What is Dry mouth?

Dry mouth or Xerostomia (zeer-oh-stoh-mee-ah), happens when the salivary glands don't produce enough saliva to keep the mouth moist.  It can be caused by many medications, or simply by aging.  We all need saliva to cleanse, chew and digest food.  It also helps to fight and control bacteria in the mouth.  Therefore, reduced saliva production increases the risk of tooth decay, demineralization of teeth, tooth sensitivity and gum infection.

Approximately one in four adults in the United States suffer from dry mouth, and this figure increases to 40 percent in populations over the age of 55. [1].  There are a variety of possible causes in developing xerostomia, including blood pressure medications, diabetes medications, and many psychiatric medication.  Other treatments and conditions, like chemotherapy, radiation therapy, and autoimmune disease, and other underlying diseases can also cause dry mouth.  If you think you are experiencing excessive dry mouth, see your dentist or doctor find out why.

What are the symptoms of dry mouth?

  • Dryness or stickiness in the mouth
  • The feeling of thick and stringy saliva, or “thick spit”
  • Bad breath
  • Difficulty chewing, speaking and swallowing
  • Dry, soreness and hoarseness of throat
  • Dry or grooved tongue
  • A change in the sense of taste
  • Problems wearing dentures or oral appliance

What can cause dry mouth?

  • Aging - Research shows that dry mouth affects 30% of patients over 65 years.  This number increases to 40% among patients older than 80 years.  In addition, those who take more than four prescription medications daily are more likely to experience dry mouth. [2]
  • Disease-related - Autoimmune disease like Sjögren’s syndrome is one of the most common autoimmune connective-tissue diseases that affect salivary glands.  Sjögren’s syndrome affects approximately 1 in 70 people. Other diseases associated with dry mouth are diabetes and HIV.  [3]
  • Drug/Therapy-Related - Chemotherapy and radiation therapy can cause salivary gland dysfunction due to direct toxicity to salivary glands and mouth issues.    Moreover, radioactive iodine that is used to treat some thyroid cancers can directly damage the salivary glands.[4]  There are also many other commonly used medications including antihistamines antidepressants, blood pressure medication, and nonsteroidal anti-inflammatories that commonly cause dry mouth.
  • Tobacco and alcohol use - Habits like drinking alcohol and smoking or chewing tobacco can increase the chance of acquiring dry mouth.

Preventing Dry mouth

There are various ways to prevent dry mouth, they are as follows:

  • Avoid drinks that contain caffeine including coffee, tea, and soft drinks. Caffeine can dry out the mouth.
  • Sip water or a sugarless drink during meals to facilitate chewing and swallowing.
  • Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow, some gum contains xylitol that helps fight cavities.
  • Avoid smoking tobacco and cigarettes.
  • Use a humidifier at night to moisten nasal and oral passages.

Dry Mouth Remedies

Your recommended treatment depends on the cause of your dry mouth.  Your doctor or dentist may suggest the following:

  • Changes in medications - your doctor may adjust the dosage of your prescribed medication or replace another medication that will not cause dry mouth.
  • Use recommended products to moisturize mouth - your dentist may suggest over-the-counter mouth rinses containing xylitol, artificial saliva or moisturizers to moisten your mouth.
  • Protect your teeth - you might be prescribed fluoride trays which you can fill with fluoride gel and wear over your teeth each night. Your dentist may also prescribe a prescription level toothpaste.
  • Dental appointments – never miss an appointment with your dentist!  If you are experiencing dry mouth, it’s best to seek advice from your dentist.  Have your teeth checked at least every six months. Remember, keeping your mouth and teeth healthy can go a long way for your general health.

Resources:

  1. Facts about dry mouth (26 May 2006) Retrieved from https://www.dentistryiq.com/articles/rdh/2006/05/facts-about-dry-mouth.html (Accessed June 22, 2015)
  2. Yellowitz JA & Schneiderman MT (2014 Apr 13) Elder's oral health crisis. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24929604 (Accessed June 22, 2015)
  3. Zero DT & Brennan MT et al. (2016 April) Clinical practice guidelines for oral management of Sjogren disease: Dental caries prevention. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26762707 (Accessed June 22, 2015)
  4. PDQ Supportive and Palliative Care Editorial Board. (2016 Dec 16) Oral Complications of Chemotherapy and Head/Neck Radiation. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26389320 (Accessed June 22, 2018)

FAQ:

Q: What causes dry mouth?

A: There are several causes of dry mouth. Dry mouth can be caused by many medications, especially medications for high blood pressure or for diabetes. Dry mouth is also linked with aging. If your dry mouth is medication-induced, do not stop taking your medication without consulting with your physician.

Q: Why is my dry mouth worse at night?

A: Nighttime dry mouth is very common, especially among people who breathe out of their mouths when they sleep. In addition, those who use devices for sleep apnea, like a CPAP machine, often experience more severe dry mouth.