Xerostomia is a medical term which refers to a subjective complaint of dry mouth, resulting from reduced saliva production. The term is derived from a Greek word, where xero means dry, and stoma means mouth.
This condition is more commonly seen in females. It can affect the life of the individual suffering from it and can cause considerable discomfort, which can cause severe anxiety and hamper the quality of life. It can affect about 15 to 20% population. It can be due to a single or multiple causes. It not only increases the urge to drink more water which never feels satisfied, but also makes the saliva thick, stringy, and mucous-like.
What is Saliva?
Saliva is a clear watery fluid that is produced 24 hours a day by the salivary glands. It contains many minerals, antibacterial, and antifungal properties. Saliva also contains enzymes that help in digestion. It is a buffer solution and helps in maintaining the mouth's pH.
Functions of Saliva:
- Oral Hygiene: It helps in preventing dental caries and gum diseases, as it has a flushing action inside the mouth. It helps in continuous flushing of the debris and pathogens from the teeth and gums. It also aids in remineralization of teeth, as it contains many minerals like calcium, fluoride, phosphorus, etc.
- Lubrication: It keeps the oral mucosa moist and hydrated, which prevents them from thinning, ulceration, and inflammation. It also prevents the mucosa from getting injured during chewing and other oral activities.
- Swallowing: As the food is mixed with saliva while chewing, it converts the food into an easily swallowable bolus. With the help of saliva, one can chew as well as swallow without any pain or discomfort.
- Digestion: Due to the presence of salivary enzymes, saliva helps at the beginning of digestion right from the mouth itself.
- Maintains taste sensations: With the help of saliva, the chemicals present in food are carried to the taste buds, where the taste sense can be perceived. In the lack of saliva, the sense of taste can get disturbed and reduced.
Causes of Dry Mouth:
Many factors can cause dry mouth, which are as follows:
- Damage to Salivary Glands: Saliva is secreted by the salivary glands. Therefore, damage to salivary glands or surgical removal of the glands, due to some certain conditions like tumors, trauma to the salivary glands, ionizing radiations, etc. can damage the salivary glands, leading to a nonreversible dry mouth.
- Side effects of the medication: Dryness of mouth is the most common side effect of certain medicines. For example blood pressure medications, anti-allergics, decongestants, muscle relaxants, diuretics, anti-depressants, etc. The side effects resolve gradually when the medication intake is stopped.
- Nerve Damage: Surgeries of head and neck region can at times damage nerves that supply the secretomotor fibers to the salivary glands, and can cause severe dry mouth.
- Severe Dehydration:Very low water intake can even reduce the watery nature of saliva, causing dry mouth as well as makes the saliva thick.
- Sjogren’s Syndrome: It is an autoimmune disease, in which the immune system of the individual starts to damage the cells of salivary glands, tear glands, etc. leading to dry mouth.
- Other causes include diabetes, smoking, aging, stroke, chemotherapy, radiation therapy, mouth breathing, snoring, stroke, Alzheimer's disease, Parkinson's disease, etc.
Symptoms of Dry Mouth:
- The mucous membranes inside the mouth can appear thinned out or atrophic, pale, and ulcerated or fissured.
- There can be a bad smell coming from the mouth or bad breath.
- Lips can appear dry and cracked. Cracks at the corners of the mouth are also known as angular cheilitis.
- The teeth can be seen sticking to the cheeks and inner lips.
- There can be ulcers in mouth, inflammation, and pain.
- The tongue can lose papillae which contain taste buds, causing loss of taste. The tongue can become red and inflamed leading to a sore tongue.
- In extreme cases or long-standing dry mouth, there can be constant burning sensation and numbness in the mouth, leading to a condition known as burning mouth syndrome.
- There can be deposits over teeth, with an increase in tooth decay and gum diseases.
- There can be lisping or difficult in speaking words.
- Painful chewing and swallowing.
- Increase in frequency of fungal infection in mouth and tongue causing oral thrush.
- Throat irritation and dryness.
- Sialography: An x-ray based examination of salivary glands and its ducts, to rule out stones and other forms of obstructions.
- Sialometry: In this procedure, saliva is collected by placing collection device over the duct opening. Citric acid is used to stimulate saliva flow.
- Biopsy: It is helpful to check suspected causes like cancer and Sjogren's syndrome.
Management of Dry Mouth:
- Management of dry mouth will depend on the cause.
- Many a time, treating the underlying cause can help in relieving the symptoms.
- If dry mouth is due to a side effect of any medication, then you should consult your physician, so that he can either reduce the dose of the medicine or change it to a drug that is less likely to cause dry mouth.
- Certain medicines can stimulate saliva production, for example, Pilocarpine.
- You can chew sugar-free chewing gums, and suck tart or sour candies, as they are helpful in stimulating saliva flow.
- Certain oral moisturizing gels that contain lubricating properties along with antibacterial and antifungal properties can be advised, for example, Oral base.
- Avoid regular alcohol containing mouthwash as they have a drying effect in the mouth. Specialized mouthwashes containing Methylcellulose like Biotene mouthwash should be used for gargling.
- Go for a regular dental checkup, so that oral hygiene can be meticulously maintained, get the cavities filled and oral prophylaxis can be done for preventing tooth and gum infections.
- Avoid smoking, chewing tobacco, sticky or sugary or spicy food.
Dry mouth can be managed with supportive or palliative treatment, so individuals suffering from dry mouth should not lose heart.
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