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Are you suffering from dry mouth?

July 18, 2017

 

Dry mouth, or ‘xerostomia’ is a condition in which the salivary glands in your mouth don’t make enough saliva to keep your mouth wet. Some may think that dry mouth is a normal part of aging but it isn’t.  However, tends to be more commonly found in older adults, mainly due to the number of medications older people may be taking.

 

Why do we need saliva?

Saliva protects and lubricates our mouth. It also:

• helps chewing, swallowing and talking
• protects the teeth against decay
• protects the mouth, teeth and throat from infection by bacteria, yeasts, and viruses and
• helps with our sense of taste

 

What causes dry mouth?

We all may get a dry mouth during the night, first thing in the morning, when we are stressed or when we are exercising in the heat. This is quite normal but there are other causes of dry mouth and these include:

• Medications – many prescription and over the counter medications cause dry mouth, including antihistamines, decongestants, anti-hypertensive medications (for high blood pressure), anti-diarrhoea tablets, muscle relaxants, urinary incontinence medications, some Parkinson’s disease medications, as well as a number of antidepressants.
• Some health conditions – the most common is poorly controlled diabetes, Sjögren’s syndrome, Parkinson’s disease and depression.
• Tobacco – either chewing or smoking tobacco increases the risk of dry mouth symptoms.

 

How is the dry mouth managed?

Management offered by your GP

Treatment for dry mouth depends on whether the cause is an underlying condition or disease, or induced by the medication that you are taking. If an underlying medical cause is found, your GP may try to manage the condition effectively to reduce or alleviate the symptoms. If a certain medication is the cause your GP may need to alter the dosage of the medication or even change the drug which may be responsible for the dry mouth. In more severe cases, the GP may decide to prescribe special medication to stimulate the production of saliva.

 

Management offered by the dentist

A patient with xerostomia should pay special attention to their oral and dental hygiene. This includes effective tooth brushing and interdental cleaning to remove plaque.  The dentist will assist with the treatment of gum infections, inflammation, and dental caries (decay). Brushing teeth and flossing regularly is really important.

1. Teeth: Lack of saliva also increases the risk for tooth-decay. Frequent dental examinations – twice a year and radiographs X-rays every 1 – 2 years, will reveal any cavities. The progression of decay in a dry mouth may be very fast and therefore the dentist may suggest that you should use prescription only high fluoride toothpaste (Duraphat 5000) to decrease your risk of getting decay or even suggest a fluoride varnish application.
2. Gums: The lack of saliva increases the susceptibility for gum infections. Daily tooth brushing and interdental cleaning to remove any plaque from the teeth is extremely important. Frequent visits to the dental hygienists (2 to 4 times a year) are recommended to improve and maintain your gum health.
3. Mouth Mucosa, Tongue and Lips: Difficulty swallowing food, changes in the sense of taste, a burning sensation or pain in the mouth and difficulty talking are some of the most severe symptoms of dry mouth. The dentist may suggest you use products which act as artificial saliva, saliva substitutes or oral moisturisers to alleviate or prevent such symptoms. Saliva substitutes are used as often as needed and although they do not cure dry mouth, they can provide temporary relief of symptoms. Alcohol-free mouth rinses, lozenges, and moisturizing oral sprays and gels are available as over the counter products for the care of dry mouth.
4. The dry environment in the mouth makes mouth infections easier to occur. Hence, any dentures should be kept out at night-time and cleaned properly to avoid any fungal infections of the roof of the mouth or corner of the lips (candidiasis). The dentist and dental hygienist will be able to diagnose these infections and offer you appropriate advice.

Above: Example of saliva substiture products available in the UK (Oralieve). 

 

Self-management at home

You can follow the following tips to relieve dry mouth symptoms:

• Sip water or sugar-free drinks or suck ice cubes throughout the day to moisten your mouth, and drink water during meals to help with chewing and swallowing.
• Chew sugar-free gum or suck on sugar-free hard sweets. Products that contain xylitol may also help prevent cavities. However, in some people, xylitol, which is often found in sugar-free gum or sugar-free candies, may cause gas or diarrhoea if consumed in large amounts.
• Try over-the-counter saliva substitutes that contain xylitol  or hydroxyethyl cellulose such as Biotene OralBalance Moisturizing Gel. 
• Breathe through your nose, not your mouth. You may need to seek treatment for snoring if it causes you to breathe through your mouth during the night.
• Add moisture to the air at night with a room humidifier.
• Moisturize your lips to soothe dry or cracked areas.

Avoid products that can make your symptoms worse. These include:

• Caffeine and alcohol. These products can cause dryness and irritation. Don’t use a mouthwash that contains alcohol.
• All tobacco. If you smoke or chew tobacco, stop, because tobacco products can dry and irritate your mouth.
• Over-the-counter antihistamines and decongestants. These can worsen your dry mouth.
• Sugary or acidic foods and sweets. These increase the risk of tooth decay. Also avoid spicy or salty food because they can cause irritation.

At Dee Shapland dental:

Our team of dentists, dental hygienists and oral health educator are trained to detect dry mouth and can often identify its presence long before you become aware of its existence. They will give offer you the appropriate care and tips and advice to help you achieve a healthy mouth.

 

 

 

TO FIND OUT MORE:

https://www.dentalhealth.org/tell-me-about/topic/mouth-conditions/dry-mouth

http://www.nhs.uk/conditions/dry-mouth/Pages/Introduction.aspx

 

 

 

 

This Blog has been written by Anastasios Plessas, Associate Dentist

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