Dry Mouth

What is dry mouth?

Dry mouth or xerostomia is a condition in which the salivary glands do not function properly.  In some cases, there is some limited salivary flow. In others, there is no salivary flow at all.  At rest (when not eating), your body is supposed to produce more than 1/10mL of saliva per minute, and when chewing, more than 7/10mL of saliva per minute.  Anything less than this is considered dry mouth.  Some people can tell when their mouth feels dry, but others are unaware of it.  If you’re not sure, ask your dentist, hygienist or dental assistant.  As dental professionals, they know what normal salivary function looks and feels like and will be able to tell you if your mouth is normal or dry.

What causes dry mouth?

The causes of dry mouth vary, and the most common form of dry mouth is medication-induced.  According to the Surgeon General’s Report on Oral Health in America, more than 400 over-the-counter and prescription medications contribute to dry mouth!  The more medications you take, the worse the dry mouth can be.  The risk for decreased salivary function also increases as you get older, which can be compounded by the prescription medications you take.

Another common cause of dry mouth is damage to the salivary glands by radiation therapy for the treatment of head and neck cancers.  There is also some evidence of dry mouth caused by certain chemotherapies, and these tend to be temporary, resolving once the chemotherapy is discontinued.  Radiation therapy, however, can create permanent dry mouth by killing cells in the parotid salivary glands, if they are in the target area for the radiation.  There is an FDA-approved drug shown to decrease the risk of salivary damage from radiation therapy if it is administered IV 15-30 minutes before radiation therapy.  If you find yourself in need of head & neck radiation therapy, ask your doctor about Amifostine!

The other causes of dry mouth can be grouped into one section of systemic or autoimmune diseases.  This means that the dry mouth is simply one symptom of a disease that can affect multiple systems of the body.  Sjögren’s disease causes severely dry mouth and dry eyes, along with many other symptoms.  Dry mouth is also a symptoms of diseases like Cystic Fibrosis, Hep C, HIV/AIDS, and can be a complication of hormone changes or head and neck injury.

What are the important functions of saliva?

  • The first step in digestion via enzymatic breakdown of food
  • Maintenance of a neutral pH in the mouth
  • Protection of the teeth and gums against bad bacteria and fungus
  • Lubrication of the cheeks, tongue, floor of mouth and lips

What are the dangers of dry mouth?

  • Improper chewing and digestion of food à increased risk of choking and decreased nutritional absorption of food
  • A prevailing pH in the mouth that is acidic à increased risk of tooth erosion and cavities, especially at the gumline and on root surfaces that may be exposed by gum recession
  • An increased accumulation of bacterial plaque à increased risk of cavities, gingivitis, periodontal disease, and fungal infections
  • Increased risk of mouth ulcers, sores, cheek- and tongue-biting, and increased discomfort of removable partials or dentures

What can you do about dry mouth?

  • Talk to your medical doctor. Confirm that you are on the proper dose of all of your medications.  Ask if any could be lowered or redistributed to taking smaller doses more frequently instead of very large doses once per day.  If your dry mouth is severe, discussed the possibility of taking a salivary stimulant prescription that could increase your body’s production of saliva.  Caution: this would involve taking an additional prescription medication, which also has its own series of side effects.  This should only be considered in an extreme case.
  • Stimulate natural saliva production! The very best way to do this is by chewing sugar-free gum with a strong flavor.  Our favorite is Ice Cubes, which contains up to 2g of xylitol per piece.  You can also use sugar-free mints if you have any concerns with chewing gum; research studies have shown the salivary stimulation is much higher with chewing gum than using mints.
  • Stay away from other mouth-drying irritants like alcohol, tobacco, and caffeine! This includes alcohol-containing mouthwashes. Check the label of the mouthwash you are using to see if it contains alcohol.  If your mouth is dry, try a mouthwash like Biotene.
  • Don’t miss a dental visit! Because of the increased risk for cavities and gum disease, it is even more important that you have consistent visits with your dentist and dental hygienist.  Follow your dentist’s recommendations for oral care products.  Most likely, he will recommend a prescription fluoride toothpaste or gel to be used daily and a professional fluoride varnish application at your teeth cleaning visits to strengthen the teeth and make them less susceptible to cavities.  He may also recommend more frequent teeth cleanings to fight against the increased accumulation of plaque.

Do You Suffer from Dry Mouth?

Call our office at 940-382-1750 today to schedule a consultation with Dr. Chowning.  He will evaluate the quantity and quality of your saliva, and give you recommendations on taking great care of your mouth.

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