Millions of people suffer from some form of dry mouth (xerostomia) on an occasional or chronic basis. Xerostomia is not a disease itself, but a symptom of an underlying issue that affects the ability to maintain a sufficient flow of saliva in the mouth. Saliva is a vital component of good oral health because it:
- Produces beneficial enzymes that help with the digestion of food
- Contains a lubricating substance that helps stabilize pH and maintain acceptable acid levels in the mouth
- Provides high levels of oxygen to keep oral tissues healthy and fresh
- Helps in the remineralization of tooth enamel by providing calcium and phosphorous
- Enhances one's sense of smell and taste
- Contains antimicrobial compounds that aid in the prevention of plaque buildup, which can lead to gingivitis or periodontal disease
Saliva helps prevent tooth and gum disease, eliminates food debris in the mouth, kills viruses, and discourages the anaerobic bacterial growth that produces chronic bad breath. Many different factors can cause a reduction or absence of saliva flow, including:
- Prescription and over-the-counter medications
- Decreased functioning of salivary glands
- Chronic postnasal drip
- Periodontal disease
- Excessive smoking or alcohol consumption
- Stress and anxiety
- Autoimmune or systemic diseases, and other health conditions
Dry Mouth Symptoms
- Cracked, chapped, or inflamed lips
- Chronic mouth lesions and/or tongue ulcerations
- Dental cavities, tooth abscesses, and dental pulp infections
- Severe bad breath
- Oral candidiasis (oral thrush)
- Infection of the salivary glands
- Thick, sticky, or stringy saliva
- Difficulty swallowing
- Loss of smell and taste
- Unrelenting thirst
- Hoarseness when speaking
- Sore throat
- Burning sensation on the tongue
Dry Mouth at Night
Many people suffer from this problem at night, which may indicate an underlying health issue that can worsen if left untreated. For example, it is common for allergy sufferers to have dry mouth at night because clogged noses lead to heavy breathing through the mouth. There are many reasons why people may experience this problem more frequently at night — from medications to lifestyle choices. Learn more about this issue by clicking here.
Medications: Both prescription and over-the-counter medications can cause this problem. Among these are decongestants, allergy medications, diuretics, sedatives, muscle relaxants, antihypertensives, and antidepressants. In addition, cancer treatments such as radiation can damage salivary glands, and chemotherapy can cause saliva to thicken, making the mouth feel dry.
Drying agents: The most common drying agent in food and beverages is alcohol. In fact, alcohol causes the worst form of dry mouth, because both the flow of saliva and oxygen content in the mouth are substantially reduced. Alcohol is the basis of all adult beverages such as beer, wine, and hard liquor. Compounding this problem is that many popular, brand name mouthwashes contain at least 15 to 20% alcohol. Using alcohol based mouthwashes makes the mouth very dry, which will actually exacerbate the problem.
Tobacco Usage: Studies have shown that long-term smoking significantly reduces salivary flow. This reduction is tied to an increase in oral and dental disorders associated with xerostomia, including dental decay, gingivitis, tooth mobility, and halitosis.
Dry Mouth in the Morning
Xerostomia upon awakening in the morning is tied to the inability to breath normally while you sleep, i.e., through your nose instead of your mouth. This situation can be caused by excessive snoring due to sleep apnea, or swollen and inflamed sinus passages related to an undiagnosed allergy. Other common reasons include excessive caffeine, sugar or alcohol consumption prior to falling asleep; nasal polyps that obstruct airways; or taking medications that further reduce the ability for salivary glands to produce sufficient saliva during sleep. When an excessive amount of air is inhaled and exhaled through the mouth, this can cause a reduction in saliva flow.
The Side Effects of Dry Mouth
If you suffer from this problem, it is common to experience a sticky and dry feeling throughout the night and/or upon awakening in the morning. In addition, many people with dry mouth are excessively thirsty. They may wake up during the night to get a glass of water or feel the need to drink something first thing in the morning to alleviate dryness.
Dry Tongue and Throat: Most people also experiencea dry tongue and throat, which may feel like a burning or tingling sensation. The tongue is moist and a healthy pink color when oral health and saliva flow are normal. The tongue has thousands of fissures in which bacteria can hide from oxygen, especially near the back, which causes the fuzzy, white coating composed of bacteria that you may notice on your tongue in the morning. This can lead to mouth irritations and other oral problems.
Eating Problems: A dry throat can make it hard to chew and swallow, especially dry foods such as bread and cereal. In addition, many people with xerostomia experience issues with taste. Taste requires moist taste buds on the tongue and swallowing requires lubrication as the food goes down the esophagus. Dryness in the mouth can often lead to a clenched jaw, which inhibits proper chewing and swallowing.
Mouth Sores: When the mouth is properly lubricated with saliva, lips should stay moist, which generally helps prevent cracking and sores. Without adequate saliva, many people develop sores in the mouth, dry or cracked lips, and small sores at the corners of the mouth.
Halitosis: The body uses saliva to break down matter in the mouth, so when the mouth is dry, it provides a perfect environment for bacteria and other matter that cause halitosis to thrive. People that suffer from dry mouth at night frequently awaken in the morning with bad breath. This is generally far worse in the morning, after a night of dryness, but can persist throughout the day.
Tooth Decay: A decrease in saliva increases the risk of developing tooth decay. This is due to the fact that saliva minimizes the harmful bacteria that cause cavities and other oral infections.
Oral Candidiasis (Thrush): Dry mouth syndrome often leads to an oral infection called candidiasis or thrush. This fungal infection can develop overnight and persist even with proactive treatment. The primary visual symptom of thrush is a thick, cream-colored coating on the tongue, tonsils and/or cheeks that may appear slightly red due to inflammation. Sometimes the fungal patches are painful and bleed if attempts are made to scrape off the deposits. Thrush produces halitosis, therefore a person with this condition has a distinctive, extremely disagreeable sulfurous odor.
Gingivitis: Often caused by dry mouth, this condition causes the gums to become red, swollen, and bleed easily, but there is usually very little or no discomfort. The good news is that gingivitis is reversible with professional treatment and good oral home care. However, when gingivitis is left untreated, it can progress to more serious periodontal disease, also known as periodontitis. Many patients suffering from xerostomia will develop periodontal disease.
Periodontitis (also called "pyorrhea"): A serious inflammatory disease affecting the gum tissues surrounding teeth, this can lead to tooth loss. Over time, plaque caused by bacteria calcifies and pushes down between the gums and the dental roots, causing the formation of periodontal pockets. These pockets are so deep that they cannot be cleaned out without professional help. Advanced periodontal disease may also affect bone growth, inhibiting the ability to bite, chew, and talk properly. In advanced cases, surgery is often needed to correct serious malformations of the jaw that may provoke other health issues.
- Brush twice a day with fluoride toothpaste, which can help fight bad breath caused by dry mouth
- Floss after every meal
- Use mouthwash that is free of alcohol, saccharin, or foaming detergents like sodium lauryl sulfate
- Drink plenty of water
- Avoid sugary and caffeinated beverages
- Scrape the tongue with a professional tongue scraper
- Chew gum or suck on mints containing xylitol, a known breath freshener
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