Xerostomia or dry mouth syndrome
Causes, symptoms, treatment
Saliva is essential for keeping the oral cavity moist and plays an important role in ensuring oral health as well as digestive function. It prevents the proliferation of germs in the mouth and helps neutralize acids in the oral cavity, thus preventing tooth decay. Additionally, saliva has the property of preventing infections by controlling the bacteria and fungi in the oral microbiome.
When the salivary glands do not produce enough saliva, the mouth becomes dry, and discomfort occurs. Below, you will learn everything about xerostomia or dry mouth syndrome.
What is xerostomia or dry mouth syndrome?
Dry mouth or xerostomia is a condition characterized by the sensation of insufficient saliva. It is more of a symptom of an underlying condition rather than a condition itself. Most often, it is a side effect of certain medications such as antihistamines or decongestants used for allergies and colds.
Causes leading to symptoms of dry mouth
Dry mouth can be caused by a pre-existing condition, lifestyle factors such as diet, hydration, and the use of various substances, or as an adverse 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 medications. These include treatments for depression, anxiety, pain, allergies, and the common cold—such as antihistamines and decongestants—as well as medications for obesity, acne, epilepsy, hypertension (diuretics), gastric issues like diarrhea or nausea, psychotic disorders, urinary incontinence, asthma, or Parkinson's disease. Dry mouth can also occur as a side effect of sedatives and muscle relaxants.
Cancer treatments: chemotherapy and radiation therapy
Damage to the salivary glands can reduce saliva production. This may occur as a result of radiation treatment to the head and neck, such as chemotherapy and radiation therapy for cancer.
Dehydration
Conditions or symptoms leading to dehydration such as fever, excessive sweating, vomiting, gastrointestinal issues that result in diarrhea, blood loss, or heatstroke and burns can cause the sensation of dry mouth.
Substance use or abuse
Habits such as smoking, tobacco use, or the consumption of various substances can affect saliva properties and lead to dehydration, exacerbating the dry mouth symptom.
Hormonal fluctuations associated with aging
Dry mouth can also be caused by aging and the hormonal changes associated with it—such as menopause and andropause. Additionally, chronic conditions related to aging and the treatments for these conditions can contribute to the sensation of dry mouth.
Other conditions
Dry mouth may be a side effect of other conditions, including HIV infection, Sjogren's syndrome, diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, strokes, mumps, as well as Alzheimer's and Parkinson's diseases.
Additionally, dry mouth can result from nerve damage in the head and neck area caused by surgery or an accident. Septal deviation is another condition that may cause dry mouth at night, as people with this condition often sleep with their mouths open.
Dry mouth: symptoms
Symptoms of xerostomia are:
- Feeling of dry mouth and thirst;
- Increased viscosity of saliva;
- Sticky feeling in the mouth;
- Bad breath;
- Lesions on the tongue and corners of the mouth, and cracked lips;
- Diminished taste;
- Bitter taste sensation;
- Dry throat and tongue;
- Hoarseness;
- Dizziness;
- Difficulty in speaking and ingesting food (chewing and swallowing difficulties);
- Discomfort when wearing dentures.
Dry mouth: complications
If left untreated, xerostomia can lead to numerous complications. Dry mouth can cause tooth decay, as insufficient saliva will no longer protect the teeth against bacterial growth. Additionally, increased acidity can damage tooth enamel and contribute to this issue.
Untreated cavities may require restorative fillings provided by a dentist and, in severe cases, extraction and replacement of the natural tooth with a dental implant if the tooth cannot be saved due to the depth of the decay. For this reason, visiting a dental office at least twice a year is essential to prevent such situations and costly treatments.
In addition to causing the symptoms mentioned above, dry mouth also increases the risk of developing gingivitis and oral infections, such as canker sores. Furthermore, if a person is diagnosed with xerostomia, it may also make wearing dentures more difficult.
Dry mouth: treatment and recommendations
Treatment for dry mouth can vary depending on the cause of xerostomia. If it is caused by an underlying condition, the doctor will recommend medications to increase saliva flow. If it is caused by medication, the doctor may recommend changing the treatment or reducing the doses administered (for example, in the case of antihistamines and decongestants).
Recommendations for balancing saliva flow
Sugar-free drops and chewing gum, especially those containing xylitol, can stimulate saliva production. However, avoid acidic ones that contain citrus extracts, as these can damage tooth enamel. Sugar-free ice cream or even ice can also balance saliva production. To reduce the risk of dental caries, consume these products in moderation; even if they do not contain sugar, they can affect tooth enamel.
Stay properly hydrated and drink water to maintain low viscosity of the oral mucosa and to moisten the mouth.
Use toothpaste and mouthwash that contain fluoride and avoid those that contain alcohol or peroxide, as these ingredients can intensify the sensation of dry mouth.
Other recommendations for balancing saliva flow:
- Breathe as much as possible through your nose and as little as possible through your mouth;
- Use a room humidifier;
- Use a saliva substitute product (gel or spray);
- Consume soft and easy-to-swallow foods with moist or lubricating ingredients, such as soups, sauces, cream, or butter. Opt for serving cold and room temperature dishes.
- Avoid salty, very dry, or bland foods and those that contain sugar (including drinks).
- Avoid consuming alcohol and caffeine, as both substances can cause dehydration.
- Avoid acidic drinks, such as orange, apple, grape, or tomato juices.
Recommendations for limiting oral irritations
To prevent lesions on the tongue and corners of the mouth, it is recommended to:
- Limit the consumption of salty and spicy foods;
- Quit smoking;
- Use a moisturizing lip balm;
- Use a soft toothbrush, gentle on teeth and gums;
- Rinse your mouth before and after meals with drinking water or a diluted mouthwash solution.
Dry mouth: questions and answers
Can you have dry mouth if you have an optimal water intake?
Dehydration is not the only possible cause of xerostomia, so you can suffer from dry mouth even if you drink enough water and consume liquids.
Can dry mouth be a symptom of another condition?
Dry mouth can indicate the preexistence of conditions such as diabetes, deviated septum, anemia, rheumatoid arthritis, cystic fibrosis, or hypertension. Additionally, dry mouth is a specific symptom for Alzheimer's, Parkinson's, and Sjogren's syndrome. Strokes, as well as mumps, can manifest through the 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 the appearance of cavities, mouth sores, and conditions such as gingivitis. Therefore, it is important to schedule an appointment at the dental office as soon as the first symptoms appear, so the doctor can determine if it is xerostomia and establish appropriate treatments.