suggestions for dental care?

[LilliaT]

Although I still don't have a diagnosis, I've been trying to read as much as possible about how to deal with dry mouth and the potential dental issues they can cause.  I know that dental problems are just the tip of the Sjogren's iceberg -- but for some reason this is the thing I'm most fixated on right now.  (I think it's because the other more serious issues -- the systemic issues, neurological and otherwise -- seem so scary to me, and so I'm focusing on other things.)

I have a close friend in his late 30s who developed severe dry mouth due to cancer treatments, and his teeth just crumbled.  He was a handsome, gregarious person, and he reached the point where he was ashamed to smile or talk because of the state of his teeth.  Last year, he had to raise money to try to pay for full implants (with bone grafts, etc.).  And I have seen so many people (here and elsewhere online) talking about their teeth falling apart.  So I'm really nervous about what the future holds.

I'm using Xylimelts and Biotene gel at night, and xylitol candy during the day.  I have a good pH-balanced fluoride mouthwash and just called my dentist to ask her to prescribe Prevident toothpaste.  I've always been good about flossing and brushing, and my teeth have been in good shape till now -- although I have noticed some gum recession. 

What else should I be doing at this point?  I understand that dental issues are probably inevitable, but I'd really appreciate hearing about what has (or hasn't) worked for others who are more experienced.  I'd also appreciate hearing about what people have done once the issues became more serious -- e.g., do people end up doing some kind of implants? 

Finally, I'm wondering if I should be looking for a different dentist, one with special experience with Sjogren's patients.  I like my dentist very much -- she is young (and thus relatively inexperienced) but is thoughtful, kind, and patient, and seems to take the time to educate herself when new issues arise.  She is also in-network for my insurance.  She has experience treating patients with other kinds of dry mouth (such as from cancer treatments) but very little experience with Sjogren's.  I'm wondering if it would make sense to stay with her and trust that (because of her willingness to do research and educate herself on new issues) she'll develop the necessary knowledge to treat my issues -- or if it's worth finding a different dentist with substantial Sjogren's experience.

Thank you for any suggestions or advice.

[Navigator]

The best thing you can do is have a saliva test to document your dry mouth and get a prescription of Salagen or Evoxac .  Both work to stimulate saliva. Your natural saliva is the best defense. Dentists can not prescribe. I would ask her if she can do the test or and give you a note for your doctor.   Many dentists have experience with dry mouth because there are other reasons people end up with that diagnosis, age, medications etc. So I would not necessarily get rid of your dentist if you like her.

You also need request cleanings. I go every 4 months. You are lucky to have dental insurance because it is going to get costly.

[cccourt1942]

Lillia,
      When I was dxed was sent to a SjS specialist dentist.  My teeth had discolored but in great shape.  He stated the bacteria in the dry mouth is what does the damage AND the discoloration.  Of course he warned against veneers or implants.  In fact, he stated his goal for me was to die with my SAME teeth.  I was 71 at the time....and at 74...no probs so far. (My teeth look awful, but they are "good".)
       I have moved away from that initial dentist (who has left his practice to teach full time at UT dental school in Houston with emphases on SjS).  My current dentist is not as knowledgeable but stated she had a few SjS patients and would study the subject  more.  She has and I am pleased.  I told her what dentist #1 said about dying with my teeth---and she said she'd make it her goal too. 
      Since you asked a question in your heading, I will tell you something the dental hygienist told me last check up:  She told me to "rock" my dental floss better along my gum line, upper part of teeth, as "the plaque you have there is more indicative of plaque associated with dry mouth."  Imagine my amazement.  I had no idea there were different types of plaque. 
      I have good insurance and am in that chair every 3 months NOW.  Have had same insurance forever...and for some reason used it at times twice yearly..but usually once.  I feel so stupid now for doing that. 
      btw:  both dentists are unable to explain why, since my teeth discolored, they are strong and in great shape.  They say genes.  Of course, my mother's side is the side from which I trace autoimmune diseases.  At this stage of my life, I'll take anything good that happens within my body.
     Happy 4th!!
    Sjoldier c3
     
     

[Catlover]

I have no saliva.  I have been talking to this dentist.  He is trying to help people like us.

http://www.chesterfieldobserver.com/news/2016-06-08/News/Dry_Run.html