In this article we will discuss a common dental problem…
Put simply, dry mouth is a lack of saliva, or reduction in it’s flow. It is also termed xerostomia (pronounced z-erostomia) and is a common complaint. It is often seen as a sign of ageing and put down to ‘getting on in years’, but this is not the case. Yes, we are more likely to get it as we get older, but this is due to medications, other illness and conditions. So don’t disregard this condition as due to ‘getting old’, instead seek help from your doctor or dentist.
Why is saliva so important?
Saliva performs some very important functions, working away without out noticing it (until we get dry mouth). Such functions include:
- Keeps the oral cavity clean with it’s washing action.
- Reduces plaque bacteria with an antibacterial action.
- Lubricates to help with chewing food and speaking.
- Initiates the digestion of certain food groups.
So if there is a reduction in salivary flow we can experience a range of symptoms…
Dry Mouth Symptoms
Obviously, one’s mouth will feel ‘dry’. But there are also a range of other signs and symptoms that may be produced, based on the above salivary functions not being performed:
- A sticky, dry feeling of the oral ‘soft tissues’. This includes the lips, tongue, gums, inner cheeks and sometimes back into the throat. Hence the occasional term ‘cotton mouth’.
- Difficulty in eating and speaking, as saliva plays a key role here. Difficulty swallowing – dysphagia – can occur
- Reduction or alteration in taste sensation (dysgeusia). Some complain of a bad, bitter or metallic taste in the mouth
- Halitosis (bad breath) – More here
- Difficulty wearing dentures, as saliva is important in keeping them in place. This is especially true of complete dentures
- A burning sensation, often most noticeable on the tongue
- Cracks at the corner of the lips and sores on the inner oral soft tissues.
Symptoms may be worse at night as salivary flow naturally decreases when we are sleeping.
Xerostomia also puts one at much greater risk of oral disease. So one may get symptoms of decay (such as toothache, broken teeth and discoloration) and/or of gum disease (such as bleeding gums, recession and in severe cases loose teeth). Soft tissue inflammation such as stomatitis and mucositis are more common with xerostomia.
What Causes Xerostomia?
There are a range of factors that can lead to dry mouth, including:
- Medical conditions such as uncontrolled diabetes and Sjögren’s syndrome (where one can also have dry eyes – xerophthalmia – and anhidrosis)
- Several groups of medications, both prescribed and over-the-counter
- Drug abuse, alcohol and tobacco
- Other causes include anxiety, dehydration and caffeine.
See our page on dry mouth causes for more detailed advice.
How is the problem treated?
The first stage is diagnosing the cause and, if possible, eliminating or reducing it. This may involve, say, a change of medication or trying to control diabetes better.
If it is not possible to alter the cause of the condition, then the treatment involves a salivary stimulant to try increasing flow, and/or ‘artificial saliva’ to reduce the symptoms. There are several things one can do at home such as sipping water, chewing sugar free gum or a variety of sprays (eg aquoral) and lozenges are available. Pilocarpine (salagen) may be prescirbed to try to increase saliva flow.
For more advice see the following page on treatment options.
Limiting the effects of dry mouth
As mentioned above, one of the big dangers of this condition is that it puts one’s mouth at much greater risk of tooth decay and gum disease. So it is really important to look after your teeth if you have xerostomia. Make sure that you:
- Brush twice daily, using a fluoride toothpaste
- Clean between the teeth with floss, interdental brushes or a waterpik water flosser
- Use a fluoride mouthwash after the above. Click here for more advice
- Limit the amount and frequency of sugar in your diet.
See our guide to keeping your teeth healthy for more advice.
Dry mouth is a common condition, and one that can lead to a variety of distressing symptoms for those that suffer with it. Always seek medical advice if you develop the problem. In particular, do not ignore it and put it down to ‘ageing’.