Saliva does far more than keep your mouth comfortable. It buffers acid, washes away food, delivers minerals back into enamel and controls the bacteria that cause decay and gum disease. Remove it and the mouth’s entire defensive system goes with it.
Dry mouth (clinically, xerostomia) is one of the most common and least discussed dental problems among veterans, and it is very often a direct consequence of treatment for an already accepted condition.
Where it comes from
Medication. This is the big one. Reduced saliva is a well-documented side effect of a large number of medications commonly prescribed to veterans, including antidepressants (SSRIs and SNRIs), antipsychotics, benzodiazepines, opioid analgesics, antihistamines, muscle relaxants and antihypertensives. Veterans are frequently on several at once, and the effect compounds.
Mouth breathing. Often secondary to sleep apnoea, nasal injury or chronic sinus problems.
Sustained dehydration. Long periods of heat, physical exertion and limited access to water.
Anxiety and chronic stress. A sustained stress response reduces salivary flow directly.
Alcohol and smoking. Both common coping mechanisms, both drying.
What it does
The damage is fast and it is not subtle:
- Rapid decay, characteristically along the gum line and around the roots, including in people who have never had decay before
- Accelerated tooth wear, because acid is no longer being buffered
- Gum inflammation and periodontal disease
- Cracked lips, a burning tongue, and oral thrush
- Difficulty wearing dentures, which no longer seal properly
- Difficulty eating, tasting and speaking
A veteran with untreated dry mouth can lose more tooth structure in three years than in the preceding thirty.
Why it matters for your claim
This is a chain that DVA’s framework is designed to follow. An accepted mental health condition leads to prescribed medication; that medication causes dry mouth; dry mouth causes decay and accelerated wear.
Each link needs to be documented, and the dental end of that chain is almost never assessed, because the dentist seeing you does not have your DVA history, and the prescriber is not looking in your mouth.
Bringing those two halves together is exactly what our assessment is for.
