Dry Mouth (Xerostomia) – Causes, Remedies, Symptoms, at Night, Morning, Spray, Lozenges

Xerostomia, commonly known as dry mouth, is a condition characterized by reduced saliva flow in the oral cavity. It can significantly impact oral health, leading to discomfort, tooth decay, and other oral complications. Understanding the causes, symptoms, and management strategies for xerostomia is crucial in maintaining a healthy mouth.

Key Facts

• Dry mouth, medically known as xerostomia, is a condition where the salivary glands don’t produce enough saliva to keep the mouth wet
• It is not only uncomfortable but can also affect the overall health of the mouth
• Dry mouth can be caused by various factors including medication, medical conditions, and lifestyle choices
• Managing dry mouth involves addressing the underlying cause and making lifestyle changes
• Saliva is essential for oral health as it helps in digestion, prevents infection by controlling bacteria in the mouth, and protects teeth from decay

Definition: What is Dry Mouth?

Dry mouth, or xerostomia, refers to the condition where the salivary glands in the mouth do not produce enough saliva to keep the mouth wet. Saliva is essential for maintaining oral health as it helps to wash away food particles, neutralize acids produced by bacteria, and provides enzymes to aid in digestion. When saliva production is reduced, it can lead to discomfort, difficulty in speaking and swallowing, and an increased risk of oral health problems such as cavities and gum disease. Xerostomia.

How Common Is Dry Mouth?

Dry mouth is a relatively common condition. It can affect people of all ages, but it’s more common in older adults. This is partly because they are more likely to be on medications, many of which can cause dry mouth as a side effect.

Why Is Dry Mouth a Problem?

Dry mouth, or xerostomia, is not just a matter of discomfort; it can have a significant impact on overall oral health and quality of life. Here are a few reasons why dry mouth is a problem:

• Increased Risk of Tooth Decay: Saliva helps neutralize acids in the mouth and wash away food particles. Without it, there’s an increased risk of tooth decay.
• Difficulty Eating and Speaking: A lack of saliva can make it difficult to swallow, chew, and even speak clearly.
• Change in Taste: People with dry mouth often report a diminished or altered sense of taste.
• Gum Disease and Infections: Reduced saliva can lead to gum disease and oral infections.
• Denture Discomfort: For individuals who wear dentures, dry mouth can cause discomfort and poor fit.

Why Is Saliva Important for the Body?

Saliva plays several vital roles in the maintenance of oral health:

• Moistening and Lubricating: It moistens food for easier swallowing and lubricates the inside of the mouth.
• Digestion: Saliva contains enzymes that start the digestion of carbohydrates.
• Neutralizing Acids: It neutralizes acids produced by bacteria in the mouth, thus protecting teeth from decay.
• Cleaning the Mouth: Saliva helps in cleaning the mouth by washing away food particles.
• Aiding Taste: It helps in the sense of taste by moistening food, allowing taste receptors to detect flavors.

Complications of Dry Mouth

If left untreated, dry mouth can lead to several complications such as:

• Severe tooth decay
• Gum disease
• Oral thrush (a yeast infection in the mouth)
• Sores or cracked lips
• Poor nutrition from difficulty in chewing and swallowing

Dry Mouth and Tooth Decay

Saliva plays a significant role in maintaining oral health by neutralizing acids and washing away food particles. Without enough saliva, there is an increased risk of tooth decay and gum disease. It’s important to maintain good oral hygiene practices and visit a dentist regularly if you have dry mouth.

Causes: What Causes Dry Mouth?

There are several factors that can cause dry mouth, including:

• Medication Side Effects: Certain medications can reduce saliva flow. Many medications, including antihistamines, decongestants, painkillers, antidepressants, and diuretics, can reduce saliva production as a side effect.
• Medical Treatments for Head and Neck Cancer: Treatments like radiation can affect major salivary glands in the head and neck area. Radiation therapy to the head and neck can damage salivary glands, reducing saliva production. Certain chemotherapy drugs can also cause dry mouth.
• Autoimmune Diseases: Conditions such as Sjögren’s syndrome, diabetes, systemic lupus erythematosus, rheumatoid arthritis, Alzheimer’s disease, and stroke can lead to dry mouth.
• Dehydration: Not drinking enough water or losing too much fluid can cause dry mouth.
• Lifestyle Choices: Smoking or chewing tobacco can affect saliva production. Consuming alcoholic beverages and caffeinated drinks can also cause the mouth to dry.
• Mouth Breathing: Breathing through the mouth during sleep or due to nasal congestion can lead to dry mouth.
• Nerve Damage: Trauma to the head and neck can damage nerves that control salivary glands.
• Aging: The elderly are more likely to have medical conditions or take medications that can cause dry mouth.

Conditions That May Cause Dry Mouth

• Sjögren’s Syndrome: This is an autoimmune disorder in which the body’s immune system attacks the glands that produce saliva and tears.
• Diabetes: People with diabetes are more likely to experience dry mouth due to high blood sugar levels affecting saliva production.
• Alzheimer’s Disease: Individuals with Alzheimer’s may experience dry mouth as a result of medication use or a decreased ability to maintain proper oral hydration.
• Hypertension and Anxiety Disorders: Medications used to treat high blood pressure and anxiety often have the side effect of reducing saliva production.
• Parkinson’s Disease: This neurological condition can cause difficulties in swallowing and reduced automatic reflexes, including salivary secretion.
• HIV/AIDS: People with HIV/AIDS may experience dry mouth due to medications and the condition’s effect on salivary glands.

What Are the Symptoms?

The symptoms of dry mouth can vary in intensity and may include:

• A dry feeling in the mouth, often described as sticky or parched
• Difficulty swallowing and chewing, especially dry foods
• Bad breath
• A sore throat or hoarseness
• A changed sense of taste
• Cracked lips or a dry, rough tongue
• An increase in tooth decay
• Gum irritation and gum disease
• Mouth sores
• Difficulty wearing dentures

Diagnosis and Evaluation

Xerostomia is diagnosed by clinical assessment including the following steps:

• Medical History: Understanding the patient’s medical history, including any chronic conditions like connective tissue disease or cancer treatment, is vital.
• Examination of Salivary Glands: Checking the residual salivary gland function and looking for signs of chronic inflammation.
• Blood Tests: To identify underlying systemic conditions that might cause xerostomia.

Treatment for Dry Mouth

The treatment for dry mouth largely depends on the cause. If it’s due to medication, your doctor might adjust the dosage or switch you to a different medication that doesn’t cause dry mouth. There are also saliva substitutes and medications that can stimulate the salivary glands. Using a mouthwash designed for dry mouth can also be beneficial.

1. Treating the Underlying Cause
   • Adjusting Medications: Consulting with a healthcare professional to modify or change medications that might be causing dry mouth.
   • Managing Systemic Conditions: Properly treating systemic diseases can improve salivary gland function.
2. Symptomatic Relief
   • Stimulating Saliva Flow: Chewing sugarless gum or sucking on sugarless hard candy can stimulate saliva production.
   • Staying Hydrated: Drinking water regularly helps keep the mouth moist.
   • Artificial Saliva: Over-the-counter mouth rinses and artificial saliva products can provide temporary relief.
3. Oral Hygiene Practices
   • Frequent Brushing and Flossing: To prevent tooth decay and maintain a mouth healthy.
   • Using Alcohol-Free Mouthwash: Alcohol can exacerbate oral dryness.
4. Dietary Adjustments
   • Avoiding Dry, Spicy or Salty Foods: These foods can aggravate dry mouth symptoms.
   • Limiting Acidic Foods: To reduce the risk of tooth enamel erosion.

Home Care Tips for Dry Mouth

Here are some tips for managing dry mouth at home:

• Stay Hydrated: Drink water throughout the day. Keep a glass of water at your bedside if your mouth gets dry at night.
• Chew Sugar-free Gum: Chewing gum or sucking on sugar-free candies can stimulate saliva production.
• Use a Humidifier: Adding moisture to the air, especially while sleeping, can help relieve a dry mouth.
• Avoid Caffeine and Alcohol: These can dry out the mouth, so it’s best to limit your intake.
• Quit Smoking and Tobacco Use: Tobacco is a common cause of dry mouth.
• Maintain Good Oral Hygiene: Brush and floss regularly. Use a fluoride toothpaste and visit your dentist for regular check-ups.
• Use Mouthwash Designed for Dry Mouth: There are mouthwashes specifically made to treat dry mouth. Avoid products that contain alcohol.
• Breathe Through Your Nose: If you tend to breathe through your mouth, especially when you sleep, try to switch to nasal breathing.

When to See a Doctor

You should see a doctor or dentist if:

• Your dry mouth is persistent and causing discomfort
• You have difficulty chewing, swallowing, or speaking
• There’s a change in your sense of taste
• You have frequent sore throats or mouth sores
• You experience an increase in tooth decay or gum infections

Bottom Line

In conclusion, dry mouth is a common condition that can be caused by various factors including medications, medical treatments, and underlying health conditions. Dry mouth is more than just an uncomfortable condition; it can have serious consequences for oral health if not managed effectively. It’s important to recognize the symptoms of dry mouth and seek treatment to avoid complications related to oral health. Managing dry mouth typically involves addressing its underlying cause, using saliva substitutes, and making lifestyle changes such as drinking more water and avoiding tobacco and alcohol.

This article is complete and was published on June 26, 2023, and last updated on December 26, 2023.