Dry Mouth (Xerostomia)

Overview

Dry mouth (xerostomia) is a condition in which your salivary glands produce insufficient saliva to keep your mouth moist and comfortable. Dry mouth is a very common side effect of certain medications, a natural part of the aging process, and a side effect of cancer treatment with radiation therapy. A condition affecting the salivary glands can cause dry mouth, but this is an extremely rare occurrence.

Saliva helps prevent tooth decay by neutralizing bacteria’s acids, limiting bacteria’s growth, and washing food particles out of the mouth. Saliva also enhances your sense of taste and facilitates the chewing and swallowing of certain foods. Additionally, saliva contains digestive enzymes that aid in the digestion process.

Reduced salivation and dry mouth are minor annoyances in some cases, but they can have a significant impact on your overall health, the health of your teeth and gums, as well as your appetite and enjoyment of food.

Diabetes frequently manifests itself through decreased salivation and a dry mouth.

Prior to initiating dry mouth treatment, it is necessary to ascertain and address the root cause of dry mouth.Your doctor may adjust your medication’s dosage or switch you to another medication that does not cause dry mouth if he or she believes that the medication you are taking is causing the problem.

Mouth rinses, artificial saliva, and mouth moisturizers are readily available options for treating dry mouth. It is possible that mouthwashes for dry mouth, particularly those containing xylitol, will be effective. Several products help to prevent tooth decay while also alleviating dry mouth symptoms.

Prevalence:

The prevalence of dry mouth varies according to factors such as medication (e.g., antihypertensives, antihistamines, and antidepressants), aging, medical conditions (e.g., Sjögren’s syndrome, diabetes, autoimmune disorders), cancer treatments (radiation and chemotherapy), dehydration, and nerve damage caused by injury or surgery.

Causes

Some of the dry mouth causes are discussed below:

• Medicines: Hundreds of drugs have been linked to dry mouth as a harmful side effect in some patients. Antihistamines, decongestants, muscle relaxants, and pain relievers that are used to treat conditions like depression, high blood pressure, and anxiety may cause constant dry mouth.
• Cancer treatment: Chemotherapy medications can alter the nature and volume of saliva produced. This is most likely a transient symptom, and normal salivary flow will restore upon completion of the medication. Salivary glands can become inflamed as a result of head and neck radiation treatments, resulting in a significant decrease in saliva production leading to dry mouth and throat. This effect may be temporary or permanent, depending on the dose of radiation and the area treated.
• Age: Having a dry mouth is a common aging symptom that affects a big proportion of the general population. Other factors contributing to this symptom include changes in the body’s ability to metabolize medicines, inadequate nutrition, and long-term health concerns.

Having a dry mouth at night is a common symptom of getting older, especially in adults over the age of 65. This is due to the fact that our saliva production drops as we get older. Perhaps you are experiencing difficulty breathing because of a nasal obstruction, which requires you to breathe solely through your mouth at night.

• Illnesses and health condition: Dry mouth is caused by diabetes, stroke, yeast infection in the mouth, Alzheimer’s disease, and anxiety. Dry mouth can be caused by breathing through your mouth or sleeping with your mouth open. It may lead to waking up with dry mouth.

The dry mouth symptom may be the first symptom of COVID 19. A virus that attacks the oral mucosa and muscle fibres of the patient causes Xerostomia. Other dry mouth symptoms include feeling of stickiness, dry or sore throat, change in taste sensation, hoarseness, bad breath and dry tongue.

Dry mouth is also one of the most common pregnancy symptoms. This is primarily due to the fact that pregnant women require significantly more water to aid in the growth of their child. Another possibility is that hormonal fluctuations are interfering with your oral hygiene.

Symptoms

Dry mouth, or xerostomia, is characterized by various unpleasant symptoms. Individuals suffering from this illness generally experience persistent dryness and stickiness in their mouths, sometimes accompanied by increased thirst due to the lack of saliva. Because saliva is required to facilitate these activities, more than sufficient saliva can make swallowing and speaking more difficult. A dry mouth can cause cracked lips and painful ulcers in the corners of the mouth, reducing daily comfort even further. Disturbing altered taste perceptions might occur, such as a metallic or bitter flavor. 

Furthermore, decreased saliva production increases the risk of foul breath (halitosis), makes people more susceptible to mouth and throat infections like thrush, and raises the possibility of dental problems like cavities and gum disease. These symptoms can range in severity and are frequently suggestive of underlying issues that should be addressed through symptom management and root-cause treatment.

Diagnosis

The following tests may be used to determine the underlying cause of dry mouth:

1. Medical History: Discussing your medical history and current medications.
2. Physical Exam: A healthcare provider may examine your mouth for symptoms of dryness and other problems.
3. Salivary Flow Tests: Determine the degree of dry mouth by measuring saliva production.
4. Blood Tests: These tests can help identify the underlying medical disorders that contribute to xerostomia, such as diabetes or autoimmune diseases.
5. Imaging: Ultrasound or MRI may be utilized to assess salivary gland function in some circumstances.

Treatment

Dry mouth treatment may include addressing the underlying cause and managing symptoms. Typical approaches include:

1. Oral Hygiene: Maintaining proper oral hygiene and scheduling frequent dental check-ups helps avoid dental problems.
2. Saliva replacements: To relieve dryness, use over-the-counter or prescription saliva replacements.
3. Medication Review: Changing or adjusting drugs that cause xerostomia.
4. Changes in Lifestyle: Drinking extra water, using a humidifier, and avoiding coffee and alcohol will help relieve symptoms.
5. Prescription Medications: Medications that promote saliva production may be prescribed in some circumstances.
6. Treatment of Underlying illnesses: Managing underlying medical conditions such as diabetes or Sjögren’s disease can aid in the relief of dry mouth.

Individualized treatment strategies should be explored with a healthcare professional based on the condition’s origin and severity.

When To See A Doctor

If you are experiencing severe dry mouth symptoms, seek medical attention as soon as possible.You should consult your physician in case of having constant dry mouth. Moreover, if you suspect any tooth decay, you should visit your healthcare provider. It is important to consult your dentist if you have had a dry mouth for a lengthy period of time to rule out any signs of tooth decay.

Call your doctor to schedule an appointment if you suspect that your drugs are causing your dry mouth, or if you notice any other symptoms that indicate an underlying problem that requires treatment.

To discover the cause of your dry mouth and select the right treatment, your doctor may perform blood tests and measure the amount of saliva you produce.

Summary 

Dry mouth (xerostomia) occurs when the salivary glands do not produce enough saliva to keep the mouth moist, leading to discomfort and potential health issues. Studies estimate that 10% of the general population suffers from xerostomia, with prevalence rising to 30% among older adults. Common causes include medications, aging, cancer treatments, and health conditions like diabetes. Saliva is crucial for preventing tooth decay, aiding digestion, and enhancing taste and swallowing. Reduced saliva production can result in a range of symptoms such as a sticky mouth, sore throat, difficulty swallowing, altered taste, cracked lips, and bad breath.

Xerostomia is often linked to medications. Approximately 80% of individuals aged 65 and older take at least one prescription drug, many of which, like antihistamines, decongestants, and antidepressants, can cause dry mouth as a side effect. Cancer treatments like chemotherapy and radiation, which affect about 60% of patients undergoing head and neck radiation, can temporarily or permanently reduce saliva production. Aging naturally reduces saliva flow, and conditions like diabetes, which affects over 37 million people in the U.S., Alzheimer’s disease, and oral infections can also contribute to dry mouth.

Treating dry mouth involves addressing the root cause, such as adjusting medications or managing underlying health conditions. Over-the-counter products like mouth rinses, artificial saliva, and saliva-stimulating medications can help relieve symptoms. Proper oral hygiene, staying hydrated, and avoiding substances like alcohol and caffeine are beneficial. Studies show that xylitol-containing products not only alleviate dry mouth but also reduce the risk of cavities by 30-85%.

Diagnosis typically includes a medical history review, physical examination, salivary flow tests, and blood tests to identify contributing factors like diabetes or autoimmune disorders such as Sjögren’s syndrome, which affects 0.5-1% of the population. Patients experiencing persistent dry mouth, especially if it impacts dental health, should consult a healthcare provider. Early diagnosis and treatment are essential to prevent complications, including a 64% increased risk of dental decay and gum disease.

In severe cases, prescription medications may be needed to stimulate saliva production, and managing underlying conditions is crucial for long-term relief.

-Disclaimer-

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about dry mouth or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.