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Xerostomia (Dry Mouth)

What is Xerostomia (Dry Mouth)?

Xerostomia, also known as dry mouth and dry mouth syndrome. condition in which the salivary glands in your mouth don't make enough saliva to keep your mouth wet.

Dry mouth affects about 10% of all people and tends to be more prevalent in women than men. Disorders of saliva production affect elderly people and those who are taking prescription and non-prescription medications most frequently.

Saliva helps prevent tooth decay by neutralizing acids produced by bacteria, limiting bacterial growth and washing away food particles. Saliva also enhances your ability to taste and makes it easier to chew and swallow. In addition, enzymes in saliva aid in digestion.

Decreased saliva and dry mouth can range from being merely a nuisance to something that has a major impact on your general health and the health of your teeth and gums, as well as your appetite and enjoyment of food.

What causes Xerostomia (Dry Mouth)?

Dry mouth most commonly occurs as a side effect of medications that cause decreased saliva production, including high blood pressure medications, antihistamines, antidepressants, diuretics, nonsteroidal anti-inflammatories, narcotics, and many others. There is a huge list of commonly used medications that can cause dry mouth. Other causes of dry mouth include dehydration, radiation treatments to treat cancerous tumors of the head and neck, salivary gland diseases, removal of salivary glands, diabetes, smoking, using chewing tobacco, hormonal imbalances, mouth breathing, sleep apnea, cystic fibrosis, mumps, and autoimmune disorders such as Sjögren's syndrome, rheumatoid arthritis, HIV/AIDS, and systemic lupus erythematosus. Eating disorders, such as bulimia and anorexia, are other risk factors for developing xerostomia. Salivary production can be decreased if a major salivary duct becomes blocked, such as from a salivary stone or infection. Dry mouth will often occur during pregnancy or breastfeeding due to dehydration and hormonal changes. Other risk factors include stress, anxiety, and depression. Alzheimer's disease and Parkinson's disease often lead to dehydration, making a person constantly at risk for dry mouth. These along with stroke can cause a perception of dry mouth even if salivary function is adequate, due to the diminished ability to perceive oral sensations. Nerve damage or trauma to the head and neck can affect the nerves that provide sensation to the mouth and result in a feeling of dry mouth.

What are the signs and symptoms of dry mouth?

If you're not producing enough saliva, you may notice these signs and symptoms all or most of the time:

Dryness or a feeling of stickiness in your mouth
Saliva that seems thick and stringy
Bad breath
Difficulty chewing, speaking and swallowing
Dry or sore throat and hoarseness
Dry or grooved tongue
A changed sense of taste
Problems wearing dentures
In addition, dry mouth may result in lipstick sticking to the teeth.

How do doctors diagnose dry mouth?

To determine the cause of your dry mouth, your doctor likely will review your medical history and all medications you're taking, including over-the-counter medications, and examine your mouth.
Sometimes you may need blood tests, imaging scans of your salivary glands.
Another test your doctor may order is a quantitative assessment of unstimulated and stimulated whole saliva. However, there is a wide variation in the amount of saliva produced by individuals and work is ongoing to devise more accurate methods of assessing salivary gland function.
If your doctor suspects your dry mouth is caused by Sjogren's syndrome, a small sample of cells (biopsy) taken from salivary glands in your lip may be sent for testing.

What is the treatment for dry mouth?

Those seeking treatment for dry mouth will most likely want something to provide comfort and relief.
Your treatment depends on the cause of your dry mouth. Your doctor or dentist may:

Change medications that cause dry mouth.
If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn't cause a dry mouth.
Recommend products to moisturize your mouth.
These can include prescription or over-the-counter mouth rinses, artificial saliva or moisturizers to lubricate your mouth. Mouthwashes designed for dry mouth, especially ones with xylitol, can be effective, such as Biotene Dry Mouth Oral Rinse or Act Dry Mouth Mouthwash, which also offer protection against tooth decay.

If you have severe dry mouth, your doctor or dentist may:
Prescribe medication that stimulates saliva.
Your doctor may prescribe pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.
Protect your teeth.
To prevent cavities, your dentist might fit you for fluoride trays, which you fill with fluoride and wear over your teeth at night. Your dentist may also recommend weekly use of a chlorhexidine rinse to control cavities.
General measures
Simple measures should be used by all patients. Dry mouth may be relieved in many patients by:
Frequent sips of cool drinks.
Sucking pieces of ice.
Sucking sugar-free fruit pastilles.
Eating partly frozen melon or pineapple chunks.
Sugar-free chewing gum - which stimulates salivation in patients with residual salivary function.
Petroleum jelly - which can be applied to the lips to prevent drying and cracking.

What is the prevention and prognosis of dry mouth?

There is really no way to prevent dry mouth, only the side effects of dry mouth. It is vital to detect, diagnose, and treat xerostomia as early as possible to avoid the devastating consequences of chronic dry mouth on dental and overall health.

The prognosis (outlook) depends on the underlying cause of the dry mouth. Management should be focused on eliminating the cause when possible, such as with dehydration, anemia, and stress. If the cause can't be eliminated, then it is necessary to keep the affected person as comfortable and free from caries and Candida yeast infection as possible. By using simple techniques to help stimulate saliva, substitute for saliva, and protect the teeth and surrounding tissues, one can expect a very good prognosis for avoiding the side effects of dry mouth.

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