Episode #303: Getting the Dryness Out of Dry Mouth, with Dr. John Cranham & Dr. Thomas Eschenroeder

Chronic dry mouth doesn’t just affect the aging population. It can be a result of genetics, various medical conditions, or prescription medications, and can negatively affect a person’s quality of life. So, today, Kirk Behrendt brings in Dr. John Cranham and Dr. Thomas Eschenroeder to introduce Voutia, a new oral hydration device that provides continuous relief for people with chronic dry mouth. You don't have to suffer with xerostomia! Listen to Episode 303 of The Best Practices Show and find out if Voutia is for you!

Main Takeaways:

• Dry mouth is a bigger problem than the dental/medical community is willing to admit.
• It’s not just head and neck cancer that affects saliva — other cancers and medications can too.
• Dry mouth can affect how a person talks, swallows, sleeps, and even what they eat.  
• Voutia is a new oral hydration device that can be used during the day or night.
• Once you start using Voutia, your salivary flow will feel like normal again.

Quotes:

• “I've restored thousands of mouths, and there's just nothing worse than having perfect margins and control over everything, and then something that is totally out of our control starts to rob the person of their saliva, and then they just start getting caries everywhere.” (06:53—07:09)
• “One of the things, to me, that was the most moving was the fact that when you have dry mouth, you basically lose the ability to have a normal feeling mucosa. Your mucosa basically turns like leather. And so, what happens is, once you start using this device . . . your mucosa feels normal again.” (13:23—13:50)
• “The other thing that happens is, people with dry mouth are constantly sipping water. And the problem with that is they feel bloated. And the water goes through their mouth so quickly that they can't really hydrate their mouth with it very well. And because of that, it’s never satisfied. So, by wearing this device, they actually feel like they have normal salivary flow again.” (13:53—14:16)
• “The other thing that makes it so complicated is, as we have this population in our practice that's getting older, particularly if you've done work on them and you're trying to maintain it, the very best-case scenario is that it holds up occlusally and it holds up biologically, and then they go off into the sunset. But when you start having increased medications, that usually means they're not as healthy. So, it’s harder and more dangerous to do procedures on them.” (15:29—16:03)
• “Nothing’s more scary when somebody walks in and you've got to go take a tooth out, or put an implant in, or do something like that on somebody that pulls out their medication list and it rolls across the table. And we’re seeing that more and more. So, anything that I can do in my practice to keep my dentistry lasting for as long as the patient does and minimizing the amount of work that I've got to do so if something does fail and it is a margin or something, maybe we can go in there and clean that margin out and put something in there without having to lose the tooth or take everything off.” (16:05—16:45)
• “[Voutia’s cannula] is almost like a human hair, practically, in terms of how thin it is. So, again, a very elegant way to solve a problem that’s larger than, I think, the dental community really wants to maybe admit.” (18:26—18:44)
• “Everybody’s familiar with lozenges, gums, rinses, artificial saliva, sprays, and whatnot that you can use. But the problem is, these things are limited to the fact that you can use them when you're awake. And you also have to keep in mind the fact that it’s a continuum. Certain people have a little bit of salivary function, certain people have none. And if you stick a piece of gum in somebody’s mouth and they have zero salivary function, it’s just not going to work.” (19:53—20:27)
• “I think people think that the only cancer that affects saliva is head and neck cancer. And there isn't any question that when they get the radiation of the head and neck, it’s bad. It’s not as bad as it once was because of the triangulation type radiation they have now. But there's somebody that I follow on Twitter that is a friend of mine through Hokie Sports, and he’s got colon cancer. Here’s a kid that's 27, 28 years old, that constantly is complaining about the chemotherapy drugs and how it just creates this horrible burning in his oral mucosa, and just miserable when he’s on that.” (21:34—22:18)
• “We have to understand that in this age of complete dentistry, which is Dr. Dawson’s word, but I think for a lot of the people that follow Kirk and ACT, that's what we’re trying to be. We’re trying to treat the whole human being. Well, it’s kind of nice to have some options for patients that are coming in when they have something that's completely unrelated to us that's going on, but then just creates a storm inside their mouth. And I just think that we need to have as many solutions as we possibly can.” (22:40—23:17)
• “The problems are broadly based across many branches of medicine. Oncology and rheumatology are the two big groups. But guess who gets these patients in their office, in their chair, and guess who really knows about it? I will tell you candidly that we’ve done a lot of talking with clinicians in the oncology field. And I'll never forget, one radiation oncologist actually said, ‘We just don't see that many xerostomia problems.’ And I just couldn't believe it when I heard that.” (24:13—24:46)
• “I think a lot of times, the surgeon does whatever cancer treatment. And say the cancer is cured. Their job is done at that point. And the side effect of xerostomia, who’s the patient going to talk to about that? Well, [dentists], because they view us as the person that's responsible for their mouth.” (26:26—26:47)
• “We always tell patients, ‘If you submit a claim and it gets rejected, don't be disheartened. Submit it again and talk to these people.’ Insurance companies are constantly rejecting things the first time. And then, when you pursue this and you press it, usually, they’ll take another look at it.” (29:19—29:39)
• “This device is principally designed and FDA-cleared for simply providing moisture. It makes acrylic prostheses more comfortable and easier to wear, and it also makes people with dry mouth with natural dentition feel more comfortable. Right now, we cannot make any claims that it will decrease the rate of caries in people with xerostomia. However, there are independent research projects going on right now, university-based research projects, to look into this.” (31:27—32:05)
• “[Voutia] simply delivers water to your mouth at the same rate that your salivary glands used to deliver to your mouth before you lost that ability. And there is a tremendous amount of research opportunity for this. And we are so excited to offer this to the world of dentistry and to all the creative minds in dentistry who will come up with research ideas that we feel will be applicable in the future that can be linked with nanotechnology, with sensors that could be cemented on teeth, with Bluetooth technology that can send a signal to your phone when the acidity of your mouth is at a certain rate. The possibilities are endless as the technology grows.” (32:08—32:57)

Snippets:

• Dr. Cranham’s background. (03:35—05:15)
• How he and Dr. Eschenroeder met. (05:28—08:04)
• Dr. Eschenroeder’s background and how Voutia was developed. (08:14—14:16)
• Xerostomia is a big problem for dentists and patients. (15:27—18:44)
• Other solutions on the market. (19:31—21:02)
• What to be aware of when it comes to saliva. (21:32—26:55)
• Affordability, availability, and implementation of Voutia. (27:25—30:14)
• How to find Voutia, and last thoughts. (30:31—33:59)

Reach Out to Dr. Cranham & Dr. Eschenroeder:

Dr. Cranham’s Facebook: https://www.facebook.com/john.c.cranham

Dr. Cranham’s Instagram: @johnccranhamdds

Dr. Eschenroeder’s Facebook: https://www.facebook.com/thomas.eschenroeder

Dr. Eschenroeder’s Instagram: @chopseschenroeder

Voutia’s website: https://voutia.com/  

Dr. John Cranham Bio:

Dr. John C. Cranham is a highly respected and renowned dentist in Chesapeake, VA. At his state-of-the-art office, he delivers unsurpassed general dentistry, cosmetic dentistry, and restorative dentistry, including TMJ THERAPY and DENTAL IMPLANT SERVICES. Dr. Cranham uses his vast experience and expansive knowledge to create healthy, natural-looking smiles.

Dr. Cranham was an honors graduate of the Medical College of Virginia in 1988. He’s an internationally recognized speaker on the esthetic principles of smile design, contemporary occlusal concepts, treatment planning, restoration selection, digital photography, laboratory communication, and happiness and fulfillment in dentistry.

Dr. Cranham founded Cranham Dental Seminars, which provides lectures, mobile programs, and intensive hands-on experiences to dentists around the world. In 2008, Cranham Dental Seminars merged with THE DAWSON ACADEMY, a world-famous continuing education facility based in St. Petersburg, Florida.

As The Dawson Academy’s acting Clinical Director, Dr. Cranham is involved with many of the courses and provides continuing education to dental professionals across the globe. He spends approximately two-thirds of his time in private practice and the other third as an educator. He believes this balance keeps him on the leading edge of both disciplines.

A published author, Dr. Cranham is committed to providing the highest quality patient care, as well as developing sound educational programs that exceed the needs of today’s dental professionals.

He is an active member of numerous professional organizations, including the American Dental Association, American Academy of Cosmetic Dentistry, American Academy of Fixed Prosthodontics, and American Equilibration Society.

Peter E. Dawson, D.D.S., is considered to be one of the most influential clinicians and teachers in the history of dentistry. He is the founder of the “Concepts of Complete Dentistry” series as well as The Dawson Academy.

Dr. Thomas Eschenroeder Bio:

The answer is “Photography, woodworking, yoga, playing music with others, fly-fishing, and just about anything under the heading of outdoor activities.” This would be the correct Jeopardy response to: “What pursuits does Dr. Eschenroeder enjoy?”

When asked how these interests relate to his practice, Dr. E explains: “There are many connections and common denominators found between these pursuits and the practice of oral surgery. Appreciation for esthetics, the need for precision, and the patience required for woodworking are also necessary to achieve favorable outcomes in oral surgery, whether it be dental implant surgery or corrective jaw surgery. Musical disciplines require constant practice and refinement to bring out the best. Appreciation for harmony and cooperation are essential components of these pursuits and for a successful private practice. Photography helps us to see things that we may have otherwise missed. Being aware of our connection with nature in any capacity is so necessary to remain balanced in this world. The best way to appreciate any field of interest is to immerse oneself. When you love what you do, becoming immersed is second nature. Finally, there is something special about sharing what you love. Whether it be through informing clinical staff about the reasoning behind different surgical techniques or sharing ideas with the oral surgery residents in training, I derive a great deal of satisfaction from teaching.”

Born in Missouri, the son of a veterinarian, Dr. E’s love of animals comes naturally. The Eschenroeders have never been without pets and rounding out their family of five includes two cats, Finn and Piper, and a vocal, rambunctious but emotionally sensitive Plott Hound named Ted. Dr. Eschenroeder’s wife, Susan, is a college guidance counselor. She has visited many colleges and universities to get a boots-on-the-ground sense of what each institution is really like. This helps her to make her recommendations to her students with confidence. Dr. E’s three children are Becky, Caitlin, and Alex. All three are pursuing different careers now. Dr. E’s youngest, Alex, just became the first of this next generation of Eschenroeders to get married.