Dry Mouth Causes and Treatments

Dry mouth is a condition that usually results from decreased production of saliva. At times, xerostomia can make it difficult to speak and may lead to malnutrition. Extreme dry mouth and salivary gland dysfunction can produce significant and permanent mouth and throat disorders and can impair a person’s quality of life. Dry mouth is also called xerostomia.

How common is dry mouth?

Dry mouth affects about 10% of all people and is more prevalent in women than men. Disorders of saliva production affect elderly people and those who are taking prescription and nonprescription medications most frequently.

What are the benefits of saliva?

Saliva is an essential part of a healthy mouth and is often taken for granted. The lubricating properties of saliva provide comfort and help protect the oral tissues against ulcers, sores, and other effects of friction. Saliva neutralizes acids and provides antibodies against bacterial threat. Saliva helps digest food and helps teeth in remineralization. Saliva is also a very essential contributor to a person’s ability to taste, as it acts as a solvent for the taste stimuli.

What causes dry mouth?

There are many causes of dry mouth. Dry mouth most commonly occurs as a side effect of medications that cause decrease saliva production, including blood pressure medications, antihistamines, antidepressants, diuretics, nonsteroidal anti-inflammatories, and many others. Other causes of dry mouth are radiation treatments to treat cancerous tumors of the head and neck, salivary gland diseases, diabetes, hormonal imbalance, mouth breathing, sleep apnea, and autoimmune disorders such as Sjögren’s syndrome, rheumatoid arthritis, and systemic lupus erythematosus. Eating disorders, such as bulimia and anorexia, are other risk factors for developing xerostomia. Salivary production can be decreased if a major salivary duct becomes blocked, such as from a stone or infection. Dry mouth will often occur during pregnancy or breastfeeding due to dehydration and hormonal changes. Other causative factors include stress, anxiety, depression, and dehydration.

People complaining of dry mouth may have trouble speaking, eating, tasting food, and swallowing. Frequently, a dry mouth may be most manifest at night during sleeping, especially in mouth-breathers. The dryness may cause chapped or cracked lips, dry eyes, dry throat, pale gums, headaches, dizziness, bad breath or a persistent cough. Those affected may also complain of sores in their mouth, or a white tongue indicative of a fungal infection like yeast (candidiasis). Fungal infections occurring in an individual with dry mouth may be associated with another underlying disease or disorder such as Addison’s disease, HIV, or diabetes. A burning tongue or throat, periodontitis, ulcers, sores, and inflamed soft tissue are also all effects of oral dryness. Without a sufficient quantity of saliva to wash food particles off teeth, neutralize acids in the mouth, and battle the bacteria population, a person frequently develops multiple cavities — especially around the gum line.

How do health-care professionals diagnose dry mouth?

When dry mouth is noticed, the dentist can be helpful to obtain a proper diagnosis. The diagnosis will help in developing a plan for management and treatment. The dentist will inspect the main salivary glands and ducts to check for blockages and may measure both stimulated and unstimulated salivary flow. The lips, tongue, and oral tissues will all be inspected for dryness. Sometimes a patient will still complain of dry mouth even if salivary flow is adequate. Since the symptoms of dry mouth vary greatly from individual to individual, treatments vary. Sometimes treatments are given for prolonged, chronic complaint of dry mouth, even without clinical signs of changes within the mouth.

Those seeking treatment for dry mouth will most likely want something to provide comfort and relief. Treatment for dry mouth can be divided into the following three categories: saliva substitution, saliva stimulation, prevention of caries, and yeast (Candida) infection.

Saliva substitution: When selecting a mouthwash, the person must choose a product that doesn’t contain alcohol, such as Biotene, for alcohol-based products will only cause further mouth dryness. There are many home remedies to help with dry mouth. These include drinking water more frequently throughout the day, especially while eating. Restricting caffeine intake and letting ice melt in the mouth will help the mouth remain as moist as possible. Humidifying the sleeping area and coating the lips with a balm or Vaseline are also helpful remedies.

Saliva stimulation: Chewing gum can help stimulate salivary flow, but it is important to remember not to use gum or candies that have sugar in them or the person will be placed at greater risk for developing cavities. Sugar-free lemon drops can be comforting in relieving dry mouth. Other remedies include medications that help increase salivary flow such as pilocarpine (Salagen) and cevimeline (Evoxac). These prescription medications are to be avoided by people with asthma or glaucoma. Artificial saliva substitutes and oral lubricants containing glycerin will provide help during eating and speaking. They won’t cure xerostomia but will provide some relief.

Prevention of caries and Candida infection: Cavities, gingivitis, periodontal disease, and fungal infections are common complications of dry mouth. A dry oral environment makes plaque control more difficult, so meticulous oral care and hygiene becomes essential in preventing rampant caries, gingivitis, and periodontal disease. The affected individual should incorporate a low-sugar diet and begin daily use of fluoride treatments and antimicrobial rinses to combat the effects oral dryness has on the teeth and oral tissues. Prescription toothpastes that contain more fluoride, calcium, and phosphate will help protect and remineralize teeth where necessary. Frequent visits to the dentist are necessary to help manage these complications. Since people with dry mouth often develop fungal infections such as thrush (oral candidiasis), they may require topical antifungal treatment such as rinses and dissolving tablets. Dentures often harbor fungal infections, so they should be soaked daily in chlorhexidine or 1% bleach.