Dry Mouth (Xerostomia)

Causes, Consequences, and Treatment of Dry Mouth

Do you feel the need to moisten your mouth frequently? Does your mouth feel dry at mealtime? Do you have less saliva than you once did? Do you have difficulty swallowing? Do you have trouble eating dry foods such as crackers or toast?

If you answered "yes" to these questions, you may be one of the many people who suffer from dry mouth, or xerostomia (pronounced "zero-stoh'-me-a").

Although xerostomia is not a disease in itself, it is a symptom of certain diseases. Dry mouth also is a common side effect of some medications and medical treatments. Most cases of dry mouth are caused by failure of the salivary glands to function properly. But in some people, the sensation of a dry mouth occurs even though their salivary glands are normal.

Patients with dry mouth have varying degrees of discomfort. Some people feel a dry or burning sensation in their mouths. A dry mouth may effect their ability to chew, taste, swallow, and speak. Changes in saliva also effect oral and dental health. Severe cases of dry mouth can result in cracking of the lips, slits at the corners of the mouth, changes in the surface of the tongue, rampant tooth decay, ulceration of the mouth's linings, and infections.

Dry mouth is a significant health problem because it can affect nutrition and psychological well-being, while also contributing to tooth decay and other mouth infections. Dry mouth also may signal more serious problems in the body. If you have a dry mouth, you should be seen by a dentist or physician to determine the cause of the symptom.

Why Is Saliva Important?

Saliva has many important functions in the body. Each person needs adequate amounts of healthy saliva to:

* Limit the growth of bacteria that cause tooth decay and other oral infections.
* Preserve teeth by bathing them with protective minerals that allow early cavities to remineralize and heal.
* Lubricate the soft tissues lining the mouth to keep them pliable and make speaking and chewing easier.
* Dissolve foods and allow us to experience their sweet, sour, salty, and bitter tastes.
* Assist digestion by providing enzymes that break down food.
* Lubricate food so it can be swallowed easily.
* Cleanse the teeth and mouth of food particles.

What Causes Dry Mouth?

Changes in salivary gland function, brought on by:

Medications

Over 400 commonly used drugs can cause the sensation of dry mouth. The main culprits are the antihypertensives (for high blood pressure) and antidepressants. Both are prescribed for millions of Americans. Painkillers, tranquilizers, diuretics, HIV medications, and over-the-counter antihistamines can also decrease saliva.

Cancer Treatment

Radiation therapy can permanently damage salivary glands if they are in the field of radiation. Chemotherapy can change the composition of saliva, creating a sensation of dry mouth.

Diseases

Sjogren's syndrome is an autoimmune disorder whose symptoms include dry mouth and dry eyes. Some Sjogren's patients also have a connective tissue disorder, most commonly rheumatoid arthritis or systemic lupus erythematosus.

Other Conditions

Bone marrow transplants, auto immune disorders, diabetes, smoking, nutritional deficiencies, anxiety, mental stress, and depression can cause a dry mouth.

Changes not related to salivary glands, such as:

Nerve Damage

Trauma to the head and neck area 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.

Does Aging Cause Dry Mouth?

Until recently, dry mouth was regarded as a normal part of aging. Researchers now know that healthy older adults do not produce less saliva. When older people do experience dry mouth, it is because they suffer from diseases that cause the condition or they take medications that produce dry mouth as a side effect.

IS RELIEF AVAILABLE?

Although there is no single way to treat dry mouth, there are a number of steps you can follow to keep teeth in good health and relieve the sense of dryness. These suggestions will not correct the underlying cause of xerostomia, but may help you feel more comfortable.

To preserve your teeth:

* Brush your teeth meticulously at least twice a day, with a soft toothbrush.
* Use dental floss regularly.
* Use a toothpaste that contains fluoride. Ask your dentist about using a topical fluoride.
* Avoid sticky, sugary foods or brush immediately after eating them.
* See your dentist at least three times a year for cleanings and early treatment of cavities.
* Ask your dentist if you should use a remineralizing solution or prescription strength fluoride.

To relieve dryness and preserve the soft tissue:

* Take frequent sips of water or drinks without sugar. Pause often while speaking to sip some liquid. Avoid caffeine-containing coffee, tea, and soft drinks.
* Drink frequently while eating. This will make chewing and swallowing easier and may increase the taste of foods.
* Keep a glass of water by your bed for dryness during the night or upon awakening.
* Chew sugarless gum. The chewing may produce more saliva.
* Eat sugarless mints or hard candies, but let them dissolve in your mouth. Cinnamon and mint are often most effective.
* Avoid tobacco and alcohol.
* Avoid spicy, salty, and highly acidic foods that may irritate the mouth.
* Ask your dentist about using artificial saliva to help lubricate the mouth.
* Use a humidifier, particularly at night.
* Avoid medications, such as cold medication, which are not medically necessary. Eliminate or change medications that contribute to the dry mouth. Consult your doctor before adjusting any prescription medications.

This information is from the National Oral Health Information Clearinghouse (NOHIC).

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