Cotton Mouth

Xerostomia is a condition causing a ‘dry mouth’ from decreased production of saliva. An essential component of a healthy mouth, the lubricating qualities of saliva are easily taken for granted. It does more than keep the mouth moist.

Benefits of saliva

  • Makes it possible for you to chew and swallow
  • Provides comfort by reducing the effects of friction
  • Protects the oral tissues against ulcers and sores
  • Neutralizes acids
  • Protects teeth from decay
  • Provides antibodies against fungi growth and bacterial threat
  • Helps digest food
  • Helps teeth in the re-mineralization process.
  • Is an essential contributor to a person’s ability to taste, acting as a solvent for the taste stimuli

What causes dry mouth?
There are multiple possible causes of dry mouth.

Side effects of medicines. More than 400 prescription and nonprescription drugs can cause saliva reduction.

  • Blood pressure medications
  • Antihistamines
  • Antidepressants
  • Diuretics
  • Nonsteroidal anti-inflammatories
  • Pain pills
  • Decongestants
  • Acne medicine
  • Epilepsy medication
  • Certain bronchodilators
  • Muscle relaxants
  • Sedatives
  • Antipsychotics
  • Many others

Disease & infection side effects. Some diseases affect the salivary glands.

  • Sjögren’s syndrome
  • HIV/AIDS
  • Diabetes
  • Alzheimer’s disease
  • Diabetes
  • Anemia
  • Cystic fibrosis
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Hypertension
  • Parkinson’s disease
  • Stroke
  • Mumps

Radiation therapy. The salivary glands can be damaged if they are exposed to radiation during cancer treatment.

Chemotherapy. Drugs used to treat cancer can make saliva thicker, causing the mouth to feel dry.

Nerve damage. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.

Dehydration

Stress, anxiety & depression

Lifestyle. Smoking or chewing tobacco can affect saliva production and aggravate dry mouth. Continuously breathing with your mouth open can also contribute to the problem.

What are the signs and symptoms of dry mouth?
Common symptoms of dry mouth include:

  • Sticky, dry feeling in the mouth
  • Frequent thirst
  • Sores or ulcers in the mouth; sores or split skin at the corners of the mouth
  • White tongue (indicative of a fungal infection like candidiasis)
  • Chapped or cracked lips
  • Dry or burning feeling in the throat
  • Burning or tingling sensation in the mouth and especially on the tongue
  • Dry, red, raw tongue
  • Trouble speaking
  • Difficulty tasting, chewing, and swallowing – leading to possible malnutrition
  • Hoarseness, dry nasal passages, sore throat
  • Persistent cough
  • Periodontis
  • Bad breath
  • Tooth decay resulting in frequent cavities

Why Is Dry Mouth a Problem?
Without a sufficient quantity of saliva to wash food particles off teeth, neutralize acids in the mouth, and battle the bacteria population, a person increases their risk for gingivitis (gum disease) and frequently develops infections in the mouth  (such as thrush) or multiple cavities – especially around the gum line. They also might not get the nutrients they need if they cannot chew and swallow certain foods.

Dry mouth can also make it difficult to wear dentures.

Extreme dry mouth and salivary gland dysfunction can produce significant and permanent mouth and throat disorders and can impair a person’s quality of life.

Diagnosis
It is important to determine if dry mouth is caused by a change in salivary function and the severity of any salivary impairment. Dry mouth is diagnosed by both dentists and physicians.

  • History — Specifics of the complaint of dry mouth are obtained: duration, frequency, and severity. The presence of dryness at other sites (eyes, nose, throat, skin, vagina) is documented. A complete medical and prescription drug history is taken.
  • Examination — Major salivary glands are palpated for the presence of tenderness, firmness, or enlargement. The amount and quality of saliva coming from the ducts inside the mouth are assessed, and the absence of saliva or presence of dry or reddish oral mucosa is noted. Active dental decay is evaluated.
  • Salivary flow rate — The amount of saliva produced during a specified amount of time may be measured. The test is non-invasive and painless.
  • Scintigraphy — Performed in the hospital, this test measures the rate at which a small amount of injected radioactive material is taken up from the blood by the salivary glands and secreted into the mouth. It is another method to measure salivary flow rate.
  • Biopsy of minor salivary glands — A small, shallow incision is made inside the lower lip to remove at least four of these glands. A pathologist then examines them for changes characteristic of the salivary component of Sjögren’s.

Prevention
There is really no way to prevent dry mouth, but you can treat the side effects.

Treatment

  • Incorporate a low-sugar diet, avoiding sodas, cookies, bread, chips, and candy
  • Daily use of fluoride treatments and antimicrobial, non-alcoholic rinses (such as Biotene)
  • Drink water more frequently throughout the day, especially while eating
  • Chew sugar-free gum or suck on candy to stimulate salivary flow
  • Medications to increase salivary flow – Pilocarpine (Salagen) and Cevimeline (Evoxac)
  • Artificial saliva substitutes and oral lubricants containing glycerin for relief while eating and speaking
  • Topical anti-fungal treatment such as rinses and dissolving tablets
  • Soak dentures daily in chlorhexidine or 1% bleach to eliminate fungal infections
  • Visit your dentist regularly
  • Breath through your nose, not your mouth, as much as possible
  • Use a room vaporizer to add moisture to the bedroom air

Prevent Dental Decay
Being so susceptible to cavities, it’s imperative that people suffering from dry mouth are extra careful to keep their teeth healthy. Practice pristine dental hygiene!

  • Brush teeth after every meal
  • Floss teeth daily
  • Use a fluoride toothpaste
  • Rinse teeth with water immediately after eating
  • Chew gum (containing no sugar) after eating to stimulate saliva and wash away food debris
  • Avoid sticky, sugary foods
  • Visit your dentist at least twice a year

Your dentist might also suggest you use a prescription-strength fluoride gel (which is like a toothpaste) to help prevent dental decay.

It is vital to detect, diagnose and treat xerostomia as early as possible to avoid the devastating effects of dry mouth on dental and overall health. Dr. Arhiri at the Premier Smiles Dental Spa can aid you in the process of determining the nature and cause of your condition. Contact him at 610.647.7611 or email drarhiri@premiersmilespa.com to schedule your appointment.

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