About 10% of the general population and 25% of the elderly experience dry mouth (not enough saliva in the mouth). Dry mouth is a symptom of an underlying problem rather than a condition on its own.
Many things can cause persistent dry mouth, including prescription drugs, medical treatments, and certain autoimmune diseases such as Sjögren’s syndrome.
Treatment includes products that help moisten the mouth. The feeling of dry mouth is also called xerostomia.
Salivary Glands
The salivary glands are located around the mouth and throat. These glands produce saliva that is pumped into the mouth through small ducts called salivary ducts. The salivary glands include:
Parotid – located on the cheek between the front of the ear and the last tooth.
Submandibular – located under the tongue on both sides of the jaw (mandible).
Sublingual – located at the floor of the mouth.
Small salivary glands – located in various parts of the mouth, including the inner cheeks and throat.
A regular flow of saliva keeps the mouth moist at all times. Chewing and swallowing food increases saliva flow. Just looking and thinking about appetizing foods can also cause increased saliva flow.
Protective Role of Saliva
Dry mouth significantly increases the risk of tooth decay and other oral diseases. Having enough saliva keeps your mouth healthy by:
.Has ingredients that can directly attack rot-causing bacteria
.Has anti-fungal properties
.Helps destroy viruses
.Neutralizes harmful acids produced by bacteria in plaque
.Contains calcium and phosphate, which are important for preventing and healing the damage caused by tooth decay
.Moisturizes food allowing you to swallow comfortably
.Helps create specific sounds when you speak
.It enhances the sensation inside the mouth and allows the experience of the texture, taste of the food as well as pain when something goes wrong.
Dry Mouth Symptoms
Dry mouth symptoms may include:
.Saliva that feels thick or stringy
.A rough, dry tongue
.The tendency of the tongue to stick to the roof of the mouth
.Chewing or swallowing problems (especially dry foods such as biscuits)
. Halitosis
.mouth ulcers
.Dry and chapped lips
.Susceptibility to oral thrush infections
.High rate of dental caries
.Prickly, burning sensation in the mouth
.Loose acrylic (non-metal) dentures because saliva helps to create suction between the gum tissues and the acrylic base of the denture.
Related Symptoms in the Rest of the Body
Depending on the cause, dry mouth may be associated with symptoms outside the mouth, including:
.Dry and itchy eyes
.Dry nose or throat
.Frequent cough
.Reduced sense of smell
.Constipation
.Joint pain or stiffness
.Generally not feeling well
.Unexplained weight loss
.Frequent vaginal thrush infections in women.
If you are experiencing some of these problems, talk to your doctor so they can investigate what might be causing them.
Dry Mouth and Caries
Poor oral hygiene (not brushing and flossing your teeth every day) and a sugary diet tend to cause tooth decay on the biting surfaces and between the teeth. People with a dry mouth are more likely to have tooth decay and may also have cavities along the gum line (tooth root surface).
Unlike enamel (the outer layer of the tooth), dentin (the inner layer of the tooth) is less resistant to acids and can decay rapidly, especially without enough saliva to protect it. People with dry mouth may also develop cavities on the lower anterior teeth, which are normally well protected by saliva produced under the tongue.
While people with dry mouth are more prone to cavities, it can still be prevented with the right diet and lifestyle. Thorough dental cleaning with a suitable fluoride toothpaste is extremely important.
Causes of Dry Mouth
Many different conditions, some short-term and others long-term, can impair saliva production. These conditions may include:
Drugs and drugs – About 600 drugs and drugs, both legal and illegal, are known to cause dry mouth. These include antihistamines, high blood pressure medications, sedatives, decongestants, analgesics (pain relievers), antidepressants, and illicit drugs such as cocaine.
Infection – a bacterial or viral infection of the salivary glands (such as mumps) can cause inflammation and restrict saliva production.
Sjögren’s syndrome – a common autoimmune disease that mainly affects the eyes and salivary glands, but can also affect the sweat glands.
Salivary duct blockages – for example, small stones made from saliva minerals can build up in the salivary ducts and restrict saliva flow.
Certain medical conditions – including AIDS, amyloidosis, cerebral palsy, diabetes, Parkinson’s disease, primary biliary cirrhosis, and lupus.
Nerve problems – the function of the salivary glands is controlled by the facial nerves. For example, injury, disease, or surgical damage to these nerves can reduce saliva production.
Some cancer treatments, such as chemotherapy or radiotherapy (if directed to the head or neck), can temporarily reduce the salivary glands’ ability to make saliva.
Other causes – including mostly mouth breathing, for example, constantly stuffy nose or stuffy sinuses, or hormone changes from pregnancy or menopause.
Dehydration – not drinking enough fluids can cause thick saliva and dry mouth. Other causes of dehydration include blood loss, chronic diarrhea, or medical conditions such as kidney failure.
Diagnosing Dry Mouth
Diagnosis of dry mouth may include:
Examination of the mouth and teeth – the inner cheeks appear dry and rough, not moist and shiny. Your dentist can check the pattern of tooth decay.
Saliva tests – for example, a typical saliva test involves rolling and drying the lower lip. Normally, saliva should rehydrate the lower lip in about half a minute.
Medical history review – to check for conditions or medications that may dry out your mouth.
Dry Mouth Treatment
Treatment depends on the cause, but may include:
Changes in medication – if you are taking a medication that causes dry mouth as a side effect, the prescriber may change the dose or prescribe a different medication.
Saliva substitutes – your doctor or dentist may prescribe an artificial saliva substitute. Use strictly as directed.
Dry mouth products – these products contain ingredients such as lubricants that can help treat your dry mouth. The product range includes toothpaste, mouthwash, gums and topical gels. Talk to your dentist for recommendations.
Dental products – these products may contain high fluoride or calcium to help prevent tooth decay. Talk to your dentist for recommendations.
Antibiotics and antifungal drugs – can be used to treat an infection.
Surgery – salivary gland blockages such as stones are usually treated with minor surgery.
Other treatments if needed – Appropriate medical treatment is required for any underlying condition, such as Sjögren’s syndrome or diabetes.
Tips for Living with a Dry Mouth
Act under the guidance of your doctor and dentist, but general recommendations for your diet include:
.Avoid any substance that increases dry mouth. These include smoking, alcohol, caffeinated drinks, and spicy foods.
.Eat chewable foods to stimulate saliva flow.
.Chew food thoroughly before swallowing.
.Include juicy foods in your daily diet.
.Avoid crunchy foods that can hurt the mouth, such as crackers or potato chips.
.Avoid sugary foods and drinks.
.Avoid acidic foods and beverages such as soft drinks, energy drinks, sports drinks, liqueurs, citrus fruits, and juices. These drinks damage tooth enamel and can also be high in sugar.
.Avoid sugar candies (especially fruit-flavored and sour candies) and mouthwashes containing alcohol, as these products tend to increase dry mouth.
.Chew sugarless gum between meals to promote saliva flow.
.Drink plenty of water, but avoid slow sipping as this can wash out saliva. Carrying a beverage bottle can help.
.Ask your dentist for other dietary recommendations, including a full list of foods and beverages to limit or avoid.
Personal Care Tips for Dry Mouth
Act under the guidance of your doctor and dentist, but general self-care recommendations include:
.Brush your teeth at least twice a day and floss once a day.
.Use products containing fluoride such as toothpaste regularly. Ask your dentist which ones are best for dry mouth.
.Treat dry lips with another type of oily balm such as Vaseline or lanolin.
.An air humidifier used in your bedroom at night can help.
.If you are wearing dentures, consult your dentist for more information, adhesive dental products may be recommended.
.Remove partial or full dentures while sleeping.
Visit your dentist every 6 to 12 months for checkups, teeth cleaning and treatment if needed.