Oral Care: Dry Mouth

Overview

Dry mouth, also known as xerostomia, is a common condition that results in your mouth feeling unusually dry due to decreased saliva production. Dry mouth can increase an individual’s risk of dental decay, infections, and periodontal disease because saliva aids in preventing tooth decay, limits bacterial growth, and washes away food particles. If left untreated, dry mouth can cause issues with speaking and swallowing. An estimated 29% to 57% of older adults experience some degree of xerostomia, but it can occur in anyone.

Signs and Symptoms

The severity of dry mouth varies from person to person, and common signs and symptoms include:

• Dryness in mouth or throat
• Saliva that seems thick and stringy
• Bad breath
• Difficulty chewing, speaking, and swallowing
• Changes in sense of taste
• Problems wearing dentures
• Frequent tooth decay/dental caries
• Gum irritation and gum disease
• Mouth sores
• Cracked lips
• Dry feeling in the throat

Causes and Common Triggers

A medical condition known as Sjögren’s syndrome is considered to be a major cause of dry mouth in many individuals. Moreover, a number of factors can cause or exacerbate dry mouth, including:

• Side effects of more than 400 medications, including decongestants, antihistamines, blood pressure medications, and antidepressants
• Radiation therapy
• Chemotherapy
• Nerve damage
• Poorly controlled diabetes
• HIV/AIDS
• Hormonal changes due to menopause
• Uncontrolled high blood pressure

Testing and Diagnosis

If you experience persistent episodes of dry mouth, you should consult your doctor or dentist to determine the cause. Your doctor or dentist will examine your mouth and review your medical and medication history. If warranted, blood tests or other tests may be ordered as well. While dry mouth can occur in anyone, treatment will be based on the underlying cause.

Prevention

Several steps can be taken to prevent the incidence of dry mouth, including:

• Sip water or sugarless drinks often
• Chew sugarless gum or suck on ice chips or sugarless candies to stimulate saliva production
• Avoid caffeine, alcohol, and tobacco, all of which can dry out the mouth
• Avoid salty or spicy foods that may cause pain if you have dry mouth
• Eat soft, moist foods that are cool or at room temperature
• Consider using saliva substitutes

Management

Proper management of dry mouth can decrease the incidence of tooth decay, gum disease, mouth sores, and infections. You can employ the following tips:

• Brush teeth at least twice daily with a fluoride toothpaste, and floss
• Use toothpaste specifically formulated for dry mouth when possible
• Use a fluoride rinse before bedtime
• Avoid mouthwashes that contain alcohol, which can contribute to dry mouth
• See your dentist at least every 6 months for teeth cleaning and an examination

Treatment and Care

Treatment goals for dry mouth include identifying and managing the cause of dry mouth when possible, preventing tooth decay, and increasing the flow of saliva when possible. The treatment selected depends on the cause. If dry mouth is caused by your medication, your doctor may change or adjust your medication or recommend products such as a saliva substitute to moisturize your mouth. If the dry mouth is severe, your doctor may prescribe a medication to treat your dry mouth.

Homeopathic and Alternative Remedies

Some individuals may elect to use alternative remedies. While the clinical data regarding their effectiveness are limited, some health care professionals may suggest:

• Taking natural herbal supplements or drinking teas made with slippery elm
• Breathing through your nose and not your mouth when sleeping
• Adding moisture to the air via a humidifier in your home

Self-Care

Various OTC artificial salvia substitutes and dry mouth relief products are available in the form of sprays, liquids, gels, mouthwashes, toothpaste, lozenges, and chewing gums to provide relief to individuals who experience dry mouth. Pharmacists can help you select the best formulation to meet your individual needs.

Resources for Patients

• American Dental Association
• Sjögren’s Syndrome Foundation

Resources for Pharmacists

• National Institute of Dental and Craniofacial Research
• GlaxoSmithKline
• The American Academy of Oral Medicine website
• Sjögren’s Syndrome Foundation