Xerostomia or dry mouth syndrome

Saliva is essential for keeping the mouth moist and plays an important role in maintaining oral health, as well as in the digestive process. As such, saliva prevents the growth of bacteria in the mouth and helps to neutralise acids in the oral cavity, thereby preventing the development of tooth decay. At the same time, saliva has the ability to prevent infections by controlling the bacteria and fungi in the oral microbial flora.

When the salivary glands do not produce enough saliva, the mouth becomes dry and a feeling of discomfort arises. Below, you will find out everything about xerostomia, or dry mouth syndrome.

A dry mouth may be caused by an underlying condition, may arise as a result of lifestyle factors – diet, hydration, and the use of various substances – or as a side effect of certain treatments. Here are the most common causes of this symptom:
 

Medications

Dry mouth is a common side effect of both prescription and over-the-counter treatments. These include medication for depression, anxiety, pain, allergies and the common cold – antihistamines and decongestants – as well as for obesity, acne, epilepsy, high blood pressure — diuretics, gastric problems such as loose stools or nausea, psychotic disorders, urinary incontinence, asthma or Parkinson’s disease. Dry mouth can also be a side effect of sedatives and muscle relaxants.
 

Cancer treatments: chemotherapy and radiotherapy

Damage to the salivary glands can lead to a decrease in saliva production. This can occur as a result of radiation to the head and neck from cancer treatments such as chemotherapy and radiotherapy.
 

Dehydration

Conditions or symptoms leading to dehydration, such as fever, excessive sweating, vomiting and gastrointestinal disorders manifesting as loose stools, blood loss, or heatstroke and burns, can cause a dry mouth.
 

Substance use or abuse

Habits such as smoking, tobacco use or the use of various substances can affect the properties of saliva and lead to dehydration, intensifying the symptom of a dry mouth.
 

Hormonal fluctuations associated with ageing

Dry mouth can also be caused by ageing and the associated hormonal changes – the menopause and andropause. Furthermore, chronic conditions associated with ageing and the treatments for these can contribute to the sensation of a dry mouth.
 

Other conditions

Dry mouth can be a side effect of other conditions, including HIV infection, Sjögren’s syndrome, diabetes, anaemia, cystic fibrosis, rheumatoid arthritis, high blood pressure, strokes, mumps, as well as Alzheimer’s and Parkinson’s diseases.

At the same time, dry mouth can result from damage to the nerves in the head and neck area, caused either by surgery or an accident. A deviated septum is another condition that can cause dry mouth at night, as people with this condition often sleep with their mouth open.

The symptoms of xerostomia are:

• A dry mouth and thirst;
• Increased viscosity of saliva;
• A sticky sensation in the mouth;
• Bad breath;
• Sores on the tongue and at the corners of the mouth, and chapped lips;
• Diminished sense of taste;
• A bitter taste;
• Dry throat and tongue;
• Hoarseness;
• Dizziness;
• Difficulty speaking and swallowing food (difficulty chewing and swallowing);
• Discomfort when wearing dentures.

If left untreated, xerostomia can lead to a number of complications. A dry mouth can cause tooth decay, as insufficient saliva will no longer protect the teeth against bacterial growth. At the same time, increased acidity can damage tooth enamel and contribute to this complication.

In turn, untreated tooth decay may necessitate the placement of fillings by a dentist, as well as the extraction and replacement of the natural tooth with a dental implant, should the tooth be beyond saving due to the depth of the decay. This is precisely why it is necessary to visit the dentist at least twice a year to prevent such situations and costly treatments.

In addition to causing the symptoms mentioned above, dry mouth also increases the risk of gingivitis and oral infections, such as mouth ulcers. Furthermore, if a person is diagnosed with xerostomia (dry mouth), this may make it difficult to wear dentures.

Treatment for dry mouth may vary depending on the cause of xerostomia. If it is caused by an underlying condition, your doctor will recommend medication to increase saliva flow. If it is caused by medication, your doctor may recommend changing the treatment or reducing the dosage (for example, in the case of antihistamines and decongestants).
 

Recommendations for balancing saliva flow

Sugar-free sweets and chewing gum, particularly those containing xylitol, can stimulate saliva production. However, avoid acidic ones containing citrus extracts, as these can damage tooth enamel. Sugar-free ice cream or even ice can also help balance saliva production. To reduce the risk of tooth decay, consume these products in moderation; even if they are sugar-free, they can affect tooth enamel.

Stay properly hydrated and drink water to keep the oral mucosa moist and keep your mouth wet.

Use a toothpaste and mouthwash containing fluoride and avoid those containing alcohol or peroxide, as these ingredients can intensify the sensation of a dry mouth.

Other recommendations for balancing saliva flow:

• Breathe through your nose as much as possible and through your mouth as little as possible;
• Use a room humidifier;
• Use a saliva substitute (gel or spray);
• Eat soft, easy-to-swallow foods with moist or lubricating ingredients, such as soups, sauces, cream or butter. Opt for cold or room-temperature dishes.
• Avoid salty, very dry or bland foods, and those containing sugar (including drinks).
• Avoid alcohol and caffeine, as both substances can cause dehydration.
• Avoid acidic drinks, such as orange, apple, grape or tomato juice.

Recommendations for minimising mouth irritation

To prevent sores on the tongue and at the corners of the mouth, it is recommended that you:

• Limit your intake of salty and spicy foods;
• Give up smoking;
• Use a moisturising lip balm;
• Use a soft toothbrush that is gentle on your teeth and gums;
• Rinse your mouth before and after meals with drinking water or a diluted mouthwash solution.

Can you have a dry mouth even if you drink enough water?

Dehydration is not the only possible cause of xerostomia, so you can still suffer from a dry mouth even if you drink enough water and consume fluids.
 

Can a dry mouth be a symptom of another condition?

A dry mouth may indicate the presence of conditions such as diabetes, a deviated septum, anaemia, rheumatoid arthritis, cystic fibrosis or high blood pressure. At the same time, dry mouth is a specific symptom of Alzheimer’s, Parkinson’s and Sjögren’s syndrome. Strokes, as well as mumps, can manifest as a sensation of dryness in the mouth and throat.
 

Why is dry mouth a problem and how can it affect you?

Dry mouth can lead to tooth decay, mouth ulcers and conditions such as gingivitis. That is why it is important to book an appointment with your dentist as soon as the first symptoms appear, so that the dentist can determine whether it is xerostomia and prescribe the appropriate treatment.

References:

1. WebMD. (n.d.). Dental health: Dry mouth.
2. Medical News Today. (n.d.). What are mouth ulcers?
3. Cleveland Clinic. (n.d.). Dry mouth (xerostomia).
4. MedicineNet. (n.d.). Dry mouth.