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1 JudyBendit.com Sponsored by:

2 Like me on Facebook at: Judy Bendit RDH, BS Just like all of us, our patients are advancing in age and are facing some complicated age-related consequences. We will chew on the facts and spit out potential solutions that will help us all age tastefully. Where to look for information ADA web site: Try Google Scholar Cochrane web site: NIH- Clinical Trials- Manufacturers web sites: Look in professional tabs that review the literature and research- Colgate, P&G, Sunstar Butler, WaterPik, Phillips, GSK, J & J For products: go to Click on the item and it will take you directly to each company s web site.

3 Read this Book: Dying from Dirty Teeth-Why the Lack of Proper Oral Care is Killing Nursing Home Residents and How to Prevent it. By Angie Stone RDH, BS Chewing gum: Freshen breath Neutralize plaque acids and increase the ph of the oral environment due to salivary stimulation. Stimulate saliva flow, which is beneficial for patients with xerostomia. Potentially increases the production of saliva from 1 ml to 2 ml per minute. GI considerations Memory Stress Resting Saliva test: <0.1 ml/min= very low ml/min= low ml/min = normal Stimulated Saliva test: <0.7 ml/min= very low** ml/min= low 1-3 ml/min = normal Saliva Check ( ck_buffer/index.php)

4 Xerostomia and Hyposalivation Xerostomia describes the feeling of oral dryness. Hyposalivation is the physical reduction in saliva output. Questions to ask patients Do you have any difficulty swallowing? Does your mouth feel dry when eating a meal? Do you sip liquids to aid in swallowing dry food? Does the amount of saliva seem to be too little, too much, or do you not notice? Things to avoid for xerostomia: Smoking Alcohol-based mouthwashes Dry or salty food Chewable vitamin C Caffeine, alcohol, citrus & carbonated beverages Sodium Lauryl Sulfate (SLS) Updated overview of most mouthwashes on the market DH/Magazine/2015/04_april/Focus_on_Mouthrinses_0415.pdf Oral Irrigation: WaterPik New SideKick ( Phillips air floss irfloss.aspx

5 Reason for mouthguards? Snoring Heavy mouth breathing Grinding/Bruxism Athletic protection TMJ issues Snoring issues.. Snoring can affect almost anyone. Habitual snoring has been found in an estimated 24 percent of adult women and 40 percent of adult men. Both men and women are more likely to snore as they age. Men become less likely to snore after the age of 70. Alcohol, drugs, muscle relaxers and tobacco products contribute to snoring for both men and women. Obese or overweight people tend to snore because there is more fat tissue in the back of their throats. Snoring appears to run in families Denture care: Dr. B s crystals ( Remember all the things you can do with your denture cleaners at home. Home care: Remember Protection vs Prevention. Discuss options. Armor Dental Preventive Tools-Mouth Mates (

6 Disclosing options: Tri-Plaque Disclosing gel ( Plaque_ID/index.php) Plac-O-Test ( -o-tect) PlaqueHD ( Interproximal aides Curaprox ( TePe ( GumChucks ( Cocofloss ( Dry Mouth Products 2017 Moisturizing Gel for Dry Mouth Available on-line or OTC GC Dry Mouth Gels-available in many flavors for those that cannot tolerate minty flavors ( Dry_Mouth_Gel/) AO ProVantage Gel PerioSciences ( Dry Mouth AO ProGel (optimized for dry mouth) PerioSciences Gelclair Bioadherent Oral rinse gel Stellalife Gel ( Medactive Oral Relief Gel ( Spry Dry mouth Gel ( Biotene Oral Balance ( OraCoat XyliGel

7 Sunstar GUM Canker- X( 1772ra.html) CTx4 Gel ( Moisturizing Sprays for Dry Mouth Spry Moisturizing mouth Spray by xlear ( CTx2 Spray ( Oral Balance ( Biotene Dry Mouth Moisturizing spray ( Artificial Saliva (does not stimulate salivary gland production) (Carboxymethylcellulose or hydroxymethylcellulose) Entertainer's Secret (KLI Corp) spray Glandosane (Kenwood/Bradley) Spray Moi-Stir (Kingswood Labs) spray, swabs Saliva Substitute (Roxane Labs) Liquid Salivart (Gevauer) preservative-free aerosol Salix (Scandinavian Natural health and beauty) Tablets V.A Oralube (Oral Dis.Res. Lab) sodium-free; liquid (not available in US) Xero-Lube Artificial Saliva (Scherer) sodium-free; spray Mucopolysaccharide Solutions: spray MouthKote (Parnell) spray

8 Salivary Gland Stimulants: Sialogogues (OTC) Natrol Dry Mouth Relief (Natrol and Amarillo Biosciences) lozenges Salese (Nuvora.com) Lozenges Xylimelts (orahealth) time release oral disc OraMoist Quantum Health Act Dry mouth Lozenges ( J & J) Prescription Salivary Gland Stimulants NeutraSal-Supersaturated Calcium Phosphate Rinse (OraPharma) SalivaMAX -Supersaturated Calcium Phosphate Rinse (Forward Science) Pilocarpine: Stimulates residual salivary glands, solution, gel or tablet form (Salagen) Cevimeline: Increases exocrine gland secretions, tablets (Evoxac) Anathole trithione: Simulates exocrine gland secretions (Sialor) Salivary Enzyme Replacement Lactoperoxidase, and Lysozyme, sodium laurel sulfate free. Toothpaste, mouthwash, gum Oralbalance (GSK) gel CankerX (Sunstar Butler) gel Lozenges and Discs (listed above in stimulants too) Oramoist dry mouth treatment patch (Quantum Health) Salese dry mouth lozenges (Nuvora) Xylimelts moisturizer and salivary stimulant

9 (OraHealth) MedActive Lozenges for Dry Mouth ( Smart Mouth Dry Mouth Mint Act Dry Mouth Lozenges ( XyliPOPS-Hager MighTeaFlow Lozenges ( Wound Dressing OraSoothe liquid oral gel (oral hydrogel wound rinse) Sockit (oral hydrogel wound dressing) Decay (Cavity) Prevention Rx. Prevident 5000 (Colgate) Prescription level fluoride toothpastes, 1.1% Sodium Fluoride available in 4 options: Sensitive, Dry Mouth (only one without SLS s) Enamel Protect, Booster. ClinPro5000 (3-M ESPE) Prescription level Fluoride, 1.1% Sodium Fluoride Dentifrice (with Tri-Calcium Phosphate) MI Paste ( Professionally dispensed amorphous calcium phosphate paste, followup self application in custom trays FluoriMax 5000 (Elevate Oral Care) contains 10% xylitol, 2.5 Sodium Fluoride OTC 1% Stannous Fluoride Rinse- (MedActive) Stannous

10 Fluoride, Ultramulsion & Spilanthol OTC (on-line or in dental office) Enamelon Gel ( OTC gel with Stannous Fluoride, ACP, Ultramulsion & Spilanthol Antibacterial MouthRinses/MouthWashes Rx. Peroex -Chlorhexidine Gluconate Oral Rinse ( The only alcohol free chlorhexidine rinse on the market. PerioGard (Colgate)( ts/colgate-periogard-rinse-rx-only/overview) Peridex (3-M ESPE) OTC Crest Pro-Health Multi-Protection (P & G) ( Colgate Total Advanced Pro-Shield (Colgate) ( Closys ( with and without Fluoride and with and without flavoring Biotene Dry Mouth oral rinse ( Biotene Moisturizing Oral Rinse ( Oral 7 Moisturizing Oral Rinse ( Hydris Hydrating mouth rinse ( Act Dry mouth Mouthwash (

11 MighTeaFlow Moisturizing Oral Rinse ( On-Line or thru dentist PerioSciences Hydrating AO ProRinse ( Stellalife Vega Oral Rinse ( CTx4 Treatment Rinse ( PlaqueHD Rinse for Severe Dry mouth (PlaqueHD.com) Gums and Candies On-line or in some retail stores Spry-(xlear) 100% xylitol gums and candies ( MedActive Lozenges for Dry Mouth ( Xylichew!00% xylitol gum ( Ice Chips 100% xylitol candies ( PUR Gum 100% xylitol gum ( Zellies 100% xylitol gums and candies ( Epic 100% xylitol gum ( gum) Dr. Johns sweets 100% xylitol candy, chocolates, gum and candy s ( MighTeaFlow Gum ( CTx2 xylitol gum (

12 Thru dental office Hager Pharma xylitol dry mouth drops ( emart_category_id/6) xylipops- Hager Miradent xylitol gums and candies 100% xylitol (Hager Worldwide) LoLoZ- licorice extract ( or Used for caries control Natural Mouth Rinses Toms of Maine ( The Natural Dentist ( Spry Alcohol Free Mouthwash ( Considerations for any product Flavorings can sometimes burn Alcohol can sometimes burn SLS s should be avoided during some phases of treatment It can be trial and error-sometimes they work and sometimes they don t Products and companies come and go. Check their web sites for further information.