Many dental researchers call saliva the miracle fluid of the 21st century. Saliva, which continually bathes the teeth, gums, and tissues inside the mouth, performs many valuable functions. Besides lubricating and protecting the tissues from foreign invaders like bacteria and viruses, saliva helps clean the mouth and maintain a normal pH. What does pH have to do with the inside of the mouth? Plenty. For starters, pH refers to how acidic or alkaline a substance is. For example, vinegar or lemon juice is obviously more acidic than milk or baking soda. If the pH inside the mouth falls below a certain level, the teeth are more susceptible to dental decay and the bacteria that cause dental decay are more active, especially at night. A chronic dry mouth results in increased tooth decay especially if an individual’s diet is less than desirable and full of fermentable, damaging carbohydrates like table sugar. Snacking on ‘bad’ carbohydrates coupled with a chronic dry mouth is a recipe for dental decay and an extensive restorative dental treatment plan. In addition to all of saliva’s wonderful attributes as listed above, saliva helps to remineralize tooth structure that may have been lost because of early dental decay, protects enamel and dentin tooth surface from microbial invasion and overgrowth.
If saliva production is lost completely or if it decreases over time, many changes take place inside the mouth. Oral mucosa dries out and becomes more susceptible to traumatic ulcerations and secondary infections. One such infection that is frequently attributed to chronic dry mouth is candidiasis. Oral candidiasis is a yeast-like infection caused by the fungus called Candida. Believe it or not, a diaper rash is also caused by the Candida yeast-like fungus. Everyone has small amounts of this fungus in the mouth, but in healthy individuals, the immune system prevents the fungus from causing disease. How would you know if you had candidiasis that is associated with dry mouth? One of the most common symptoms associated with fungal-related dry mouth is a bright or deep red (erythematous) dorsal surface of the tongue, and red patches may occasionally be viewed on the hard or soft palate. These patches can also accompanied by a ‘burning’ sensation, soreness, or bleeding in severe cases. Sometimes a fungal infection in the mouth will show up as a cottage cheese-like film that can be scraped off the tongue. This form of candidiasis, referred to as pseudomembranous, can appear as a removable white plaque on almost any mucosal surface.2