mouth scum

nona

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Oct 1, 2018
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207
Reason
PALS
Diagnosis
02/2015
Country
US
State
NH
For the past few months, my teeth and gums feel scummy, no matter how often I have them brushed. This trickles down my throat and I'm constantly clearing and coughing it up. For awhile I thought it was allergy related and Allegra helped a little bit. My palliative care nurse said it's biofilm from mouth breathing and not eating solid foods. My PCP thought it was thrush and I did a ten-day course of Nystatin that seemed to help but the scum came right back after I stopped.

Is this just typical of progression? I don't have much of what I thought were secretions and not a lot of phlegm outside of this slimy mouth. If this is typical, is there a way of reducing it? I do drink water by mouth all day.
 

KarenNWendyn

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Jul 29, 2017
Messages
2,876
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PALS
Diagnosis
07/2017
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OR
I have noticed the same problem. I think my saliva has become more scant and sticky. I know I’m a mouth breather if I fall asleep lying on my back and I think the BiPAP dries out my secretions. I think the problem has gotten worse since I’ve been on tube feedings, but my tongue is also less mobile and therefore less able to stimulate the salivary glands. THC and CBD oil also dry out the mouth.

I’m not yet sure of the solution. Increasing humidity in the BiPAP just made me sweat more. Biotene products make my mouth more sticky. My dry mouth is so severe that I just started a medication to increase saliva production (Evoxac, or Cevimeline). My mouth feels less dry and sticky when I take it (suggesting my problem is a saliva issue), but this is a double-edged sword because too much saliva leads to drooling and possibly choking.

Nona, you might try NAC or Guaifenesin to thin out your secretions. Beyond that, I’m not sure I have a solution for you.
 

ReginaS

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Nov 20, 2018
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Lost a loved one
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02/2018
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LL
My pALS had the same issue. He thought that the chemical consistency of his saliva had changed, that it cold not longer break down nutrition as it had done before. I used a tongue scraper with regularity. He took Nystatin too. Same experience. When he could no longer swallow thick liquids like protein shakes or thicker soups and we changed to clear liquids it seemed to be 'better'. He did not have a feeding tube.
 
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