Xerostomia (Dry Mouth)

By Jerry A. Laws, DDS

Published on July 21, 2006

Does your mouth feel dry at mealtime? Do you have trouble eating dry foods? Is swallowing difficult? Do you need to moisten your mouth often or sip liquids often? If you answered yes to any of these questions, you may be one of the many people who suffer from xerostomia, also known as dry mouth.

Dry mouth, which results from thickened or reduced saliva flow, can be caused by a number of factors:

• Medications, both prescription and over-the-counter
• Systemic diseases such as anemia or diabetes
• Manifestations of Sjogren's syndrome, such as rheumatoid arthritis, lupus, chronic hardening and thickening of the skin, or chronic and progressive inflammation of skeletal muscles; infections of the salivary glands
• Blockage of the salivary ducts caused by stones or tumors forming in the ducts through which the saliva passes
• Dehydration
• Medical therapies, such as local surgery or radiation; saliva secretion reduction (a normal part of the aging process)
• Emotional stress

Dry mouth may also be caused or poor air quality, dry air, breathing through the mouth and cigarette smoking.

The Importance of Saliva

Technically speaking, saliva is a clear, usually alkaline, somewhat viscid secretion from the parotid, submaxillary, sublingual and smaller mucous glands of the mouth. Saliva consists primarily of water, but also contains enzymes and other proteins, small organic molecules, electrolytes and constituents of non-salivary origin.

Saliva has important functions. Everyone needs saliva to:

• Wash away food debris and plaque from the teeth to help prevent decay.
• Limit the growth of bacteria that cause tooth decay and other mouth infections.
• Bathe the teeth and supply minerals that allow remineralization of early cavities.
• Lubricate foods so they may be swallowed more easily.
• Provide enzymes that aid in digestion.
• Help us enjoy food by aiding in the “tasting” process.
• Moisten the skin inside the mouth to make chewing and speaking easier.

Signs, symptoms and Treatment of Dry Mouth

Signs and symptoms of xerostomia include complaints of dry mouth, fissures or sores at lip corners, halitosis (bad breath), difficulty with speech and swallowing and the constant need for fluids. Chewing some types of food is also difficult. People with xerostomia often describe a “burning” or “tingling” of the tongue. Changes in taste are also common. In addition, the tissue in the mouth can crack and may bleed easily. Finally, because bacteria in the mouth often proliferate with xerostomia, frequent fungal infections may occur.

The treatment of dry mouth essentially amounts to managing the condition that causes it. If dry mouth is caused by blockage of the salivary ducts, the cause of the blockage should be investigated. If dry mouth is caused by medication, the medication should be changed, if possible. When systemic diseases such as diabetes and anemia are the root cause of the condition, problems often decrease as these conditions are brought under control.

Those suffering from xerostomia should keep consumption of caffeinated beverages, alcoholic beverages, and mouthwashes containing alcohol to a minimum. Drinking water and fruit juices, on the other hand, will decrease dry mouth problems. Chewing gum and lemon drops can also be used to stimulate saliva flow, as can bitters, so long as the salivary glands and ducts are functional. Commercial saliva substitutes, which can be obtained without prescription, are available as well and can be used as frequently as needed. Using a humidifier in the bedroom can reduce nighttime oral dryness.

Anyone concerned about dry mouth should always make sure to ask his or her health care provider if medications being prescribed will cause dry mouth. Patients with persistent xerostomia need to practice good oral hygiene and visit a dentist on a regular basis, as the lack of adequate saliva can cause severe dental decay. Also, since the salivary glands are very sensitive to radiation, any patient scheduled for radiation therapy of the head and neck needs to discuss with the radiation therapist ways to minimize exposure of the salivary glands to radiation.

For more information on the author, please visit www.cosmeticdentistrync.com