Dry Mouth (Xerostomia)

Dry mouth is a common condition that often goes undetected. It occurs gradually in some cases and the person is unaware of the changes that the reduced saliva present. It results when the six large salivary glands that produce saliva in the mouth produce less saliva or no saliva. Their saliva production can be affected by the side effect of over 500 different drugs; ¹ head and neck radiation for cancer treatment; autoimmune diseases (Sjogren disease); or other conditions (e.g., uncontrolled diabetes, infections, hormonal changes, stress, dehydration) ¹

Saliva is important to maintain the integrity of a healthy mouth. The three pints of saliva the average healthy adult produces daily serves protective functions: it cleanses the mouth, aids in the swallowing and digestion of food, salivary antibodies, and proteins aid in removing microbes and other infectious agent, the bicarbonate in saliva aids in neutralizing the acids in the mouth, saliva provides lubrication and moisture for speaking, swallowing and taste. ¹ We lose a wonderful fluid when saliva is not produced.

Normal saliva neutralizes the acid in 15 to 30 minutes from eating and drinking.². Dry mouth extends this acid period from thirty minutes to hours depending on the lack of saliva, causing dental decay to be very costly. Long periods of acid, create long periods of demineralization resulting in lots of decay. The person with dry mouth must understand the conditions that cause dental decay and be on guard to prevent caries.

Signs and Symptoms of Dry Mouth ¹

Teeth:

Increased incidence of tooth decay; Increased plaque accumulation; Increased tooth sensitivity; Enamel erosion and attrition.

Soft Tissue of the Mouth:

Infection of the gums and soft tissue; Recurrent thrush or fungal infections; Painful or burning mouth (intolerance to spicy, sour, or salty food and drinks) Ulcerations on the sides of the tongue.

Oral Cavity:

Halitosis (bad breath); Difficulty talking, chewing, or swallowing; Sores at the corners of the mouth, cracked lips.

Detection

Despite the prevalence of xerostomia and its related discomfort, the signs and discomfort often go unnoticed by the patient. Dry mouth is a slow-progressing side effect of many conditions and medications, and most patients cannot pinpoint when it started. To identify their dry mouth conditions, it is helpful to review the patient’s medical history. Perform an oral exam for conditions of Dry Mouth, if conditions are present, it is best to access the severity of xerostomia by measuring the production of saliva over a period of a few minutes. Or using the Challacombe scale to assess the clinical conditions in the mouth that result from xerostomia. ¹ Accessing the amount of saliva that is secreted by the glands, aids in determining the presence and severity of the Dry Mouth.

Dry mouth relief and management

Relief from Xerostomia and management is possible. This can vary from lifestyle changes and over the counter solutions for mild discomfort, to prescription saliva substitutes, systemic medications, and lipid-based sprays for moderate to severe.

Water-based solutions⁵

Act Dry Mouth Mouthwash
Act Dry Mouth Spray
Biotene Dry Mouth Oral Rinse
Biotene Moisturing Gel
GC Dry Mouth Gel
Lubricity

Saliva substitutes

Caphosol
NeutraSal
SalivaMax

Lipid-based solution

3M Xerostomia Relief Spray

Mild discomfort responds to lifestyle changes.

Patients experiencing mild discomfort and symptoms can sometimes be managed through lifestyle changes that aid relief. The American Dental Association (ADA) suggests sipping on water, sucking on ice chips, using lip lubricants frequently, and avoiding salty, spicy, sticky, sugary, or hard-to-chew foods. They also recommend chewing sugar-free gum or sucking on sugar-free mints that contain xylitol, and avoiding alcohol, tobacco, and caffeine. They also suggest using a humidifier at night.

Over-the-counter and prescription strength solutions for moderate to severe cases

Stronger preventative solutions and interventions can aid in easing the symptoms of moderate to severe dry mouth.

The water-based mouth rinses and sprays are available at less cost than the prescription Lipid-based solution.

The 3M Xerostomia Relief Spray is a lipid (fat type) that adhere to the surfaces of the mouth—to form a protective film that moistens and lubricates the tongue, teeth, gums, throat while limiting water loss and restoring the elasticity of the cheeks. The spray delivers rapid and lasting relief. Unlike water-based products that tend to dissipate quickly, the lipid-based delivers proven relief for up to four hours.

Conclusion

Dry Mouth is a slow occurring condition in the mouth that takes place over time because different conditions effect the saliva glands. It can affect our susceptibility to dental decay and other health effects such as difficulty in eating, swallowing, speaking, tastes, and general discomfort. If present, it should be evaluated and treated.

Home Care Options and Treatment

Understand the dental decay process that occurs in the mouth. Read the essay “Understanding and preventing dental decay.” and follow those guidelines to prevent decay.
Do home care twice a day.
Use a saliva substitute that has a pH above 7 after snacking, eating, or drinking a carbohydrate drink. This will neutralize the acid.
Since saliva with its minerals is reduced, rinse with various products that place minerals back into your teeth. Products needed are calcium-phosphate, fluoride, xylitol, hydroxyapatite—minerals in enamel, etc.4 This can be done by using Carifree-CTx4 Gel 5000, it has 1.1% Neutral sodium fluoride, hydroxyapatite to remineralize the enamel, Xylitol, and pH Neutralization.

Bibliography

Department of Scientific Information; ADA Science Institute. Oral Health Topics: Xerostomia (Dry Mouth). American Dental Association website. www.ada.org/en/member/oral-health-topics/xerostomia
VK Kutsch, Balance, 2nd ed, p.12
www.mayoclinic.org>dry-mouth>syn20356048
VK Kutsch, Balance, 2nd ed, pp36-37
www.Xerostomia relief Dry Mouth treatment/Dental Economics