Dry mouth: When is dry mouth serious?

Dry mouth is the condition of not having enough saliva to keep the mouth wet. This is due to inadequate function of the salivary glands. Everyone has dry mouth once in a while when they are nervous, upset or under stress. But if someone has a dry mouth most all of the time, it can be uncomfortable and lead to serious health problems.

Dry mouth can cause difficulties in tasting, chewing, swallowing, and speaking. If it goes untreated, severe dry mouth can also lead to increased levels of tooth decay and infections of the mouth such as thrush. Severe dry mouth is not a normal part of aging. It can be a clue to systemic diseases such as Sjogren syndrome, systemic lupus erythematosus, rheumatoid arthritis, scleroderma, sarcoidosis, amyloidosis, and hypothyroidism. Some medications can also cause dry mouth.

What are the salivary glands?


The salivary glands make spit (saliva). Saliva is important in the breaking down of the food that you eat. It makes food moist, lubricating it as it passes from the mouth to the gullet. It also contains enzymes in the saliva which break down some of the starch and fat in your food.

There are three pairs of glands that make saliva. From these glands, saliva drains into the mouth down short tubes (ducts). The submandibular glands are under the floor of your mouth – one on each side – and drain saliva up into the floor of your mouth. The parotid glands lie just below and in front of your ears. Saliva passes down the parotid duct into the inside of your cheeks. The sublingual glands are just beneath your tongue.

You make small amounts of saliva all the time to keep your mouth moist. When you eat, you normally make much more saliva which pours into your mouth.

What Happens Without Enough Saliva?


Dry mouth is that uncomfortable feeling you get when you’re not generating enough saliva to meet your needs. When your mouth fails to produce enough saliva, you will find yourself with more problems than just being thirsty.

By salivating, your mouth helps you taste and digest what you eat and drink. Food particles get flushed from your teeth and acid is washed away as well, which helps prevent tooth decay (cavities).

What Dry Mouth Feels Like


Dry mouth is unpleasant and uncomfortable, but some of that discomfort takes surprising forms. Did you know that lack of salivation can make your tongue burn? It’s a condition known as burning tongue syndrome, and it’s just one of the surprising symptoms of dry mouth.

When your mouth is dry, you may notice your mouth feels sticky. It may become difficult to eat and swallow. Your throat may become dry as well, making choking more common.

Along with all the other discomforts, dry mouth may make your lips crack, it may make your tongue rough and dry, and it could cause sores to form on and in your mouth.

Adding to all the other possible problems, you may find it difficult to talk without the saliva necessary to keep your tongue lubricated.

Is dry mouth dangerous?


When you get a dry mouth on a regular basis it can be from something more serious. If left untreated, it could worsen or cause further problems. You could be experiencing a dry mouth from medications including cancer treatment, or you could suffer from an autoimmune disease.

Bad breath, sometimes called halitosis, can be another consequence of dry mouth. That’s because food particles aren’t being flushed away as frequently.

While wearing lipstick, you may notice your makeup getting stuck to your teeth because nothing is there to rinse it away. A hoarse or ticklish throat may be another consequence. If you’re concerned about having a dry mouth, book an appointment with your dentist as soon as possible.

Causes


There are a few different reasons why you might experience a dry mouth. Some reasons are more common than others. You could be experiencing a dry mouth due to the weather, not drinking enough water, or sleeping with your mouth open. In these situations, dry mouth will go away or can easily be prevented.

Dry mouth could be caused by certain medications, from having cancer treatment or from smoking or using methamphetamine. Suffering from an autoimmune disorder such as Sjogren’s Syndrome will cause a dry mouth. This disease can affect the moisture-producing glands in the eyes and in the salivary glands in the mouth. Good oral hygiene and regular dentist visits can often prevent or help with dry mouth.

Medications Can Cause Dry Mouth

It was once believed that xerostomia was a consequence of aging. Doctors now know that many medications seniors frequently take may be the actual culprits. Some of the more than 400 possible medicines that cause dry mouth include

  • painkillers,
  • diuretics,
  • blood pressure medicine,
  • antidepressants,
  • antihistamines,
  • asthma drugs, and
  • muscle relaxants.

Along with prescription drug treatments, a lot of over-the-counter drugs like decongestants may cause dry mouth, too. These include drugs for allergies and cold symptoms.

Medication isn’t the only health-related cause. Sometimes other treatments for disease can bring on xerostomia. Radiation therapy for oral cancer can damage salivary glands in the process of attacking cancer cells. Another cancer treatment, chemotherapy, can thicken your saliva, causing your mouth to feel drier than usual.

Head and Neck Injuries

Sometimes xerostomia can be traced back to nerve damage in the head or neck. When you have been injured in these places, the injury may impact the health of your nerves. Some of those nerves are responsible for carrying messages between your brain and salivary glands. If those nerves become damaged, your glands may not know when to produce saliva.

Sjögren’s Syndrome and Other Medical Causes

Sometimes disease causes xerostomia. A health condition known as Sjögren’s (SHOW-grens) syndrome can cause white blood cells to attack the tear and salivary glands. This can dry out the eyes and mouth. Older women are particularly susceptible.

With Sjögren’s syndrome, patients remain otherwise healthy, but may find their mouths are dry, and may also experience swollen glands around the face and neck, irritated, gritty-feeling eyes and dryness in nasal passages, throat, and vagina. Acid reflux may also accompany this inflammatory disease.

Those with diabetes may also experience dry mouth when their blood sugar levels are too high. This may be a result of diabetes medications. HIV patients sometimes get dry mouth, too.

Smoking

Dry mouth may not be the most destructive effect of smoking. But wouldn’t it be nice to be free of it? Smoking alone doesn’t cause xerostomia, but the condition can be aggravated with cigarettes, cigars, pipes, or other tobacco products—even smokeless ones.

How do you treat a dry mouth?  


Both medical and dental health professionals can be useful allies if you suffer from xerostomia. If the cause is not a prescription medication, a doctor’s exam may unearth undiagnosed medical conditions interfering with your oral wellness like diabetes or Sjögren’s syndrome.

treat any underlying cause

In some cases, it may be possible to treat the underlying cause. For example:

  • If a medicine is causing the dry mouth as a side-effect, it may be possible to change to a different medicine or to reduce the dose.

  • Lack of fluid in the body (dehydration), a blocked nose and anxiety can often be treated.

Practical measures

Whatever the cause, the following will often help:

  • Take frequent sips or sprays of cold water. Always have a glass of water next to you when you go to bed.

  • Suck ice cubes.
  • Sugar-free chewing gum is often helpful.
  • Eating pineapple chunks or partly frozen melon is often soothing and helpful.
  • Some people find that it helps to suck boiled sweets. (But, sugary or acidic sweets may not be good for your teeth.)
  • Consider reducing or cutting out caffeine and alcohol. They make you pass out more urine, which can be dehydrating. Caffeine occurs in tea, coffee, cola and other drinks. It is also part of some medicines.
  • You can apply petroleum jelly to your lips to prevent drying and cracking.

Artificial saliva

If the above measures are not adequate then your doctor may prescribe a spray, gel or lozenge which acts as a substitute for spit (saliva). Each dose only lasts a short time and so they need to be used frequently. Some people find artificial saliva products more helpful than others.

Saliva stimulants

In some cases of dry mouth, the saliva glands are only partly affected and can be stimulated to make more saliva:

  • Chewing sugar-free gum can help to increase the production and flow of saliva.
  • Pilocarpine is a medicine that can stimulate salivary glands to make more saliva. It may be prescribed if other measures have not helped much:
    • Pilocarpine usually works well and quickly in most people with a dry mouth caused by a medication side-effect.
    • Pilocarpine is not very effective in treating people whose dry mouth has been caused by radiotherapy. An operation that moves the saliva gland on one side so that it can be protected from radiotherapy is sometimes an option in these people.
    • Pilocarpine can cause side effects in some people, such as:
      • Runny nose.
      • Blurred vision.
      • Frequent trips to pass urine.

Side-effects tend to become less troublesome in time as your body becomes used to them. A doctor may suggest a low dose at first and that you take this for a while until any side effects have eased. The dose may then be gradually increased with the aim of getting maximum benefit but with minimum side effects. Pilocarpine should not normally be used if you have asthma, chronic obstructive pulmonary disease (COPD), a slow heart rate (bradycardia), bowel obstruction or angle-closure glaucoma.

Prevention


You can greatly reduce your chances of developing a dry mouth by taking good care of your oral health. That means a combination of at-home dental care and building a great relationship with your dentist.

Drinking more water and sugarless drinks and avoiding drinks high in caffeine will help prevent dry mouth. Oral care products to help moisturize your mouth can also help. Avoiding tobacco and alcohol as well as minimizing spicing and sugary foods will also help with prevention.

We recommend daily healthy habits and regular visits to the dentist. For optimum oral health:

  • Practice good oral hygiene habits at home including brushing your teeth twice a day and flossing once a day
  • Book hygiene visits with an oral hygienist or oral health therapist twice each year
  • Book routine exam and x-rays visits with your dentist once each year

Faq


What products are there to help with dry mouth?

There are a number of products designed to help your mouth stay moist and comfortable. These are usually gels or sprays. Some have extra ingredients which may help prevent tooth and gum problems. There are also special products to help with your day-to-day oral hygiene (for example toothpaste and mouth rinses).

How often should I visit my dentist if I have a dry mouth?

You have a higher risk of tooth decay and gum disease with dry mouth, and these can get worse more quickly than usual. So it is important to visit your dental team regularly. Your dental team will tell you how often you should visit.

What toothpaste should I use?

It is important to use a fluoride toothpaste containing at least 1350 to 1500ppm (parts per million) of fluoride. A ‘total care’ toothpaste may be best as these contain antibacterial agents and other ingredients to control the build-up of plaque.

Some products contain Sodium Lauryl Sulphate (SLS), and some people with dry mouth find this can irritate the mouth and make the condition worse.

What can my dental team do to help prevent the problems caused by dry mouth?

Your dental team won’t be able to help with the cause of dry mouth. But by helping you keep your mouth clean and by using fluoride they can, in many cases, help to delay the start of tooth decay. Your dental team will be able to give you advice about your diet and tell you how to care for your teeth and gums properly.