What causes excess saliva with dentures?

Because a denture is perceived by the body as a foreign object in the mouth, it is not unusual for first-time denture wearers to develop an excessive flow of saliva, or hyper salivation. This reaction is considered normal, and reduces after a while as your mouth becomes accustomed to the dentures.

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Causes of excess saliva and mucus with dentures

Hyper salivation, also known as Sialorrhoea, occurs when the soft tissues respond to the presence of an artificial object in the mouth by changing the size and shape of Gingiva. Whenever you put something in your mouth, the brain automatically increases saliva production thinking that there is food in the mouth.

So, when you first wear dentures, their presence stimulates the salivary glands, increasing blood flow to the salivary glands. The result is increased flow of saliva. This is a short-term problem for first-time dentures wearers, and will usually resolve without any medication if there are no issues with your dentures.

That said, there are other things that can contribute to excess saliva in denture wearers, including:

Higher VDO (vertical dimension at occlusion) – if the VDO recorded is higher than usual, then there excess pressure will be exerted – when the wearer bites – on the soft edentulous ridge tissue structures, stimulating nerve endings to the salivary glands and causing excess salivation.
Improper registration of the centric jaw relation – when a patient with edentulous is asked to bite in their normal physiological position, he/she may mistake the rest position and make a bite that is a bit forward compared to the normal bite.

Anxiety towards success of dentures – many patients getting full dentures tend to experience fear and anxiety about how the new artificial teeth will change their appearance, and feel nervous about the success of the procedure. The fear and anxiety tends to stimulate salivation.
Excess denture border thickness – is the denture border is in excess of 2mm, it can stimulate excess salivation.
Increased pressure on nerves, gingiva, and buccal mucosa can also cause excess salivation

How to reduce saliva production

Because it is a normal process for first-time denture wearers, it helps to remain calm as you wait for it to subside with time. Find distractions to prevent anxiety, drink plenty of water, and brush your teeth and rinse your mouth with mouthwash to dry it out. Also make sure to seek advice from your denture dentist if you feel like your dentures are ill-fitting.

As you get used to your denture, it’s important to seek professional advice to ensure that your case of hypersalivation is not being caused by an underlying condition. Otherwise, you only need to manage the immediate effects using the tactics mentioned above, and any other therapies or medications that may be recommended by your dentist. For instance:

Behavioral modification and speech therapy – This can benefit people struggling with hypersalivation by improving their posture and head control, as well as learning techniques for tongue control, swallowing, and lip closure.

Medication – Anticholinergic medication is typically used to reduce saliva production, though you may experience an array of side effects including flushing, constipation, irritability, restlessness, drowsiness, and urinary retention.

Can Emotional Denture Stress Cause Excess Saliva?

Emotional Denture Stress (EDS) is more prevalent that dental professionals realize. And even when dentists and other dental professionals notice that their patients are suffering from some form of emotional pain, they do not know how to respond to it.

Emotional Dental Stress is usually characterised by one or more of the following symptoms:

Red and rashy gums
Sore spots on gums that won’t go away
Loss of gum bone

Loose dentures
No effect on soreness even when the dentures are adjusted
Constant gritting and grinding to try to make dentures comfortable

Dentures continue to feel lose after a reline
Gum tissues in your mouth become soft, fatty, flabby, or spongy

Not every symptom is indicative of a patient suffering from EDS, but nearly all patients suffering EDS exhibit multiple of these symptoms. The stress and anxiety may also cause excess salivation.

Causes of Emotional Dental Stress

There are 6 key areas of life that can cause EDS, including health, sex, marriage, employment, self-esteem, and money. Other triggers include an accident, divorce, death, relative, or close friend.

For instance, a very close loved one suffering from a terminal illness can cause the denture wearer to stay excessively emotionally affected. Even dissatisfaction with one’s employment, sexual life, or the financial struggles of a close friend could trigger EDS.

Progression of EDS

The progression of EDS usually happens in a series of stages:

Stage 1: When the stress is triggered by any of the mentioned factors

Stage 2: In a matter of hours or days, the stress causes you to clinch your teeth continuously

Stage 3: The pressure from clinching/grinding exerts excess pressure on the gum tissue, forcing the fluid in the tissues to be forced out into the floor of the mouth

Stage 4: Since there is no gum tissue fluid, the gums shrink, causing the dentures to loosen and press against the hard bone. The pressure results in sore spots and eventually bone shrinkage.

Stage 5: The shrinkage, sore spots, and looseness become too uncomfortable forcing the patient to seek treatment from a dental professional.

If the dental professional is unable to identify the root cause of the problem (what triggered the emotional stress), and address it, the stress cycle begins again. No amount of denture adjusting or relining can adequately solve the EDS problem.

That said, combining corrective dental procedures, like relining, with some form of counselling has been shown to address the problem of emotional denture stress. Usually, the patient has to realize they are suffering from stress, and be able to identify the cause of the emotional pain. Talking to a non-judgemental person or therapist usually solves the emotional trauma, allowing physical treatment to be effective.

References

Ahmadbehbahani, Houman & Demeter, Tamás & Gótai, Laura & Károlyházy, Katalin & Márton, Krisztina. (2014). Effect Of A Denture-Adhesive On Salivation And Orofacial Sicca Symptoms.