I had received a request for advice as to how to stave off dental problems
when so many medications cause dry mouth.  What follows is my reply.  I
thought I'd post it to the group as it might answer some questions.  Hope it
helps.  If anyone has any specific questions, please don't hesitate to
contact me at [log in to unmask]

What follows are the secrets of maintaining good dental health in the face
of medications that cause dry mouth.  This information is highly classified
and should be memorized and destroyed, lest the dental industry collapse
because of a lack of decay.

Saliva is important for two reasons.  First, its flow washes remnants of
food away from the surface of the tooth.  It also acts as a buffer when the
bacteria that cause decay begin to produce acid.  When your mouth is dry
food tends to stick to your teeth and the decay process continues for a
longer period of time than it normally would.

The solution to the problem is relatively simple.  After you eat, try to
immediately remove the food from teeth.  If brushing is impractical
sugarless gum is a reasonable alternative.  Each time you eat the decay
process begins again.  Thus, the more often you eat the more frequently you
expose your teeth to the prospect of decay.  Cutting down on snacking
greatly reduces the risk of decay.

For some reason the medical profession as a whole has not seen fit to
address the consequences of prescribing medications that dry the mouth.  I
have still seen recommendations that hard candy be used as a remedy.
Putting anything in your mouth that continuously releases sugar,
particularly with a reduced salivary flow, is committing dental suicide.

Over-the-counter fluoride can be very useful in protecting your teeth as
well.  In general, it helps not to eat or drink (or rinse) for 30 minutes
after applying the fluoride.

In a nutshell, eating less frequently, avoiding sweet sticky food, cleaning
your teeth after eating and using fluoride will greatly reduce the risk of
decay.  Unfortunately, this takes a certain amount of discipline.  My
motivation comes from my experience of seeing people lose a large number of
teeth simply from substituting hard candy for cigarettes in an attempt to
quit smoking.  Patients that I have treated with dry mouth caused by
medication have had an even more difficult time controlling the decay
process.  Personally, I have enough inconveniences in my life without adding
dental problems to them.  But, like everything else, everyone has a
different tolerance to the degree of effort involved.  Think of it this
way-imagine that each time you eat you are releasing millions of bacteria,
each with a chainsaw, determined to cut down every tooth in your mouth.  I
don't know about you, but that image is enough to get me to run for my
toothbrush and floss.