Showing posts with label Dr Cindy Marek. Show all posts
Showing posts with label Dr Cindy Marek. Show all posts

Sunday, 29 June 2014

Taking control Part 5 - Dr Cindy Marek: Oral Health

Dr. Cindy Marek is a Dental Pharmacist at the University of Iowa in the Department of Oral Pathology, Radiology and Medicine. Her presentation was titled "Strategies for Oral Health and Comfort in Sjogren's Syndrome"


Dr Marek at the round table discussion

The practical advice she is able to give because of her experience as a clinical pharmacist specializing in dental pharmacotherapy can immediately be put to use. She explained to us how modification of lifestyle, medication administration and careful selection of over-the-counter products may lessen dry mouth symptoms and improve oral health and comfort.

She talked about how easy it is to overuse lip balm. She suggested that if it really worked well it would be impossible to sell as much - this design flaw is deliberate. The best product to use for dry lips is one that contains HPA modified lanolin. One product you can use is Lansinoh. It is sold as a product for use by nursing mothers so can be found at many drug stores as an over the counter purchase. 


Don't hang your lips out to dry

It is also a good idea to protect your lips in cold weather by using a scarf and also to make sure there is enough moisture in the air by using a cool mist humidifier. You need a sunscreen in your lip balm because you need to protect the thin and sensitive outer layer. It's a good idea to stock up in summer since it is a seasonal product.

There are over 500 medications that can affect oral dryness (xerogenic agents). These include antihistamines, antihypertensives, opiods, muscle relaxants and psychotropics such as antidepressants and antipsychotics. For the antihistamines she pointed out that products containing diphenhydramine (like Benedryl) are more drying than those which contain loratidine (like Claritin)

If you need to take a medication that has a drying effect sometimes taking a smaller dose, or perhaps a lower dose more frequently will help. Many healthcare providers are not aware of the incidence of dryness with certain drugs. Pharmacists are good resources for this information but of course you should consult your doctor about changes in medication dosages.

All stimulants are drying - this includes caffeine. Most of us are unaware of the amount of caffeine we consume. If you decide not to drink any more beverages with caffeine go slowly - caffeine withdrawal will occur if you stop suddenly.  Even gradually reducing the amount by 10% a week can help you.

I was surprised to learn that only added caffeine must be listed on labels in the US. If a product naturally contains caffeine the amount is not listed. Look for guarana, yerba mate, chocolate or coffee flavoured foods - they will contain caffeine. Even energy gummy bears have caffeine. 


From Vat19.com

Other things to avoid are alcohol-containing mouth rinses, acidic foods and beverages and toothpaste that contains SLS (sodium lauryl sulfate) which can cause tenderness and ulceration in the mouth.

According to a 2011 Cochrane review there is no strong evidence that any topical therapy is effective for relieving dry mouth. Oxygenated glycerol triester (OGT) spray is more effective than an electrolyte spray. 

In some studies chewing gum was the preferred product of patients. Chewing does stimulate saliva flow: the best gum choice is sugar free and contains xylitol or a xylitol/sorbitol mix. Cinnamon and strong flavours should be avoided

Another suggestion was MI Paste, especially at night, to give a good slick feeling in the mouth. 

Dr Marek also said "The burn is bad." If what you are eating or chewing gives you a burning sensation in your mouth, it's best that you avoid it.

Sunday, 20 April 2014

Sjogren's Syndrome and the National Conference 2014 (Taking Control)

It's spring almost everywhere and time for the National Conference held by the Sjogren's Society of Canada.  "Taking Control" is the name of this year's event.


Spring Crocuses

There is a great deal of evidence that suggests that patient knowledge, skill and confidence with managing chronic disease is a good indicator of better outcomes.


This weekend I saw Sjogren's Syndrome spelled like this: Sourjons, Soujgrens,Sjorgen's and Sojourns, all by different people who suspected this was a diagnosis that they would be adding to their other autoimmune disease(s). You can only imagine how difficult their searches for accurate information are going to be.

The upcoming National Sjogren's Conference should be a great way for both patients and health care professionals to learn more reliable facts. All you need to do is register and come to the Delta Chelsea in Mississauga on May 3. Health care professionals who attend are eligible for continuing education credits.



I am planning to take notes and post what I learn as I have in the past. This conference has a distinctive special feature. For one hour the speakers and other volunteer heath care professionals from Sjogren's related fields will host round table talks where attendees have a chance to ask personally relevant questions.  It's great to have that opportunity and also interesting to hear about the problems others face.

Here's a quick overview of the speakers and their topics.

Dr Arthur Bookman, the co-ordinator of the Multidisciplinary Sjogren's Clinic at Toronto Western Hospital and co-chair of the Sjogren's Canada Medical Advisory Board will start the program with "An Overview of Sjogren's Syndrome."

The talk on "Brain Fog in Sjogren's" by Dr. Sherise Ali, Neuropsychiatrst, is sure to get a good reception. This is a subtle complication that some doctors don't really believe in. The role of medical treatment is limited so for patients any ideas for taking control will be welcome. 

Dr. Cindy Marek's presentation is titled "Strategies For Oral Health and Comfort in Sjogren's Syndrome." For those of us struggling with this symptom new strategies and an understanding of  the causes will be welcome. Her field is dental pharmacotherapy. 

Dr. Rookaya Mather will discuss "Tear Film Dysfunction in Sjogren's Syndrome." She manages patients with complex ocular surface problems.

Dr. Ann Parke is a rheumatologist who studied in the UK and Canada before she settled in the US at the University of Connecticut. She is speaking about "Current Treatment Options and New Therapies On The Horizon." As an active researcher her opinions are always informed and welcome. She is the co-chair of the Sjogren's Canada Medical Advisory Board, as well as serving on the International Sjogren's Syndrome Advisory Committee. 

"Oral Manifestations of Sjogren’s Syndrome". Dr. Mahvash Navazesh, DMD, Dentist will raise awareness about the role of saliva in health and disease and will focus on the common oral complications associated with salivary gland hypo-function in patients with Sjogrens

Dr Raed Alhusayen "Sjogren's Syndrome and the Skin." His areas of interest are autoimmune skin diseases and skin lymphoma.



Dryness of the mucous membranes is a hallmark of Sjogren's Syndrome

This is the 8th Annual Conference.  You can register at the Sjogren's Society of Canada website


Notes for Health Care Professionals:
Physicians will earn 7.25 Continuing Medical Education Credits approved by the Canadian Rheumatology Association (CRA) and the Royal College of Physicians and Surgeons.

The SjÓ§gren's conference this year will allow your healthcare professionals to receive accreditation if they attend. Optometrist, Dentist, Hygienist, and health care professionals can receive CE credits for attending the Saturday Conference.