Managing your oral health with Sjogren’s Syndrome

As a registered Dental Hygienist, I understand it can be very challenging and uncomfortable to live with a dry mouth. The most important factor in keeping your mouth healthy is maintaining a good level of oral hygiene and using the right products. Saliva does not just moisturise the mouth; it also has important protective qualities. It contains proteins and minerals to help protect tooth enamel, prevent tooth decay, and gum disease.

There are many products available, and I encourage my patients to try different products to find something they like. This does involve some trial and error, but here are some tips on managing the oral effects of Sjogren’s Syndrome.

It is very important that people with limited saliva flow keep their sugar intake very low to reduce the risk of tooth decay. Spicy foods, caffeine, carbonated drinks, and alcohol can dry the mouth even further. Acidic fruits and acidic fruit juices should be kept to a minimum because the teeth will be exposed to the acids for much longer without the saliva’s buffering qualities. Smoking should also be avoided.

Without the lubrication of saliva, the soft tissues of the mouth can feel very sore and painful when brushing and can be more susceptible to traumatic ulceration. Therefore, it is important to use a gentle toothbrush twice a day. An electric toothbrush with a sensitive toothbrush head will remove soft plaque deposits effectively with a very gentle action. Some people may find a powered toothbrush uncomfortable, in which case I would recommend a soft manual toothbrush.                                                                                        

The correct toothbrushing technique is important to keep your teeth and gums healthy. Brush the inside, outside, and biting surfaces of the teeth for at least two minutes. Angle the toothbrush so that the filaments reach the gum line.

After toothbrushing, it’s time to clean your tongue, for which you can use your toothbrush or a tongue cleaner. When using a toothbrush, stick out your tongue as far as it will reach and brush lightly forward and backward along your tongue. It is important to clean your tongue as often as you brush your teeth. A tongue scraper can be plastic or metal. The technique again is to stick the tongue out as far as you can, then place the tongue scraper towards the back of the tongue. Press the scraper on your tongue and move it towards the front of your tongue.

It is important to clean between the teeth with floss or interdental brushes at least once a day to remove dental plaque effectively, since your mouth is at a higher risk of dental disease. An interdental brush is designed to clean between your teeth. Plaque and food debris trapped between the teeth can lead to gum disease and tooth decay. Interdental brushes are available in a range of sizes, and it is important to use the right size brush so the cleaning is effective. You will often need more than one brush size for the different spaces in your mouth. Your Dentist or Hygienist can help you select the correct size and show you how to use them.

Generally, Sodium Lauryl Sulphate (SLS) in toothpaste can be very irritating to the oral tissues. There are several toothpastes available that do not contain SLS, but it is important to use one that contains fluoride, which is the extra protection needed for those with Sjogren’s.  TePe’s Pure toothpastes are suitable for people with sensitive gums and a dry mouth. This toothpaste is SLS-free, with no foam for comfortable brushing, as it contains only a few carefully selected ingredients. This toothpaste is available in a mild peppermint flavour or unflavoured.

Mouthwashes can be useful in lubricating the mouth and inhibiting the growth of plaque bacteria in the mouth. It is important to use the correct type. Avoid mouthwashes containing alcohol or witch hazel, as these are astringents and can dry the mouth even further. It is best to use a rinse specifically for a dry mouth.

TePe has recently launched a Hydrating Mouthwash. This gentle and protective mouthwash will moisturise, soothe, and help ease the feeling of dry mouth. This is a gentle and protective fluoride mouthwash; it is available unflavoured or in a mild apple-peppermint flavour. The TePe Hydrating range also has a Hydrating Mouth Gel which offers immediate comfort. The gel creates a thin and protective layer that gives prolonged comfort. The Hydrating Mouth Gel is available in a mild peppermint flavour or unflavoured.

There are ways of moistening the mouth throughout the day, such as sucking ice cubes, taking regular sips of water, and chewing sugar-free gum. Patients with Sjogren’s Syndrome have a higher risk of tooth decay and gum disease with dry mouth, and it is therefore important to have regular dental check-ups with your Dentist and Dental Hygienist.