Dry mouth, which in medical terms is known as Xerostomia, can cause severe discomfort to the individual suffering from it. In this article, we will discuss the causes and the simple remedies that can ease the symptoms.
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 digestion. It is a buffer solution and helps in maintaining the mouth's pH.
Oral Hygiene: It helps prevent dental caries and gum diseases, as it has a flushing action inside the mouth. It helps in the continuous flushing of the debris and pathogens from the teeth and gums. It also aids in the remineralization of teeth, as it contains many minerals like calcium, fluoride, phosphorus, etc.
Lubrication: It keeps the oral mucosa moist and hydrated, preventing the oral cavity 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 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.
The term is derived from a Greek word, where Xero means dry, and Stoma means mouth. Xerostomia is a medical term that refers to a subjective complaint of dry mouth resulting from reduced salivary production by the salivary glands. Reduced salivary production is not sufficient to keep the oral cavity wet.
This condition is more commonly seen in females. It can affect the life of the individual suffering from it and cause considerable discomfort, which can cause severe anxiety and hamper the quality of life. It can affect about 15 to 20% of the population.
It can be due to a single or multiple causes. It increases the urge to drink more water, which never feels satisfied, and makes the saliva thick, stringy, and mucous-like.
The following are the causes of dry mouth:
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 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, antidepressants, etc. The side effects resolve gradually when the medication intake is stopped.
Nerve Damage: Surgeries of the head and neck can damage nerves that supply the secretomotor fibers to the salivary glands and cause severe dry mouth.
Severe Dehydration: Deficient water intake can even reduce the watery nature of saliva, causing dry mouth and making the saliva thick.
The conditions which cause dry mouth are the following:
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.
Oral thrush or yeast infection of the mouth.
The mucous membranes inside the mouth can appear thinned out or atrophic, pale, ulcerated, or fissured.
There can be a foul 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 the 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 difficulty in speaking words.
Painful chewing and swallowing.
Increase in frequency of fungal infection in mouth and tongue causing oral thrush.
Throat irritation and dryness.
Sticky and stringy saliva.
Painful tongue or glossodynia,
Difficulty in chewing and swallowing dry and crumble foods.
Patients who wear dentures experience problems like poor denture retention, formation of denture sores, and sticking of the tongue to the palate.
Salivary gland infection or sialadenitis.
Frequent gum infections.
Increased thirst, especially at night.
Dysgeusia or taste disorders.
Sialography: An x-ray based examination of salivary glands and their ducts to rule out stones and other forms of obstructions.
Sialometry: In this procedure, saliva is collected by placing a 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 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, you should consult your physician to either reduce the dose of the medicine or change it to a drug that is less likely to cause dry mouth.
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.
Use fluoridated toothpaste and fluoride-containing oral rinse prescribed by your dentist.
Avoid sticky or sugary, or spicy food.
Do not use tobacco products in any form like chewing or smoking tobacco because they can increase dryness and cause irritability.
Try breathing through your nose and avoid mouth breathing.
Avoid caffeine and alcohol that can increase the dryness and irritation associated with dry mouth.
Do not use over-the-counter decongestants and antihistamine medication as these can further increase the dryness.
Drink water or sugar-free candies and suck ice chips to moisten your oral cavity.
Use over-the-counter salivary substitutes like Xylitol, Carboxymethylcellulose, or Hydroxyethylcellulose.
Use a room humidifier to keep the room moist while you are sleeping.
Use a moisturizer for your lips to avoid cracked lips.
You can chew sugar-free chewing gums and suck tart or sour candies, as they help stimulate saliva flow.
Certain oral moisturizing gels containing lubricating, antibacterial, and antifungal properties can be advised, such as an oral base. These help in keeping the oral cavity moist.
Avoid regular alcohol-containing mouthwashes as they have a drying effect on the mouth. Specialized mouthwashes containing Methylcellulose like Biotene mouthwash should be used for gargling.
There are also kinds of toothpaste that can be used for dry mouth.
Some prescription medications are also available, which help in increasing saliva production. Pilocarpine and Cevimeline are the generic names of the drugs used to enhance saliva in the mouth. Cevimeline sold under the brand name Evoxac is used to treat dry mouth in Sjogren’s syndrome. Sjogren’s syndrome is an autoimmune condition characterized by dry eyes, dry mouth, dry skin, and muscle aches.
There are also new treatments in the study for the treatment of dry mouth. Scientists also are studying the possibility of replacing the diseased salivary gland with an artificial salivary gland.
Oral thrush or yeast infection of the mouth.
Increases the risk of gum diseases and dental cavities by increasing plaque deposition.
Difficulty in chewing and swallowing, which eventually leads to poor nutrition.
Dry mouth can be managed with supportive or palliative treatment, so individuals suffering from dry mouth should not lose hearts. Follow the instructions given by your dentist, which can help you manage a dry mouth.
Dry mouth or xerostomia occurs due to diabetes, oral thrush, stroke, Alzheimer's disease, Sjogren's syndrome, alcoholism, using tobacco, mouth breathing, HIV/AIDS, etc.
Drinking adequate water, stopping medications that cause xerostomia, using sugarless candies and chewing gums, maintaining good oral hygiene, rinsing with xylitol-containing mouthwashes, avoiding mouth breathing, and using over-the-counter salivary substitutes help in overcoming dry mouth. In cases with severe dry mouth, the dentist may recommend Pilocarpine or Cevimeline medication to stimulate salivary secretion.
Dry mouth or xerostomia at night is mainly due to nasal blocking, which causes snoring or breathing through the mouth. As age progresses, the rate of salivary production decreases, resulting in dry mouth.
- Using a room humidifier.
- Avoiding acidic or spicy foods for dinner.
- Eating dinner at the appropriate time.
- Avoiding alcohol and tobacco.
- Keeping a glass of water near the bed and sipping it when there is thirst or dry mouth.
- Using nasal decongestant sprays to relieve nasal congestion to enable mouth breathing.
- Using alcohol-free mouthwashes.
- Using sugar-free candies and chewing gums.
- Maintaining good oral hygiene.
- Tricyclic antidepressants.
In case of paralysis of the facial nerve or facial palsy, the parasympathetic branch of the facial nerve is affected, which supplies the sublingual and submandibular salivary glands. It results in decreased salivary secretion resulting in dry mouth.
Neuroleptics or antipsychotic drugs have an anticholinergic effect on the salivary glands, thereby decreasing saliva production. These drugs block acetylcholine which is an essential messenger for the salivary glands that regulate salivary secretion.
Even after drinking excessive water, if there is dry mouth or xerostomia, it results from reduced salivary production.
The deficiency of vitamin A and B12 causes dry mouth, burning sensation, and inflammation of the sides of the mouth.
Although xerostomia itself is not a severe condition, it can sometimes be due to an underlying chronic medical condition that requires medical intervention. Further, it causes dental complications like dental caries, periodontal diseases, malodor, loss of taste sensation, etc., which might need dental treatment.
Chemotherapy causes dry mouth which usually returns to normal after a couple of months, but in few cases, it may last from six months to one year.
Dry mouth or xerostomia is often associated with a sore throat, burning sensation, speech impediment, swallowing difficulty, and dry nasal passages.
Mouthwashes help improve the overall oral hygiene and have a role in treating dry mouth. Mouthwashes containing Xylitol help enhance the salivary production whereas alcohol mouthwashes should not be used in the dry mouth as it hampers the production of saliva.
Last reviewed at:
14 Dec 2021 - 6 min read
Query: Hello Doctor, I am 19 years old. My teeth are yellow from childhood (from 10 years of age). A black layer is formed at the backside of teeth. When I see my teeth it seems very dirty and too much of creamy layer is formed on my teeth especially in lower canines and lower incisors. In the lower teeth... Read Full »
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