Saturday, February 13, 2010

Acidic Saliva, Dry Mouth & Throat Infections

In a perfect world, I would be able to go to a doctor, the doctor would spend much time with me, do a careful examination, offer useful suggestions, and make an appropriate diagnosis. The doctor would be either able to effectively treat my condition or refer me to a specialist who could. I wish. The current healthcare system offers the exact opposite solution for patients with chronic health ailments, such as myself. Modern health care consists of a hurried environment where the doctor gets paid more to see more patients, the patient's questions or concerns are not valued, and the doctor is trained to think in accordance with the major medical societies and not outside the box (e.g., not see the value or have training in nutrition or supplements, not question the medical journals, which are at the mercy of Big Pharma).

Is it any wonder, then, that it took me 6 years post-surgery and an Internet search (when only 2 or 3 sites mentioned empty nose syndrome) to discover I had a little-known condition called empty nose syndrome? Or that it took 12 years of intense suffering, pressure around my ears, to discover that I had a tempromandibular joint disorder, even after I asked doctors repeatedly to examine my ears? In my case, and I am sure with many patients who may be reading this blog, you have to be your own doctor. Do your homework and don't rely on doctors for good health. You are your best advocate when it comes to your health- no one else is looking out for you.

Now my big question I am presently grappling with is "how do I get to the root of my throat infections?" I get about 6-7 per year, and the infections just linger in my throat until I go on an antibiotic. I would actually say I am free of sinusitis now and am just trying to eradicate infections that linger in my throat - well after a cold is done. There are so many avenues I could pursue to treat infections and build immune health, so my ultimate goal is to get to the root of the problem and attempt surgery (such as a tonsillectomy) only if the preventative treatments fail. Recently, my primary care provider noted I always have a dry mouth and I think he hit the nail on the head. He was not the first doctor to note I had an "extremely dry oral mucosa." A third doctor also noted I had mildly erythmatous throat - mildly inflamed - with thick, sticky mucus, which is the way my throat is all the time. So I think the line of attack is, in my situation, good oral hygiene. These issues are closely linked to increase in cavities, so that should be a second benefit, with (I am hoping) the primary benefit being a decrease in throat infections.

The problem is I have acidic saliva (ph of 5.75-6.25 most of the time), but very alkaline urine. A main function of saliva is to neutralize acids in the mouth after eating. Saliva also eradicates bad bacteria, mold, viruses, and fungi in the mouth, so there is an increased risk of candida and infections among people who have dry mouth. What this suggests to me is that my body has weak digestive enzymes and poor oral health, but excellent ability to excrete acids and assimilate nutrients. Based on what I have read, there can be many causes to acidic saliva, including the possibility of dry mouth as a causative factor. And dry mouth has a number of causes as well. (Of course, my mouth does have more saliva than people with xerostomia - dry mouth, so doctors are reluctant to put me on saliva stimulating medication, such as pilocarpine, but maybe that's just as well because most medications have side effects). Did you know I am on NO medications? That's right, I just take some supplements as of this writing.

So here are some thoughts on causes of acidic saliva:

1. Dry mouth. Sjogren's syndrome, which includes a dry mouth and dry eyes, can lead to acidic saliva. Insufficient saliva is produced, so the mouth is unable to dilute acids. This may apply to me on some mild level, although I have not undergone testing from a rheumatologist (e.g., salivary gland biopsy, salivary flow test, eye test).

2. Radiation. Cancer patients who have often undergone chemotherapy have damaged salivary glands (from the radiation) that leads to acidic saliva. This does not seem to apply to me personally, although I have undergone multiple CT scans of my sinuses in my life.

3. Smoking. Smoking decreases saliva production. This does not apply to me, as I don't smoke.

4. Acidic foods. Spicy, salty, sweet foods - oh, I do admit that I am a big fan of citrus fruits and hot, spicy foods, so this could definitely be a culprit in my case.

5. Sugary foods. Sugar is very difficult to eliminate entirely, but reducing the load - by primarily eating sugar in fruits, called fructose - is one way I have reduced my sugar intake. As you may be aware, sugar immediately paralyzes the immune system. In the mouth, bacteria thrive on sugar and a byproduct of that is acidic saliva. In my own experiences, diet is critical for immune health, with removal of sugar and yeast as the two major culprits to poor immune health. I was reading somewhere that acidic saliva with mercury amalgam fillings can lower the immune system. (I recently had my 7 amalgam fillings replaced with resin composites, while simultaneously undergoing a heavy metal detox - we'll see if that helps!)

As you read above, dry mouth may be one of the causes of acidic saliva. There is a good discussion on why saliva is so important for cleaning the mouth and preventing infections at: I also appreciated Dr. Mercola's discussion of dry mouth at:"

In any case, reasons for dry mouth are similar to reasons for acidic saliva, as follows:

1. Medications. More than 400 medications can cause dry mouth. I personally have been on antihistamines and decongestants long-term in the past (for about one year), which I surmise could be a contributing factor at present, even though I was on these medications about 9 years ago. I am only on supplements, and I suppose it is possible that the binding elements of these supplements cause dry mouth.

2. Stress. I definitely notice a close relationship between stress and my degree of dry mouth.

3. Nerve damage or injury to the salivary glands from surgery.

3. Sjogren's and other medical conditions.

4. Dehydration. Not drinking enough. I drink a lot each day, about 10-12 8-ounce glasses of water per day, so this is not an issue for me. If anything, I am usually thirsty. I also don't talk a lot, so this doesn't cause it either for me.

5. Smoking or chewing tobacco.

6. Mouth breathing. I am sure I do this, given my nasal anatomy, but I doubt this is the main reason I have dry mouth.

To be perfectly frank, this issue of unhealthy saliva, dry mouth, and acidic saliva sort of remind me of the type of battle I face with TMJ. Think about it: both seem to have a neuromuscular component and are related to stress, both can make life uncomfortable, and both can primarily be managed, not cured. I have done a pretty good job of controlling my TMJ symptoms, now it's onto good oral health. Keep in mind I have not had any additional cavities in the past 10 years, so I must be doing something right.

Here are some treatments for dry mouth:

-Using a dry mouth mouthwash & toothpaste, among other dry mouth products (gels, gum, moisturizing sprays, lozenges).
-Prescription medication such as pilocarpine - "salagen."
-Using an over-the-counter artificial saliva substitute.
-Sucking on sugar-free candy.
-Chewing sugar-free gum, with xylitol.
-Sipping water throughout the day.
-Protecting your teeth by brushing regularly.
-Breathing through your nose instead of your mouth to the extent possible.
-Using a room vaporizer or humidifier in the bedroom.

Here is my personal course of action for attacking the issues of acidic saliva and dry mouth:

1. I definitely need to attempt to aggressively treat dry mouth and improve the saliva PH, which I can measure in the comfort of my home. I think the biotene mouthwash & biotene toothpaste are the two best products toward this end. I also hope to try the prescription medication eventually, if a doctor will test me for a dry mouth syndrome and agree to try it with me. Okay, perhaps I should seek medical opinion from a rheumatologist.

2. As I admitted earlier, I am a sucker for spicy, salty and sweet foods, as well as acidic fruits. I need to cut back on these. Hopefully that should help with both the PH of my saliva, as well as my dry mouth.

3. Decrease stress. This is always a challenge for me, but possible. My mouth (and perhaps throat infections would appreciate it!)