Dry Mouth

By Catherine M. Fascilla, D.D.S.

Xerostomia is the term that means dry mouth. It is the condition of not having enough saliva to keep the mouth wet due to inadequate function of the salivary glands. It is not unusual for us to have a dry mouth on occasion if we are upset, nervous or stressed. Some individuals, however, experience xerostomia most or all of the time.

Xerostomia is not a disease but can be a symptom of certain diseases. It can produce adverse effects on the quality of life, affecting dietary habits, nutritional status, speech, taste, tolerance to dental prosthesis like partials and dentures, and an increased susceptibility to infection and tooth decay. Some of the diseases where we see severe dry mouth are Sjogren’s syndrome, lupus erythematosus, rheumatoid arthritis, scleroderma, sarcoidosis, amyloidosis, and hypothyroidism.

Dry mouth is not a normal part of aging. However, as the life expectancy increases, so does the prevalence of age-related chronic diseases and conditions and the use of medications to treat these conditions. There are over 400 medications that can cause xerostomia. These include antihypertensives, antidepressants, analgesics, tranquilizers, diuretics and antihistamines. Chemotherapeutic drugs can change the flow and composition of the saliva. Radiation treatment focused on or near the salivary glands can temporarily or permanently damage the glands.

Nerve damage due to trauma to the head and neck from surgery or wounds can damage the nerves that supply sensation to the mouth. While the salivary glands may be left intact, they cannot function normally without the nerves that signal them to produce saliva.

Treatment involves finding correctable causes if possible. In many cases, it is not possible to correct xerostomia and treatment focuses on relieving the symptoms and preventing cavities. Careful attention should be paid to oral hygiene. The use of decongestants and antihistamines and excessive mouth breathing should be avoided. Frequent sips of water, alcohol-free oral rinses, gels, sugar-free chewing gum, and mints all help. Using a humidifier at night is beneficial. Minimizing caffeine and alcohol consumption is recommended. Artificial saliva is not well-liked and does not last. Pilocarpine HCl can be prescribed to increase salivary gland function but the side effects of that medication (sweating, vasodilation, headaches and urinary frequency) often decrease compliance.

Fluoride treatments and a low sugar diet are critical for preventing tooth decay. Regular dental exams should be every 2 to 6 months based on risk factors such as past susceptibility to cavities, the existence of gum disease, the quantity and quality of saliva produced and disabling conditions that prevent good oral hygiene.

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