Xerostomia (Dry mouth)

Symptoms: A dry, sticky sensation in the mouth. difficulty speaking, tasting, swallowing, or chewing. a sensation of burning or itching in the throat or mouth. throat feeling parched.

Causes: Drug side effects are the most common cause, followed in no particular order by Sjogren syndrome (SS), radiation therapy, and other autoimmune diseases.

Risk Factors: Medications (xerostomia is a side effect of over 400 medications); psychological issues, like anxiety and stress; diseases of the salivary glands, including Sjogren's syndrome; radiotherapy to the head and neck.

Prevalence: Studies found that the prevalence of xerostomia varied between 10 and 26% in men and 10 and 33% in women.

Severity: Mild to severe 

Which doctor to consult: ENT specialist

Overview:

Xerostomia, or "dry mouth," can occur when there is insufficient saliva. To keep your mouth lubricated and sanitary, saliva is produced by the salivary glands in your mouth.

Sometimes, having a dry mouth is normal. When you're dehydrated, for example, your mouth becomes dry. However, if you have persistent dry mouth, which occurs constantly, it may indicate a more serious medical issue. Antihistamines, decongestants, and some antidepressants are among the drugs that frequently cause xerostomia as a side effect. About 1 in 5 people suffer from dry mouth on a regular basis. As you age, you are more susceptible to dry mouth.

Symptoms of Xerostomia:

Here are some common symptoms:

Dryness or a sticky feeling in the mouth: This is the hallmark symptom.

Bad breath: Due to the lack of saliva, which helps keep the mouth clean.

Sore throat: Persistent dryness can lead to a sore or scratchy throat.

Difficulty speaking, chewing, or swallowing: Saliva helps with these functions, so its absence can make them challenging.

Dry or cracked lips: The lack of moisture can cause the lips to become dry and cracked.

Altered taste: You might notice changes in how food tastes.

Increased thirst: You may feel the need to drink water more frequently.

Mouth sores: Painful sores can develop due to dryness.

If you experience these symptoms persistently, it’s a good idea to consult a healthcare professional for proper diagnosis and treatment.

Causes of Xerostomia:

Xerostomia, or dry mouth, can be caused by several factors:

Medications: Many prescription and over-the-counter drugs, such as antihistamines, decongestants, pain medications, and antidepressants, can reduce saliva production.

Medical Conditions: Diseases like diabetes, Sjogren’s syndrome, HIV/AIDS, and Parkinson’s disease can lead to dry mouth.

Cancer Treatments: Radiation therapy, especially to the head and neck, and certain chemotherapy drugs can damage salivary glands.

Dehydration: Not drinking enough fluids or conditions that cause excessive sweating, vomiting, diarrhoea, blood loss, or burns can lead to dehydration and dry mouth.

Lifestyle Factors: Smoking or chewing tobacco and breathing through your mouth instead of your nose can also contribute to dry mouth.
If you suspect any of these causes, it might be helpful to discuss your symptoms with a healthcare provide.

Risk Factors:

Risk of dry mouth is higher in people who:

• Take medications that may cause dry mouth as a side effect.
• Those who are receiving cancer treatment.
• Suffer from head and neck nerve damage.
• Possess additional medical conditions, such as HIV/AIDS, diabetes, stroke, Alzheimer's disease, or Sjogren syndrome.
• Make use of tobacco products.
• Sip some booze.
• Take drugs off the street.
• Consume candy or foods high in sugar or acid.

Possible complications:

Xerostomia, or dry mouth, can lead to several complications if left untreated. Here are some potential issues:

Tooth Decay and Gum Disease: Saliva helps protect teeth and gums from decay. Without enough saliva, the risk of cavities and gum disease increases.

Oral Infections: A lack of saliva can lead to oral infections such as oral candidiasis (thrush), which is a fungal infection.

Difficulty with Oral Functions: Reduced saliva can make it hard to chew, swallow, and speak, which can affect nutrition and communication.

Mouth Sores and Cracked Lips: Persistent dryness can cause painful sores in the mouth and cracks at the corners of the lips.

Altered Taste: Dry mouth can affect your sense of taste, making food less enjoyable.

Plaque Buildup: Without saliva to wash away food particles and bacteria, plaque can build up more easily, leading to dental issues.

Prevention:

Preventing xerostomia, or dry mouth, involves several strategies to maintain adequate saliva production and oral health:

Stay Hydrated: Drink plenty of water throughout the day to keep your mouth moist.

Good Oral Hygiene: Brush your teeth at least twice a day with fluoride toothpaste and floss daily to maintain oral health.

Chew Sugar-Free Gum: Chewing sugar-free gum or sucking on sugar-free candies can stimulate saliva production.

Avoid Tobacco and Alcohol: Both can dry out your mouth, so it’s best to avoid smoking and limit alcohol consumption.

Limit Caffeine: Caffeine can contribute to dry mouth, so try to reduce your intake of coffee, tea, and caffeinated sodas.

Use a Humidifier: Adding moisture to the air, especially at night, can help keep your mouth from drying out.

Regular Dental Check-Ups: Visit your dentist regularly for cleanings and exams to catch and manage any oral health issues early.

If you are taking medications that cause dry mouth, talk to your doctor about possible alternatives or solutions. They might recommend saliva substitutes or other treatments to help manage the condition.

When to see a doctor?

If you have dry mouth symptoms that don't go away, make an appointment with your healthcare professional.

Diagnosis:

Diagnosing xerostomia (dry mouth) typically involves several steps:

Medical History: Your doctor will ask about your symptoms, medical history, and any medications you are taking, as many medications can cause dry mouth.

Physical Examination: The doctor will examine your mouth for signs of dryness and may check the salivary glands for any abnormalities.

Saliva Flow Measurement: This can be done using sialometry, a simple procedure that measures the flow rate of saliva.

Additional Tests: In some cases, further tests like blood tests, imaging studies, or a biopsy of the salivary glands might be necessary to determine the underlying cause.

Treatment:

The reason behind your dry mouth will determine how you are treated. Your doctor may suggest the following:

Switch out any medications that are causing dry mouth: Your doctor may adjust your dose if they believe that one of your medications is the problem. Alternatively, you could move to a different medication that doesn't produce dry mouth.

Suggest mouth hydration products: These goods may consist of over-the-counter or prescription mouthwashes, artificial saliva, mouth lubricants, or prescription medications. Mouthwashes formulated with Xylitol, particularly those for dry mouth, have been shown to be beneficial.

In order to help you produce more saliva, your doctor may prescribe Pilocarpine if you have severe dry mouth from Sjogren syndrome or radiation therapy for head and neck cancer. For those with Sjogren syndrome, a prescription for Cevimeline may be necessary to increase saliva production.

Home remedies and lifestyle changes:

Here are some effective home remedies and lifestyle changes to help manage dry mouth:

Stay Hydrated: Drink plenty of water throughout the day to keep your mouth moist. Sipping water during meals can also help with chewing and swallowing.

Chew Sugar-Free Gum: Chewing sugar-free gum or sucking on sugar-free candies can stimulate saliva production. Products containing xylitol are particularly beneficial as they also help prevent cavities.

Use a Humidifier: Adding moisture to the air with a humidifier, especially at night, can help keep your mouth from drying out.

Avoid Certain Foods and Drinks: Limit intake of caffeine, alcohol, and acidic or spicy foods, as they can exacerbate dry mouth symptoms.

Breath Through Your Nose: Try to breathe through your nose rather than your mouth to reduce dryness.

Use Saliva Substitutes: Over-the-counter saliva substitutes in the form of sprays, lozenges, or gels can provide relief.

Good Oral Hygiene: Brush your teeth gently with fluoride toothpaste at least twice a day and floss regularly to maintain oral health.

Avoid Tobacco: Smoking or using other tobacco products can worsen dry mouth, so it’s best to avoid them.