DRY MOUTH: CAUSES, REMEDIES, TREATMENTS - Dr. Lara Coseo
March 22 2021
A healthy mouth is normally lubricated by a plentiful supply of saliva. But if this flow of natural secretions is reduced, we encounter a condition called xerostomia, also commonly known as dry mouth. Dry mouth affects millions of people worldwide and it is a condition that shouldn’t be ignored since it can cause significant discomfort, poor oral health and an impaired quality of life.
It may seem like a no-brainer that the main symptom of dry mouth is a feeling of dryness in the mouth. Surprisingly, most dentists find that patients can have severe dryness and be unaware of it. Because the condition can develop gradually over time, you can actually adapt to the feeling of dryness and not know there is a problem.Dry mouth can also lead to additional symptoms that can alert you to the problem.
A dry mouth is prone to bad breath due to an overgrowth of bacteria in dental plaque. These bacteria often produce bad-smelling gases that you emit when speaking, laughing or breathing. Dental plaque is more difficult to remove from the teeth in a dry mouth, and the lack of saliva allows more plaque to accumulate. Any increase in plaque corresponds to an increase in bad breath.
Rapid Teeth Decay
People who suffer from a dry mouth tend to have a much higher risk for cavities (tooth decay). Because dry mouth allows more dental plaque to collect on the teeth, these cavities are particularly prevalent on the cheek side of teeth, near the junction of the gum tissues. When dentists see multiple cavities in this gumline area, they automatically suspect a dry mouth.
Bad Taste in Mouth / Taste Alterations
Another unfortunate symptom of a dry mouth is changes in taste, including a constant bad taste in the mouth. Most dry mouth sufferers state that they are unable to taste flavorful foods the way they used to taste them. People often compensate by over-salting or over-spicing their foods, which can lead to stomach upset or other GI problems.
In a dry mouth, there is not the necessary lubrication that allows the lips, cheeks, and tongue to smoothly glide around and create various speech sounds. People who have extreme dryness will feel their soft tissues getting “stuck” to their teeth and cannot speak for long without water to moisturize the inside of the mouth.
Problems Wearing Dentures
Dentures or other dental appliances become very uncomfortable when the mouth is dry. The same lack of lubrication that causes speech difficulty causes sticking and friction to any type of dental prosthesis. Patients with dentures and a dry mouth have more difficulty keeping the dentures in the mouth (lack of suction) and suffer more sore spots.
One painful symptom of a dry mouth is a burning sensation. Some people call this burning mouth syndrome or glossitis, when the tongue is the affected site. This burning can make even the mildest food uncomfortable to eat, and drinking anything besides cold water will hurt.
Frequent Ulcers and Mouth Sores
Another painful problem associated with dry mouth is a higher risk for ulcers and sores inside the mouth. Sometimes these ulcers are the result of simple friction. Without proper lubrication, the friction between the teeth and soft tissues can damage the tissue, causing an ulcer. In other cases, there is a greater chance of biting your lips, cheeks or tongue in a dry mouth. These injuries often turn into painful canker sores that linger for up to two weeks.
Dry mouth can have many causes, and most people actually have a combination of one or more contributing factors to their dry mouth. This fact can complicate treatment, and that is why understanding it is so important!
The reason we left a question mark behind the word aging is that it is a questionable cause of dry mouth. Many have suggested that, like other bodily functions, salivary production simply declines as we age. While it makes sense to think along those lines, there is no research to confirm this. More likely, it is the fact that as we age, we become more susceptible to the other causes of dry mouth.
We can cause or worsen dry mouth through habits like smoking and mouth breathing. When we say smoking, we don’t mean just tobacco. Smoking of any substance will dry out the mouth. Mouth breathing may or may not be controllable, as some people suffer from nasal obstructions that force them to breathe through the mouth.
This is by far the most common cause of dry mouth. Prescription medications, especially when you take a combination of multiple medications, can lead to extreme dry mouth. Hundreds, maybe thousands, of medications cause dry mouth as a side effect. This also applies to over-the-counter medications for allergies and sinus problems.
Stress itself could predispose someone to dry mouth. While the link is not clear, it is probable that people undergoing extreme stress are less likely to stay hydrated and more likely to take medications, smoke, or drink alcohol (all of which cause dry mouth).
Certain autoimmune disorders can cause dry mouth. The most severe is Sjögren’s Disease. This disorder affects both the salivary glands and the tear glands, so patients suffer from extreme dry mouth and dry eyes. Other conditions like celiac disease and Crohn’s disease tend to cause dryness, too.
Patients undergoing cancer treatment, including chemotherapy and/or radiation, are likely to suffer from dry mouth, especially those whose radiation affects the head or neck and damages the salivary glands.
Because of the discomfort and symptoms people with dry mouth experience, it is important to combat the symptoms with several remedies. Not only will these remedies relieve some of the pain of dry mouth; they will also help reduce the negative oral health consequences dry mouth carries.
Many people consume foods that can cause the body to lose water and become dehydrated. A body that is dehydrated will not create the appropriate amount of saliva because it is attempting to conserve water for other essential body functions. The most noteworthy dehydrators are diets that are high in salt or high in sugar. Both salt and sugar pull water out of the bloodstream with them as they are filtered through the kidneys.To remain hydrated and support healthy salivation, you should commit to eating a diet that is low in salt and low in sugar!
One of the best remedies for a dry mouth is using products that stimulate your body’s natural production of saliva. The simplest is chewing sugar-free gum. The stronger the flavor, the better! Chewing flavored gum “tricks” your mouth into thinking it needs to produce saliva in order to digest food. Another great way to stimulate saliva is with Xylimelts, an innovative oral patch that sticks to the inside of the mouth and releases a sugar-free sweetener. Most people use these overnight to prevent the extreme dryness that tends to develop.
In addition to avoiding foods that dehydrate you, what you drink is important! In order to produce adequate saliva, you must have adequate water intake. Many people do not drink water, opting instead for drinks that contain caffeine or high levels of sugar. Unfortunately, these beverages actually dehydrate you, making the risk for dry mouth even higher. In order to relieve dry mouth, drink plain water throughout the day!
When dry mouth is severe and affects your quality of life, you should speak with your dentist and your medical doctor about it. Some patients require medical intervention to counteract dry mouth.
In rare cases, your medical doctor may prescribe a drug that causes saliva production by stimulating the salivary glands. This is typically a last resort due to the side effects these prescription medications can cause.
Your doctor and dentist may prescribe the use of ointments or gels that act as salivary substitutes, to moisten and lubricate the inside of the mouth. While no lab-made substance can perfectly mimic saliva, patients can experience real relief with these substitutes when used consistently.
Scientists are studying the effects of acupuncture on dry mouth, and current evidence is showing that it could be a valuable treatment option, especially in patients who have undergone radiation therapy for cancer of the head and neck. Researchers are unsure as to the mechanism of action of acupuncture in the relief of dry mouth, and initial studies show that it may involve stimulation of the brain centers controlling salivary production.
--- By Dr. Lara I She is a 2004 graduate of Baylor College of Dentistry. She practiced general dentistry for 13 years before retiring for medical reasons. She currently serves as an Adjunct Associate Professor at Texas A&M College of Dentistry.