Expert: Howard Finnk, D.D.S., P.A., CEO - 6/15/2004

Question
Hi, a little bit of background... I am a 27 yr. old female, I drink once a week and ex-smoker. I currently take a multi-vitamin, Vitamin B Complex with Vitamin C, Garlic tablet, Calicum with Vitamin D, some kind of Anit-Oxidant tablet (forgot name),Aciphex for Reflux, and Zrytec D for allegries and sinus problems. Have been taking Zrytec D almost daily for 3 yrs. Use to take anti-depressants but I took myself off of them due to dry mouth. I wear a splint at night for TMJ. I have a high level of anxiety and a huge fever of cancer, since I saw my grandmother die of ovarian cancer a few years ago. That seems to be when my anxiety started and dry mouth to where I noticed it. Sometimes I think I'm turning into a Hypocondriac. Last time that I had really bad dry mouth was last summer(was also on antidepressants then) - felt like my tongue was burning, it eventually went away. I also have really thick nasal secretions that are dripping down the back of my throat right now. Read that you shouldn't take Fluonase when taking Anti-Fungual medicine so I haven't used my nasal spray for a while. About two months ago I noticed that I was starting to get really bad dry mouth and my tongue and roof of mouth felt like it was hot and sometimes had a burning feeling to it. So about three weeks ago I was getting those white/yellow smelly tonsil things a lot and read on the internet that you should brush your cheeks and roof of your mouth. Well I did that and that seemed to irritate the roof of my mouth and a few days later I remember eating and drinking some things that were hot. Then I noticed a red patch in the roof of my mouth and I went to my dentist and he thought that it was an acidic burn, so I went back the next week and he said that it looked much better. The color would vary, for ex. I would wake up in the morning and it was almost its normal pink color but throughout the day it would gradually get red and sometimes it would feel thick and then it would feel normal. So the following week I went back (after having had another panic attack) and it seemed that I had a mild form of oral thrush (a few white spots that would wipe off) and that it looked much better than the previous two times. I just recently completed treatment for Oral Thrush with Nystatin oral rinse that was prescribed by my dentist along with eating like 3 to 4 yogurts a day along with taking 1 to 2 Acidilphois tablets (misspelled - that stuff that is in yogurt). Just went back to my dentist this past Saturday and he said everything looked normal and felt normal. He felt the roof of my mouth a few times with his fingers, felt my glands, lymph nodes, looked at my tongue even pulled it out to look at both sides, I guess he looked at everything. I'm just getting so frustrated with having dry mouth because I feel like its causing me to have cavities because I use to never have them, sometimes my teeth are very sensitive to hot and cold  and I'm tired of that burning feeling. But I had a few questions...

1. Can dry mouth can make your mouth feel like its on fire and sore and tender in some spots. For example, every now and then my tongue will feel sore then it will go away. Also the burning feeling goes away when I drink or eat. The burning feeling ususally starts on tip of tongue then just gets worse throughout the day and sometimes it feels like the roof of my mouth is burning. It doesn't feel burny everyday just some days.
2. Can dry mouth take your mouth sometimes feel inflammed?
3. Is it possible for dry mouth to make the roof of my mouth feel thick in some parts. As I had said earlier, the thick feeling seems to come and go. It seems like sometimes it will feel thick after I eat then it will go away but I haven't been eating soft foods like I should be.  Also, when I use my finger to feel the roof of my mouth I don't feel anything that seems weird or swollen or thick and it looks normal when I use one of those dental mirror to look at it. Plus my dentist was just feeling the roof of my mouth and everything felt fine he said.  I kinda feel like maybe its all in my head, like I'm just imaging it.
4. SHould I try to come off my medicine? If so, how long can it take to get out of your system.
5. I use fluoride toothpaste - Crest and Act mouthwash. Can ACT mouthwash dry out your mouth? I use the Bubble Gum Flavor - was using the Mint flavor. I have tried Listerine but that burns. I brush twice a day and floss once a day. I suck on sugarless candy all day (just about sick of that) and drink water all day. I don't eat soft bland food like I should. Is there anything else that I can do?  SHould I try using just baking soda as toothpaste for a few weeks?
6. Should I be worried? Do I need to have a biposy done?  Does this sound like oral cancer?  If it was oral cancer, would the thick feeling come and go.  Or could it all just be in my head -I feel very confused at the moment. I don't want the dentist and/or doctor to think that I'm annoying because I do tend to over react when I feel anxious and panic which I know doesn't help my dry mouth and I seem to dwell on it...I just went to my Ear, Nose and Throat doctor last week and he said nothing looked suspicious and that everything looked good.

Sorry for such a long question, I'm just frustrated with it. Thank you for your time.

Answer
Dear Tara:  The answers:
1. Yes
2. Yes
3. Yes

4. Yes.  You should discontinue all your medicines.  You should first contact your doctor(s) who recommended or prescribed your medicines and tell them you would like to discontinue, and get their instructions for discontinuation.
Then devise a plan to re-start taking the most important one first, for one week.  Then the next-most important, and so on, until you begin to experience the dryness again.  Report that medicine to your doctor, and get his/her instructions on what to do next.

5. I have not heard that ACT dries the mouth.  The sucking candy, even though sugarless, may contribute to your tooth decay. Stay away from spicy foods.  Baking soda is known to contribute to dry mouth.

6. You already are worried.  Maybe too much.  This does not sound like oral cancer.  It rather sounds more like dry mouth from too many medications, or a combination of a few of them, or just one medication that dries your mouth.  You might want to seek counselling to help you deal with your inordinate fear of cancer.  You admit that you overreact.  That, plus all your meds, likely causes your dry mouth.  Some talk therapy might help a great deal.  Good luck.  dd