Additional information on oral problems
The oral cavity and the importance of saliva
The role of saliva is critical to oral health. Saliva cleans and protects the mouth. An adequate volume of saliva is a critical component of oral health. Saliva helps to keep the lining of the mouth healthy and prevents the loss of minerals from the teeth (tooth erosion).
The medical/dental importance of saliva includes lubricating and moistening food for swallowing, initiating digestion, preventing dental caries, maintaining the health of the oral mucosa and preventing infection by keeping the oral micro flora in balance. After food is eaten the flow of saliva washes away bacteria that can cause tooth decay (cavities) and other disorders. Saliva also acts as a buffering agent during the continuous acid production in the oral cavity.
Lack of saliva (dry mouth = xerostomiasis) is therefore a cause of severe bacterial unbalances and complaints. When insufficient saliva is produced, the mouth becomes dry, sticky and uncomfortable. In these circumstances problems in the mouth may develop.
Diabetes and dry mouth
One of the most common oral health problems for people with diabetes is a dry mouth (xerostomia). It is strongly associated with objective measurements of poor salivary flow and with other oral and extra oral symptoms of desiccation.
The most common causes someone with diabetes suffers from a dry mouth are side effects of medication, Neuropathy (autonomic), lack of hydration, kidney dialysis, hyperglycemia, mouth breathing and smoking. However in most cases dry mouth is caused by side effects of medication. There are over 500 prescription and nonprescription medications that have been found to cause dry mouth. Medications that treat high blood pressure or other heart problems are used by many people to manage complications of diabetes. Other drug groups that cause dry mouth are those used for depression, anxiety and allergies, as well as diuretics, anti-psychotics, muscle relaxants, sedatives and anti-inflammatory medications. Caffeinated beverages also cause dry mouth, and these should therefore be limited.
Typical symptoms of a dry mouth are: loss of moisture, glistening of the oral mucosa, a burning or tingling sensation in the mouth and especially on the tongue, a dry, red, raw tongue, problems with speaking, difficulty tasting, chewing and swallowing, dryness of the oral membranes, irritated corners of the mouth (cheilitis), gingivitis, difficulty wearing dentures, mucositis and mouth sores.
Dry mouth and oral flora
The oral cavity is a complex ecosystem with highly diverse microbiota, the “oral flora”, consisting of more than 600 species. Just 1 ml of saliva contains a hundred million bacteria, beneficial ones, but also harmful ones. A healthy oral flora means that the useful microorganisms are more abundant than the harmful bacteria (pathogens). When the harmful bacteria disrupt this balance by outnumbering the beneficial ones, various problems will occur that will often be noticed in complaints. A healthy oral flora is the key to the prevention of oral problems such as plaque, caries and halitosis (bad breath), but also for a healthy condition of the tissue.
A dry mouth is one of the major problems that can lead to several oral diseases such as dental caries, periodontitis and oral infection. The high value of glucose in the oral tissues stimulates growth of bacteria, which frequently results in plaque formation and gum irritation. xerostomia and hyposalivation are associated with higher numbers of oral pathogens in the saliva; significantly higher numbers of mutans streptococci, Lactobacillus spp., and Candida spp. are present in the saliva of people with diabetes who suffer from a dry mouth, compared to those without. As a result dental cavities are increased prevalence and located in sites generally not susceptible to decay, bad breath (halitosis) and excessive build up of plaque are frequently seen in diabetes.
Dry mouth and oral flora
Oral care undoubtedly begins with oral hygiene. Frequent brushing and flossing of the teeth helps to remove bacteria and fermentable substances. Disinfectants and antibiotics are non-selective and kill all types of microorganisms, good and bad. This creates the opportunity for bacterial overgrowth in the vacuum that is left behind. These treatments, although efficacious in combating complaints are often detrimental to a healthy oral flora and do not guarantee a long lasting solution. Unfortunately the control of infections with medication also often leads to more gum problems. The 2QR-complex directly neutralizes harmful bacteria and does not affect the beneficial ones. Therefore it restores a healthy, natural flora.