Oral & Dental Health Basics

Dry mouth

Introduction

It takes two quick licks to seal an envelope. But, if you find that you're often reaching for tape because you don't have saliva to spare, you may have a condition called xerostomia (zeer-o-STO-me-uh) — the medical term for dry mouth.

Lack of saliva is a common problem that may seem little more than a nuisance, but a dry mouth can affect both your enjoyment of food and the health of your teeth. That's why it's important not to ignore a dry mouth.

Although the treatment depends on the cause, dry mouth is often a side effect of medication. Dry mouth may improve with an adjusted dosage or new prescription.

Signs and symptoms

Aside from the sensation of dryness in your mouth, xerostomia may result in:

  • Saliva that seems thick, stringy
  • Sores or split skin at the corners of your mouth
  • Cracked lips
  • Bad breath
  • Difficulty speaking, swallowing
  • Sore throat
  • An altered sense of taste
  • Increased plaque, tooth decay and gum disease

In women, dry mouth may result in lipstick adhering to the teeth.

Causes

On any given day, the average healthy adult produces about 3 pints of saliva. This secretion serves many purposes. Saliva helps prevent tooth decay. It washes away food and plaque from your teeth. Minerals found in saliva help repair early tooth decay. Saliva also limits bacterial growth that can dissolve tooth enamel or lead to mouth infections. And saliva neutralizes damaging acids in your mouth. Saliva enhances your ability to taste your food and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

As you get older, your salivary glands may secrete less saliva. Thirst and your perception of thirst also may change. Thirst receptors in your brain become less responsive to your body's need for fluids. But xerostomia is more often related to the medications taken by older adults rather than to the effects of aging.

Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson's disease medications.

Among the other causes of dry mouth are:

  • Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount produced. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production.
  • Nerve damage. An injury or surgery that causes nerve damage to your head and neck area also can result in xerostomia.
  • Other health conditions. Dry mouth can be a consequence of certain health conditions — or their treatments — including the autoimmune disease Sjogren's syndrome, diabetes, Alzheimer's disease, stroke, anxiety disorders and depression.

In addition, smoking or chewing tobacco can affect saliva production, aggravating dry mouth. Snoring and breathing with your mouth open also can contribute to the problem.

Screening and diagnosis

To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you'll need blood tests and imaging scans of your salivary glands to identify the cause.

Treatment

If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn't cause a dry mouth. Your doctor may also consider prescribing pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.

Self-care

When the cause of the problem either can't be determined or can't be resolved, you may be able to improve your saliva flow by sucking on sugar-free hard candy or chewing sugar-free gum. Avoid acidic foods or hard candies — they make saliva acidic, increasing the possibility of tooth decay. It's also a good idea to avoid sugary foods and candies because they increase the risk of tooth decay as well.

If you smoke or chew tobacco, quitting will reduce your dry mouth symptoms.

To protect your teeth, brush with a fluoride toothpaste and visit your dentist regularly. Your doctor or dentist may suggest using prescription fluoride toothpaste. Using a fluoride rinse or brush-on fluoride gel before bedtime also may offer protection.

You might also try the following:

  • Sip water regularly.
  • Try over-the-counter saliva substitutes.
  • Breathe through your nose, not your mouth.
  • Add moisture to the air at night with a room humidifier.

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2007-04-06






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