How Important Is Your Dental Hygiene?

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According to articles in journals, such as, Current Psychiatry and others published by the Mayo Clinic, your dental hygiene is more important than you might realize.  Without proper oral hygiene, the bacteria in a person’s mouth can reach levels that might lead to oral infections, such as tooth decay and gum disease.  This becomes more significant for those taking medications that reduce saliva production.  Saliva washes away food and neutralizes acids produced by bacteria in the mouth, helping to protect you from microbial invasion or overgrowth that might lead to disease.

Xerostomia, commonly known as “dry mouth,” is a reported side effect of >1,800 drugs from >80 classes.  This condition often goes unrecognized and untreated, but it can significantly affect patients’ quality of life and cause oral and medical health problems.  Although psychotropic medications are not the only offenders, they comprise a large portion of the agents that can cause dry mouth. Antidepressants, anticonvulsants, anxiolytics, antipsychotics, anticholinergics, and alpha agonists can cause xerostomia. The risk of salivary hypofunction increases with polypharmacy and may be especially likely when ≥3 drugs are taken per day.

Among all reported side effects of antidepressants and antipsychotics, dry mouth often is the most prevalent complaint. For example, in a study of 5 antidepressants 35% to 46% of patients reported dry mouth. Rates are similar in users of various antipsychotics. Patients with severe, persistent mental illness often cite side effects as the primary reason for psychotropic noncompliance.

Some other medications that people take that limit saliva production include: decongestants, antihistamines, painkillers and diuretics.

Studies also suggest that oral bacteria and the inflammation associated with periodontitis — a severe form of gum disease — might play a role in some diseases. In addition, certain diseases, such as diabetes and HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe.

Your oral health might affect, be affected by, or contribute to various diseases and conditions, including:

  • Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.
  • Cardiovascular disease. Some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause.
  • Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight.
  • Diabetes. Diabetes reduces the body’s resistance to infection — putting the gums at risk. Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels.
  • HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.
  • Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — might be linked with periodontal bone loss and tooth loss.
  • Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
  • Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome — an immune system disorder that causes dry mouth — and eating disorders.

Here is one innovative way that some people use to cleanse the mouth:

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http://www.ncbi.nlm.nih.gov/pubmed/?term=oil+pulling

http://www.ncbi.nlm.nih.gov/pubmed/21911944

http://www.ncbi.nlm.nih.gov/pubmed/18408265

http://www.ncbi.nlm.nih.gov/pubmed/19336860

http://www.currentpsychiatry.com/index.php?id=22661&tx_ttnews[tt_news]=176472

http://www.mayoclinic.org/healthy-living/adult-health/in-depth/dental/art-20047475

Drymouth.info. Overview of drugs and dry mouth. http://drymouth.info/practitioner/overview.asp. Accessed September 2, 2011.

Stewart CM, Berg KM, Cha S, et al. Salivary dysfunction and quality of life in Sjögren syndrome: a critical oral-systemic connection. J Am Dent Assoc. 2008;139(3):291-299.

Friedman PK. Xerostomia: The invisible oral health condition. http://www.dentistryiq.com/index/display/article-display/295922/articles/woman-dentist-journal/health/xerostomia-the-invisible-oral-health-condition.html. Accessed September 6, 2011.

Physician Desk Reference. Montvale NJ: PDR Network LLC.; 2011.

Bardow A, Lagerlof F, Nauntofte B, et al. The role of saliva. In: Fejerskov O, Kidd E, eds. Dental caries: the disease and its clinical management. Oxford, United Kingdom: Blackwell Munksgaard; 2008:195.

Vanderkooy JD, Kennedy SH, Bagby RM. Antidepressant side effects in depression patients treated in a naturalistic setting: a study of bupropion moclobemide, paroxetine, sertraline, and venlafaxine. Can J Psychiatry. 2002;47(2):174-180.

Löffler W, Kilian R, Toumi M, et al. Schizophrenic patients’ subjective reasons for compliance and noncompliance with neuroleptic treatment. Pharmacopsychiatry. 2003;36(3):105-112.

Lambert M, Conus P, Eide P, et al. Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence. Eur Psychiatry. 2004;19(7):415-422.

Rettenbacher MA, Hofer A, Eder U, et al. Compliance in schizophrenia: psychopathology, side effects, and patients’ attitudes toward the illness and medication. J Clin Psychiatry. 2004;65(9):1211-1218.

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