The following back and forth took place between Dr. Linden and a woman who was not his patient, but who had posted a question regarding dry mouth following LANAP treatment.
Dear Dr. Linden,
I am 53 years old and have had gum disease since I was a child. My dentist just recently “learned” how to do laser surgery. I believe that I am his third or fourth patient. I had the surgery in Sept. 2013. Since then, I have had problems with my mouth. I have no taste and can’t eat certain foods. My mouth is swollen and I have dry mouth. I have used the Biotene products, but they help just for the moment. My tongue is usually numb. I was told by my dentist that it takes about a year for the process. But I didn’t realize that I would have such a problem with my mouth. Can you help me?
Thank You
Darlene
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Dr. Linden: In order to help you, I first need to ask a few questions. What type of “laser surgery” did you have? Was it with the Periolase and LANAP? Was it with an Erbium, CO2 or YAP laser? You probably don’t know the answers to these questions, but you’re certainly entitled to ask your dentist. Please let me know what he says. Thanks.
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Darlene: Thank you for getting back to me. I contacted my dentist and he said that he used the same procedure that Dr. Linden uses –he knew the name. He said it was Periolase LANAP. He didn’t have an answer for the other question. He also said that he would ask his instructors on the dry mouth issue. He has only done this procedure a few times. I really don’t care ‘how” I got the dry mouth, I just need a solution. Thank you for any help.
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Dear Darlene:
My understanding is that you had full mouth LANAP in Sept 2013. It is quite unusual to have “dry mouth” as a long term side effect of LANAP.
Are you using any kind of mouth rinses currently? Are you taking any medications? Smoker?
Are you a mouth breather?
Are you wearing a night guard appliance?
Has your diet changed? Supplements?
Pregnant? Hormonal issues?
Please advise so I can help you.
Best,
Dr Linden
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Dear Dr. Linden:
I have been using Biotene toothpaste, rinse and soft gels. The medications that I take are Losartan and a few vitamins–my doctor recently told me to take zinc & vitamin E. I am not a smoker or a mouth breather. I was given a night guard, but I am not using it. My diet has not changed, no supplements, not pregnant, no hormonal issues. Thank you Darlene
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Hi Darlene:
Just so you have a perspective here:
I have been performing and teaching this laser procedure for many years. We have never seen dry mouth syndrome as a result of the full mouth protocol.
Keep in mind the bacteria flora in your mouth has changed for the better. (The bad bugs that cause the gum disease have been eliminated). This might have affected the “balance of power” in your mouth. Bottom line: something listed below has kicked in, whether it is your medication or some other underlying issue. I am assuming you do not drink alcohol and you are hydrating and drinking a lot of water. If you drink a lot of coffee this can also have a drying effect. Please also note that you are on Losartan (anti-hypertensive)…a main culprit!
Here are the possibilities:
- Medications: over 400 commonly used drugs can cause the sensation of dry mouth. The main culprits are the antihypertensives and antidepressants
- Cancer treatment: radiation therapy can permanently damage salivary glands if they are in the field of radiation. Chemotherapy can change the composition of saliva, creating the sensation of dry mouth.
- Diseases: Sjogren’s syndrome is an autoimmune disorder whose symptoms include dry mouth and dry eyes.
- Other conditions: bone marrow transplants, endocrine disorders, nutritional deficiencies, anxiety, mental stress, and depression can cause a dry mouth.
- Changes not related to salivary glands include nerve damage (trauma to the head and neck area from surgery or wounds that can damage the nerves that supply sensation to the mouth), and altered perception (conditions such as Alzheimer’s disease or stroke may change the ability to perceive oral sensations).
Have you been tested for Sjogren’s syndrome?
Also…are you aware that Losartan can have the following effects, although not as common: notice dry mouth listed below:
In addition to the adverse events above, potentially important events that occurred in at least two patients/subjects exposed to Losartan or other adverse events that occurred in < 1% of patients in clinical studies are listed below. It cannot be determined whether these events were causally related to Losartan:
- Body as a Whole: facial edema, fever, orthostatic effects, syncope;
- Cardiovascular: angina pectoris, second degree AV block, CVA, hypotension, myocardial infarction, arrhythmias including atrial fibrillation, palpitation, sinus bradycardia, tachycardia, ventricular
- Digestive: anorexia, constipation, dental pain, dry mouth, flatulence, gastritis, vomiting;
- Hematologic: anemia;
- Metabolic: gout;
- Musculoskeletal: arm pain, hip pain, joint swelling, knee pain, musculoskeletal pain, shoulder pain, stiffness, arthralgia, arthritis, fibromyalgia, muscle weakness;
- Nervous System/Psychiatric: anxiety
This is the best that I can think of at this point. Check out all the above and adjust accordingly.
Please let me know of your progress.
Best of luck and I hope you feel better.
Dr Eric Linden
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Dear Dr Linden,
Thank you so much for the information. I will speak to my doctor about the Losartan. Lately I have been drinking a lot of coffee. I was drinking tea then switched to coffee. I will go back to tea. Thank you.
Darlene
