Dry Mouth Explanation and Solutions
By Dr. Binon
Saliva helps to lubricate the mouth, helps in digestion, swallowing, speech, taste and bathes the teeth to help them stay clean. The lubricant action prevents food particles from packing against the teeth, crowns, bridges and dentures. When absent, it dramatically increases the decay rate due to chronic accumulation of heavy plaque and food debris along the gum line (causes gum line decay). Persons who wear dentures rely on saliva to help keep them in place (suction seal). Without it, the dentures chafe the tissues and they become very sore and irritated. The tongue also gets irritated and may have burning sensations as well. Frequently, this prevents denture wear and some patients will resort to considering implants so that dentures are not resting and rubbing on the gums. When little or no saliva is present, the bacteria that live in our mouths also change. The good bacteria decrease and the harmful ones increase. As a consequence decay not only increases a great deal, but the bacteria multiply so fast and in such large numbers that they overwhelm the good ones completely. This often leads to a fungal infection called Thrush (oral candidiasis).
As you can surmise from the above, dry mouth and salivary dysfunction can produce significant mouth and throat disorders that seriously impact the person’s quality of life. Age, for the most part does not affect salivary function unless other factors are present. Dry mouth has many causes ranging from systemic disease such as Sjogren’s syndrome, cancer radiation treatment to the head and neck region and decreased salivary flow due to some 400 medications taken for a variety of reasons.
The aging population is vulnerable due to medical conditions such as diabetes, Alzheimer’s, dehydration, Sjogrens (SS), depression, heart conditions etc. The drugs include: antidepressants, sedatives, tranquilizers, antihistamines, calcium channel blockers, angiotension inhibitors, cancer treating agents, anti-Parkinson medications and anti- seizure drugs. As noted, radiation treatment for cancer is also known to destroy salivary gland cells. Auto immune diseases such as the many variants of SS, rheumatoid arthritis, systemic lupus, scleroderma, poly-myositis and poly- arthritis can also reduce salivary flow and cause dry eyes and other mucous membranes.
Sometimes it is possible to have your physician change your medication to one that does not cause dry mouth. Unfortunately that does not occur too frequently. So what can you do to minimize the damage? Below are some strategies that are recommended by the American Dental Association.
Dry Mouth Treatment
- Moisturturizers/Lubricants, Mouth washes and sprays
- Sugar free gums, mints, lozenes, artificial salivary replacements
- Prescription sialogogues (Pilocarpine - 5mg, 3 times a day and at bedtime), (Cevimeline - 30mg, 3 times a day)
- Lubricants on the lips every 2 hours
- Bedside humidifier during sleeping hours
Non-prescription Mouth Lubricants are available at most pharmacies -- ask your pharmacist for the most cost effective saliva substitutes, lubricant sprays and moisturizers.
Typical appearance of a dry mouth patient’s mucosa and tongue. (Fig 1 & 2) Oral mucosa get very red and the tongue has “cobble stone" appearance. (Fig 4) The corners of the mouth often have small fissures or cracks that are typically painful. (fig 3a & b)
For further information, please visit one of the following resources: