Dry mouth (Xerostomia)

What is dry mouth?

The medical term for dry mouth is xerostomia, and it is a condition which occurs when the production of saliva sharply decreases or stops altogether. Saliva is the clear, watery solution which is present in the mouth at all times, and its function is to lubricate the mouth so that we can speak and taste our food. It also aids in preventing tooth decay as it washes away food and plaque from the surface of the teeth.

People who suffer from dry mouth are at increased risk of tooth decay, gum disease and a range of other illnesses affecting the soft tissues of the mouth. The diet may also be severely affected because food cannot be tasted as it normally would.

What causes it?

There are several reasons why dry mouth may occur. Among them are the following:

  • A side effect of medication: Medications are by far the most common cause of dry mouth, and the range of medications which can give rise to this condition include everything from pain relieving drugs to anti-depressants. Because older people tend to take a wider range of medication than their younger counterparts, there is a much higher rate of dry mouth among this age group. Patients who are undergoing chemotherapy/radiation therapy, or other forms of treatment for cancers in the head and neck area, are found to suffer particularly from dry mouth or xerostomia.
  • A side effect of diseases and infections: Many diseases and infections can give rise to dry mouth, particularly those associated with HIV. There is also another type of auto-immune disease called Sjogren’s disease which gives rise to severe xerostomia. Patients affected by Sjogren’s disease find that, not only does their saliva disappear, but they are also unable to shed tears because their lachrymal glands (which secrete tears) are also attacked by the disease.
  • Surgical removal of the salivary glands: In rare cases where the salivary glands have been removed surgically, xerostomia will be a permanent feature of life, and steps will be taken to treat it.

What are the symptoms?

The symptoms to watch out for in cases where xerostomia may be present are:

  • Frequent and severe thirst.
  • Red, raw tongue.
  • A painful, burning sensation in the mouth, and especially on the tongue.
  • Pain on swallowing food or water, or difficulty in speaking.
  • Sores inside the mouth or at the corners of the lips.
  • Any alteration in taste.
  • Sore throat or hoarseness.
  • Halitosis (bad breath).
  • The sudden onset of dental problems, or difficulty in wearing dentures.
  • Recurring yeast infections in the mouth.

Many of the above symptoms are quite common and, taken in isolation, they rarely indicate the onset of a condition as serious as xerostomia. However, if a number of them are present at the same time, medical investigation is warranted.

How is it diagnosed?

Dry mouth can be diagnosed either by your doctor or dentist. As well as taking a thorough medical history and asking for a description of your symptoms, your dentist will also look for signs of cavities and gum disease and may suggest a referral to your GP if the onset of dry mouth is suspected.

Your GP will carry out a thorough examination of your mouth to assess the flow of saliva and will also look for cracks and sores inside the mouth and around the area of the lips. They will also take account of what medication, if any, you are currently taking either with or without prescription, and if you are receiving any medical treatment for a particular condition.

What is the treatment?

The treatment of xerostomia depends on the severity of the problem, and very often the condition will remain a problem as long as its cause is present. For example, if you are receiving radiation treatment for head or neck cancer, xerostomia will remain a side-effect for as long as the treatment continues. In some cases, radiation therapy may permanently affect the ability of the salivary glands to produce saliva.

Having said that, the treatment of xerostomia focuses on three main areas:

  • Relieving the symptoms of the condition.
  • Preventing the onset of dental decay and.
  • Trying to increase the flow of saliva.

Sometimes, your doctor and dentist will work in tandem in the management of xerostomia, with your dentist concentrating on oral hygiene and the prevention of dental decay and your GP working on reducing the more unpleasant side effects of the condition, and trying to increase the flow of saliva.

Are there any self-help remedies?

The symptoms of xerostomia may be relieved to some degree if you follow some of these self-help tips:

  • Give up smoking.
  • Take sips of water on a regular basis to keep the mouth moist. Carry water at all times throughout the day, and keep a glass of water close by your bed at night.
  • If you like chewing gum, try to stick to the sugar-free variety.
  • Over-the-counter saliva substitutes and oral moisturisers are now available in many pharmacies, so they are worth checking out.
  • If you feel you need to suck on something to relieve the symptoms of dry mouth, try sugar-free hard sweets, chips of ice cubes or sugar-free ice pops.
  • Always use a mouth rinse which is alcohol and peroxide-free.
  • Things to avoid include salty foods, dry foods, and food and drink which contain high doses of sugar. Caffeine and alcohol should also be avoided, if possible, as these increase water loss by triggering frequent urination, thereby causing further dehydration.
  • Use a moisturiser on your lips to prevent them from becoming dry and chapped, and use a soft-bristle toothbrush on teeth and gums to prevent further damage inside your mouth.

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