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Do you have trouble swallowing certain foods? Are you constantly thirsty? Is your saliva thick or foamy? Do you have bad breath?

If you answered yes to any of these questions, you may have xerostomia. It’s a fairly common problem, and it could lead to serious health issues down the road if it’s not addressed by a dentist soon.

One of every four people has xerostomia, also known as dry mouth. It’s caused by decreased saliva production, which can happen as you age or as the result of an underlying health condition. The lack of saliva can hamper your quality of life in a variety of ways, and it also may cause damage to your teeth.

“In the absence of saliva, you’re going to be at higher risk of dental decay,” said Patricia Robinson, team-leader dental hygienist at Gentle Dental Associates in Ann Arbor. “I see this occurring quite a bit with my patients.”

Saliva is the mouth’s first defense against cavities, rinsing teeth of the bits of food that can lead to the growth of bacteria. But for many people, saliva production declines as they get older. And that can lead to xerostomia, or dry mouth.

Dry mouth often is uncomfortable, making it difficult to eat and digest certain foods. It can make it hard to taste and enjoy meals, and it can give you bad breath. In extreme cases it can even cause painful cracks and sores in the mouth and leave your tongue, lips and other tender tissues parched.

More significantly, dry mouth increases your risk of chronic and pervasive tooth decay because there’s not enough saliva to flush icky bacteria from your mouth.

So, what can you do about it?

“Bring your concerns to your dentist or your dental hygienist,” Robinson said. “We’ll look at the symptoms and signs and make some suggestions.”

RELATED: How do I avoid bad breath?

For example, here are 10 things you can do to counteract dry mouth:

• brush and floss your teeth every day to reduce bacteria buildup on your teeth
• chew sugarless gum to stimulate your salivary ducts and increase saliva production
• drink plenty of water to keep your body hydrated
• use fluoride toothpaste to reduce risk of cavities
• avoid dry foods such as bread, crackers and dry, salty snacks
• limit caffeine and alcohol – even mouthwash with alcohol – because they reduce saliva production
• breathe through your nose instead of your mouth
• use lip moisturizers to relive drying and cracking
• sleep with a humidifier in your room to keep the air from getting dry
• visit the dentist regularly for exams

RELATED: I drink a lot of coffee. Could it be hurting my smile?

Saliva production tends to decline in people after age 65, so dry mouth is more common in older people. Dry mouth also can be a side effect of medications or cancer treatment and can be a byproduct of smoking.

In addition to constant thirst, bad breath, foamy saliva and difficulty swallowing, other common symptoms of dry mouth include an irritated tongue, burning mouth, dry lips and nasal passages, sore throat, hoarseness and cavities.

Your dentist will look for symptoms of dry mouth and can prescribe medicine or other products to ease the inconvenience and prevent tooth decay. If you are dealing with dry mouth, call 734-975-0100 to schedule an appointment that will improve your quality of life and prevent painful dental problems before it’s too late.

About one of every six people say they floss their teeth at least once a day, according to a recent survey conducted in partnership with the American Dental Association (ADA). But that doesn’t mean they’re using dental floss for the job.

More than 60 percent of Americans say they sometimes use their fingernails to get food and gunk out of their teeth. And that’s not the only unsafe and unsanitary tool people admit to using.

Here are 10 more things people use to floss their teeth, according to ADA surveys:

• folder paper or cards
• cutlery
• safety pins
• strands of hair
• twigs
• toenails
• matchbooks
• loose electrical wires
• screwdrivers
• pocket knives

The list makes you wonder if the 8 percent of Americans who never floss with anything are better off! However, lack of flossing is a key contributor to gum and bone disease, or periodontitis, which affects nearly one of every two adults age 30 and up, according to the U.S. Centers for Disease Control.

Not only is gum disease bad for your mouth, but it also is linked to other serious health problems like cancer and heart disease. Yet, many people with periodontitis don’t even know they have it.

“Because the nerve endings in the gum and bone tissue around the teeth are not particularly sensitive, there normally is no pain when those sites present with infection. The problem is thus ignored,” said Dr. Debby Hwang, a periodontist with Gentle Dental Associates in Ann Arbor.

Every adult should have a periodontal exam once a year, and it is even better when that exam is done by a gum specialist known as a periodontist. At Gentle Dental Associates, periodontist Debby Hwang examines each adult patient once a year at no additional cost.

What is gum disease?

Bacteria naturally builds up in your mouth over the course of a day. If not removed, the bacteria cause plaque and, over time, tartar along and under your gum line. Eventually, that plaque and tartar can cause inflammation of your gums. That’s called gingivitis, an early stage of gum disease.

Symptoms of gingivitis include bad breath, caused by bacteria and bits of decaying food stuck in your teeth, and gums that are red, swollen or bleeding. The good news is that gingivitis can be reversed with attention from a dentist or a periodontal specialist.

But it also can progress into periodontitis, which is an advanced stage of gum disease when the damaged tissue pulls away from the teeth and creates gaps or pockets for even more bacteria. Those pockets can cause permanent damage to the bones in your jaw, loosening teeth and even causing them to fall out.

How gum disease leads to bigger problems

In addition to causing jaw bone and tooth damage, people with gum disease have a higher risk of other serious diseases. The bacteria that cause periodontitis can travel through the bloodstream to other parts of the body, or the body may work so hard to fight periodontitis that other organs are exposed to threats.

There’s evidence connecting periodontal inflammation to heart attack, stroke, pre-term/low-birthweight infants, chronic obstructive pulmonary disease, pneumonia, osteoporosis and cancers of the lung, skin, breast, kidney, pancreas and blood.

“Basically, no part of the body is isolated somehow from other parts,” Hwang said. “If there is a problem in one location, then there is potential for a problem in another spot.”

What you can do to prevent periodontitis

Nearly half of Americans have some level of gum disease, and it afflicts more than two-thirds of adults age 65 and older. It’s so prevalent because people often are lax in their daily oral hygiene or they may neglect a regular semi-annual visit to the dentist.

Many people just aren’t aware of periodontitis and how damaging it can be. But you should know that it is preventable. The best way to prevent gum and bone disease is by daily brushing and flossing, along with regular dental checkups.

Brushing and flossing gets rid of bacteria before it can build up, and your dentist can remove plaque in hard to reach places that regular brushing and flossing miss. Still, the vast majority of people do not floss regularly. For example, surveys find that 20 percent of adults say they only floss when something is stuck in their teeth, and nearly half admit they lie to their dentist about how often they floss.

For many people, daily flossing just takes too much time, hurts too much or is too gross. Unfortunately, the alternative could end up being much worse.

“Using only a toothbrush is like washing only half your body when showering,” Hwang said. “It’s best to do a complete cleanse.”

In addition to daily brushing and flossing (with floss, not toothpicks or fingernails), every adult should have a periodontal exam once a year by a gum specialist known as a periodontist. Call to schedule your gum health evaluation.

Just because you may have great-looking, healthy teeth does not necessarily mean that your gums and jaw bones are healthy, since the microorganisms that cause cavities are different than the bacteria that cause gingivitis and periodontitis.

As a child growing up in Taiwan, Angela Chao didn’t like to brush her teeth. Oral hygiene in her community was not a big priority, and her parents “had more challenges to face than my stubborn hatred for the spicy mint of toothpaste.”

The result, of course, is that Chao developed many cavities as a middle schooler. A fear of doctors made her hesitant to visit the dentist, though she eventually did get fillings. But several years later, after moving to the United States, those fillings failed and her teeth began breaking apart.

Still wary of the dentist, “it wasn’t until the pain stopped me from eating and smiling and caused me to avoid social interaction that I decided to do something,” she said.

Chao went to Gentle Dental Associates in Ann Arbor for a consultation and was advised to get a dental implant. Skeptical at first, she did her own research on implants and other options for replacing missing teeth, then talked with other people who had gotten implants.

She decided to go through with the procedure.

“I told myself that if I don't do it now, then when?” said Chao, now in her 50s. “Getting an implant was an easy choice for me over other options.”

Chao is like 170 million other adults in America who are missing teeth. Half of adults age 20-64 are missing at least one permanent tooth, according to the latest national survey data from the National Health and Nutrition Examination Survey.

While a majority of people age 20-39 still have a full set of teeth, only one of every three people age 40-64 do. The primary causes of tooth loss include cavities and periodontal disease, which both stem from poor oral hygiene and lack of consistent dental care.

A missing tooth can cause several problems.

“If a tooth is missing, then chewing becomes less efficient and the neighboring teeth alongside the space may be subject to over-function and eventual fracture,” said Dr. Debby Hwang, a periodontist at Gentle Dental Associates. “An absent front tooth also may hinder cosmetics and speech.

“Replacing a tooth can protect the remaining teeth, allow for normal eating and digestion, restore any speaking deficits and contribute to psychological health.”

There are three options for replacing a missing tooth:

• A removable denture is a cost-effective choice, but it needs to be taken out every night and is relatively fragile, so it might not provide full chewing function. Chao preferred to have a permanent replacement instead of something removable.
• A fixed bridge fuses a fake tooth to adjacent teeth and is not removable. The neighboring teeth get crowns that are fused to a fake tooth in the middle. Chao wanted to avoid cutting into her healthy, natural teeth to support a bridge.
• A dental implant involves a titanium anchor that’s placed into the bone where the tooth is missing. The jaw bone grows around the anchor, which is then capped with a crown several months later. It’s like having your own tooth back.

An implant is typically a long-term solution that, unlike the other options, does not rely on neighboring teeth for support and cannot decay, Hwang said. Plus, many people are surprised by the lack of discomfort they experienced during and after the procedure.

A dental implant is the most-costly option to replace a missing tooth, at least initially. But because it doesn’t decay or break it often can be the most cost-effective solution over the long term. If something breaks in a bridge, for example, you have to replace all three teeth. It’s also more likely to get cavities with a bridge because you can’t floss in between those teeth.

Because a dental implant is fixed into the jaw, it can be a “high-value, high-return choice,” Hwang said.

Chao was able to afford dental implants because her family had put aside money to pay for health care costs. If you have a Health Savings Account through your employer, that can be a great way to cover the cost.

Many employers also allow people to put money into a flexible spending account (FSA) for health care, and that “use-it-or-lose-it” money has to be spent by the end of the year or it’s gone. If you have an FSA, that can be a good way to pay for implants before the end of 2018 — or a good place to put money in 2019 to pay for implants next year.

The reward of being able to smile and laugh and eat with ease again has been well worth the cost to Chao.

“I don’t have to worry about my smile anymore,” she said. “Chewing food is becoming easier and my posture and my facial features are slowing coming back in balance since I had my implants done. I am very happy!”

Dreading the dentist ranks right up there with being scared of snakes and afraid of heights as the biggest fears of Americans. Now, a new study finds that fear of the dentist has a clear, negative impact of people’s oral health.

One of every eight people has dental phobia, and they are more likely to have decayed or missing teeth, the study concludes. People scared of the dentist also tend to have more negative feelings like sadness, tiredness and lethargy, lead author Dr. Ellie Heidari said.

“This phobia can have a major impact on a person’s quality of life,” she said. “An action as simple as smiling will be avoided due to embarrassment of their poor teeth.”

While extreme dental anxiety is relatively rare, as many as 80 percent of Americans are at least a little afraid of going to the dentist. Unfortunately, that fear hinders people’s oral health because they put off regular teeth cleanings. Nearly a quarter of people who suffer from some level of dental anxiety do not get regular dental treatment, and upwards of 10 percent avoid going to the dentist entirely.

That’s a problem because “regular dental attendance is central for maintenance of oral health as well as avoiding dental pain,” Heidari said.

So what can be done about dental anxiety? First, let’s look at some of the causes. People worry about going to the dentist for any number of reasons: maybe they had a painful experience in the past, or maybe they’re scared by the sadistic, drill-happy dentist stereotype portrayed in movies. For some people the cost of dental care can give them pause, and for others it might be embarrassment about the health of their teeth.

“Another one is fear of the unknown,” said Dr. Neha Kuthiala, DDS, a dentist at Gentle Dental Associates, an Ann Arbor practice that offers free consultations. “It’s a situation where you’re asked to sit with your mouth open and you can hear things and feel things but you have no idea what is being done to you.

“Dental work is not something people want to have done. It’s just one of those things.”

But whether you want to get dental work or not, going to the dentist is vital for your oral health. And there’s no reason a trip to the dentist can’t be pleasant. In fact, here are three ways to make seeing a dentist a smooth, stress-free experience:

*Get preventative care before it’s too late — It’s better to fill a cavity than to wait and have to remove the tooth later. “The thing with avoiding the dentist or waiting until you have pain is that a lot of times by that point you need something that costs more than preventative care would have,” Kuthiala said. “Coming in for a preventative cleaning tends to save you in the long run.”

*Commit to consistent home care — You may not have to floss every single day (although that’s not a bad idea), but you should do it more than once a month. The better you follow the advice of your dentist and hygienist, the better results you’ll have when you go in for a checkup. “A lot of people are feeling very judged on their oral hygiene and any existing cavities or anything that might be diagnosed at the dental office,” Kuthiala said. “As long as patients are doing their part at home and cleaning to their best of their ability, that’s all they can do.”

*Talk with your dentist about your anxiety — Share what you’re worried about. At the same time, a good dentist will take time to talk with anxious patients before looking into their mouths. “If we know the reason for anxiety, a lot of the time we can work with the patient to alleviate that,” Kuthiala said.

The dentist can have a big impact on your level of anxiety simply by treating patients as people rather than procedures. That can include keeping patients up to speed on the progress of a procedure and talking about what they’re doing each step of the way, or giving patients control by allowing them to stop a procedure any time they feel uncomfortable.

In addition, scheduling patients with the same hygienist and dentist every visit is a proven way to ease anxiety. Also, distractions like office music or a TV in the operating room can take people’s minds off their fear.

Of course, providing nitrous oxide, or laughing gas, can be a good option for some anxious patients, too.

“We’re all aware of how people don’t like to come to the dentist,” Kuthiala said. “We try our best to treat them with a gentle touch.

“There’s much more to that person than just whatever it is that you’re working on (in their mouth). We want to treat patients as the person, not just the tooth.”