Dry Mouth (Xerostomia)
Dry mouth describes any condition in which reduced secretion of the salivary glands results in inadequate saliva, and the saliva that is produced is thicker than normal. Depending on the severity of the problem, a person may have not only dryness in the mouth, but also increased thirst, dry lips, or, in the worst cases, difficulty chewing and swallowing. Taste and smell may be impaired. Because mouth dryness permits more rapid bacterial growth, tooth decay and gum disease are more likely to occur.
Commonly, dry mouth is a consequence of smoking or a side effect of certain drugs, especially decongestants, antihistamines, antidepressants, atropine, and some heart and ulcer medications. Cancer chemotherapy and radiation therapy to the mouth and throat also cause dry mouth. To some degree, all older people experience this condition, because saliva production naturally declines with age.
Diagnostic Studies and Procedures
A doctor or dentist can often diagnose a salivary gland disorder simply by feeling the glands and noting the reduced moisture in the mouth. However, if the cause is not readily apparent, the physician may order blood tests to check for autoantibodies (antibodies that attack the body) and X-rays to check for structural abnormalities.
Medical Treatments
If an autoimmune disorder, such as lupus or Sjogren's syndrome (see section on other causes), is responsible for the dry mouth, treatment is directed to controlling the underlying disease and alleviating the dryness. In severe cases, immunosuppressive drugs are given to halt the immune-system attack on healthy tissue.
If salivary glands suddenly become enlarged and painful, a painkiller with anti-inflammatory action, such as ibuprofen or aspirin, may be advised.
Anyone with dry mouth should see a dentist every three months for cleaning and periodontal treatments to help prevent a potentially dramatic increase in dental cavities and gum disease. The dentist may recommend special preventive fluoride treatments that can be performed at home.
Alternative Therapies
Herbal Medicine. Herbalists recommend sour or bitter herbs to stimulate the flow of saliva. Chinese green tea is a popular remedy. Teas made of ginger, cayenne, lemon balm, or chamomile may help. A mouthwash made of 5 to 10 drops of myrrh in a cup of warm water helps control mouth bacteria. Chewing mint leaves will freshen the mouth and help prevent bad breath -- a common consequence of dry mouth.
Homeopathy. If gum disease accompanies dry mouth, practitioners may prescribe staphysagaria, mercurius solubilis, or a folic acid solution.
Nutrition Therapy. Vitamin C and beta carotene, found in such foods as carrots and sweet potatoes, may help prevent gum disease.
Self-Treatment
Self-care can alleviate the discomfort of dry mouth and help prevent dental disease. If you smoke, make every effort to stop; smoking aggravates dry mouth, and greatly increases the risk of serious dental problems. Avoid drugs, such as antihistamines and decongestants, that further decrease salivary secretion. Sip water or other sugar-free fluids throughout the day. To stimulate saliva production, try sucking on a lemon or sugarless lemon drops, nibbling a sour pickle, or chewing sugarless gum.
If dry mouth makes chewing and swallowing difficult, mash or puree food and moisten it with broth or other low-fat liquids. You may also want to try nonprescription saliva substitutes, available at most pharmacies. Some of the available products are liquid mouth sprays; others are gels that are placed along the gum line and then moved around the mouth to protect mucous membranes. Experiment with different types and tastes, and read product labels carefully to avoid those that contain sugar, which will increase the risk of tooth decay.
To reduce bacteria and freshen your breath, rinse your mouth often with an antiseptic mouthwash. To further protect your teeth, practice scrupulous dental hygiene, brushing your teeth at least twice a day and flossing every evening. Consider using an antibacterial toothpaste made especially for persons with dry mouth problems. Or mix baking soda and a few drops of 3 percent hydrogen peroxide into a paste and use this to brush your teeth, paying special attention to the gum line. To increase the antibacterial effect, let the paste remain in your mouth for a few minutes before rinsing it out.
Other Causes of Dry Mouth
Dry mouth may also accompany facial nerve paralysis (Bell's palsy), mumps, and infection of the mouth, throat, or salivary glands.
An extremely dry mouth is a primary symptom of Sjogren's syndrome, a chronic inflammatory disorder in which the immune system attacks the salivary glands. It may occur alone or in conjunction with other autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and scleroderma. Other mucous membranes -- the eyes, nasal passages, throat, larynx, bronchi, vagina, and vulva -- may also be abnormally dry.