tooth decay is higher than usual in people who are undergoing head and neck cancer treatment. This is because of the reduced salivary flow. Saliva not only washes food particles away from teeth and gums, but it can also contain the cavity fighter fluoride. Saliva bathes the teeth in fluoride, making the outside layer of the tooth harder. With limited saliva flow and reduced fluoride, teeth are at higher risk of developing tooth decay. Your dentist may be able to help you protect your teeth. There are mouth rinses and toothpastes that have a high fluoride content that he or she can prescribe. There are also fluoride gel treatments that can be given in the dental office. Your dentist can talk with you about which approach would be best.

MAKE YOUR DENTIST PART OF YOUR TEAM

Make your dentist a part of your treatment team as soon as possible. If you can, see your dentist before your cancer treatment begins. Your dentist can help ensure that you do not have an oral infection that could complicate your cancer therapy. In addition, your dentist is knowledgeable about your dental health; this could be helpful during your cancer treatment. He or she has a good understanding of the effects cancer treatment can have on the mouth and how to treat them.

CONCLUSION

Head and neck cancer treatment frequently affects the mouth from oral sores to dry mouth to cavities to oral infections. People who are undergoing such treatment should bring their dentist onto the treatment team as soon as possible. The dentist can help ensure that the mouth is in good health before the cancer treatment begins and can help manage oral side effects once treatment is underway and after it ends

The infection that causes COVID-19 can be spread through droplets of moisture that contain the coronavirus. Many dental procedures like dental cleanings and fillings can send droplets into the air, which puts dentists and dental staff members at increased risk of getting COVID-19. According to surveys, dentists and dental hygienists are taking steps to reduce the risk of the spread of COVID-19.

WHAT ARE DENTISTS AND THE DENTAL TEAM DOING TO HELP?

Dental offices have worked to reduce the spread of infection for a long time. For example, dental offices disinfect treatment rooms between patients, including wiping down frequently touched equipment like chairs and countertops, following guidance from the Centers for Disease Control and Prevention, and the American Dental Association. But, surveys from 2021 show that dental offices are taking extra precautions to help control the spread of the virus that causes COVID19 Dental practices reported.

• asking patients and staff members about whether they have had symptoms of COVID-19 or been around people who have had those symptoms
• encouraging social distancing between patients (by scheduling only a few patients to be in the office at a time, for example
• providing face masks for patients to wear when not being treated.

In addition, most dental practices also said they provide face masks for staff members to wear at all times. Eight of 10 dentists said they wore a special mask that offered additional protection as well as glasses or goggles to protect themselves while treating patients, which makes the office safer for everyone. Many dental practices also added physical forms of protections such as barriers, open windows to increase the flow of air, or air filters.

WHY IS REGULAR DENTAL CARE IMPORTANT?

In addition to your home oral care routine, it is important that you and your family see your dentist regularly not just in an emergency. Regular dental visits are key to reducing the risk of getting cavities, gum disease, and oral cancer.

According to the US surgeon general, tooth decay is the most common chronic childhood disease, and the risk of developing it continues into adulthood.5 Cavities and gum disease need to be prevented and treated because they can lead to tooth loss if not caught early. Your dentist will also be able to look at any signs of change in your mouth that could be linked to oral cancer.

CONCLUSION

It is important that you see your dentist regularly. Dentists are taking steps to reduce the risk of getting COVID-19 to both patients and the dental staff to help provide safe dental care. Talk to your dentist about what is being done to prevent the spread of disease.

Bad breath is very common. It can last a short time or can be a chronic problem lasting for days or months (or even longer). This article talks about some causes of bad breath and offers some tips on controlling it.

WHAT CAUSES BAD BREATH?

Several things can cause bad breath, like conditions in your mouth, illnesses in other parts of your body, medications, or certain foods and drinks.

Conditions in your mouth

Most of the time, chronic bad breath is caused by a problem in your mouth. Some of these conditions are common, such as

• deep cavities
• dry mouth
• coating of food and bacteria on the back of the tongue
• severe gum disease

Illnesses in other parts of your body

Bad breath can be a sign of illnesses involving other parts of your body. For example, bacteria associated with bad breath can grow in the nose, sinuses, or tonsils when those tissues are swollen, such as when you have an infection or allergic reaction. Sometimes debris can collect and harden in the folds of the tonsils, forming tonsil stones that can cause bad breath. Conditions that affect the digestive system, like gastric reflux or ulcers, also can cause bad breath. Other illnesses that can affect breath odor include diabetes and liver or kidney failure.

Medications

Some people develop bad breath while taking certain medications. Medications that might affect breath odor include acetaminophen and some allergy medicines and chemotherapy treatments.

Certain foods and drinks

Certain foods and drinks can trigger temporary bouts of bad breath. Some of the most well known are garlic, onions, and fish, including tuna. Coffee and alcoholic beverages can dry your mouth, which can also contribute to breath that smells bad.

CONTROLLING BAD BREATH

Since most bad breath starts in the mouth, good oral care is a smart first step to controlling breath odor. To help keep your mouth

• clean brush twice a day with a fluoride toothpaste
• clean between your teeth daily with floss or another product made for this, like tiny brushes, picks, or water flossers.

Over-the-counter mouth rinse can help freshen breath. Look for products that have the ADA Seal of Acceptance for the relief of bad breath. These products have been demonstrated to meet ADA Seal standards for safety and efficacy.

Pay attention to what you eat and drink. Avoid foods like garlic and onions and limit your consumption of coffee and alcoholic beverages. Drink plenty of water or use sugar-free candies or gum to keep your mouth moist.

Talk to your dentist if you are concerned about your breath. He or she can help keep your mouth clean and healthy, which may solve the problem. If your breath is still a concern, your dentist may suggest that you speak with your physician.

CONCLUSION

A number of things can cause bad breath, including your oral or general health. In many cases, brushing and cleaning between your teeth as recommended can help keep your breath fresh. If this does not help, talk to your dentist about possible causes and options for improving the situation.

Prepared by Anita M. Mark, senior scientific content specialist, ADA Science & Research Institute, Chicago, IL.