Expert: Howard Finnk, D.D.S., P.A., CEO - 7/29/2004

Question
I'm a 27 yr. old female, drink once a week (4-5 beers), ex-smoker, take Aciphex for Reflux, Zrytec-D, multi-vitamin w/ numerous supplements, birth control pills, Xanax on occassion.  I have high levels on anxiety/panic/obessive complusive disorder.  Hugh fear of cancer - grandmother died of Ovarian cancer.  I'm suppose to wear a splint at nite for TMJ but when I do wear it I feel like I have been sucking on it all nite or my tongue feels like its been playing with it, so I have quit wearing it.  I do clench my teeth a lot and I have noticed more popping sounds in my ears when I eat or yawn or drink.  Anyway, it all started about 2 yrs. ago after the death of my grandmother and my wedding.  At first I was freaking out because I didn't realize at the time that I was having dry mouth (so I thought I was dying from oral cancer) but my dentist and ENT couldn't find anything wrong.  It was dry mouth then I developed oral thrush.  After all that cleared up and I was put on Paxil for anxiety the dry mouth returned and I started getting this burning type of sensation on my tongue, especially the tip of my tongue.  I ask my dentist and he said that was common with dry mouth.  Now everytime that I go to the dentist for my usual check up I have at least one cavity - I never use to get cavities.  I have tried to come off of my medication that has side effects of dry mouth but I had to go back on them (Zrytec-D, Aciphex).  The dry mouth seems to come and go, some days are better than others.  A few months ago, I had dry mouth so bad and developed this red patch on the roof of my mouth with a few white patches that you could wipe off - that turned out to be oral thrush, took Nystain and it went away. Lately, I have been having that burning feeling on my tongue again and my tongue looks and feels dry.  I suck on sugarless candy and drink tons of water through out the day.  When I suck on the candy or drink or eat the burning goes away.  I use ACTT mouthwash, Listerine burns if I use it. I also take Acidophilus once a daily and eat one yogurt a day. Can anxiety also contribute to dry mouth?  I do have about 2 cups of caffinated coffee while I'm at work in the mornings (sometimes that seems to trigger the burning feeling).  Sometimes some acidic food will make my tongue feel like its burning.  I also tend to play with my tongue a lot, I think its called tongue thrusting.  I don't know what else to do.  Can you offer any other ideas?  Should I be concerned about this?  I feel so confused and frustrated at the same time.  Thank you for your time.

Answer
Dear Leigh:  All the meds you take, plus the coffee, plus the anxiety... all contribute to dry mouth.  There is no substitute for your own saliva.  So I would suggest that, you under your doctors' guidance, begin to reduce, then eliminate the meds, starting with the least important first.  No more coffee.  Continue with lots of water.  Supplement with a Gatorade-type beverage.  Ease up on salt and salty foods.  Ease up on spices and spicey foods.  All these contribute to the dryness and burning.  
NO Listerine. This is an astringent and dehydrator, as are most mouthwashes.  If all this fails, Biotene has a line of products for dry mouth.  Try one.  And most important....
STOP WORRYING!  It's all going to be fine.   dd