There are many underlying causes for dry mouth, also called xerostomia. People can develop this problem due to medications, lifestyle choices, or health conditions and diseases. Most people experience this problem during the night or upon awakening in the morning. Regardless of the underlying cause, dry mouth is directly associated with a reduction in normal saliva flow.
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
The Role of Saliva in Oral Health
- 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
Underlying Dry Mouth Causes
Aging: Just as different parts of the body deteriorate as part of the aging process, so does salivary gland functioning. Furthermore, older people generally take more medications and develop chronic illnesses that require prescription and over-the-counter drugs, many of which cause xerostomia. When dry mouth accompanies receding gums, a problem more common in older people, the incidence of dental decay and gum disease increases.
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. There are about 400 medications that have been identified as having dry mouth as a possible side effect.
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.
Cancer: Although cancer itself may not cause dry mouth, common cancer treatments are contributing factors. Radiation can damage salivary glands, and chemotherapy can cause saliva to thicken, making the mouth feel dry.
Diabetes: Xerostomia may be attributed to the unhealthy impact that unstable blood glucose levels have on the salivary glands' ability to release adequate saliva into the mouth. Furthermore, the small amount of saliva secreted by the parotid glands contains excessive amounts of unabsorbed glucose, which further contributes to the deterioration of teeth, gums, and overall oral health. Bacteria thrive in this sugary, dry, anaerobic environment.
Sinusitis: This is an infection originating from bacterial, fungal or viral infections, which causes inflamed sinuses. Classic signs of sinusitis include fever, loss of taste and/or smell, fatigue, coughing, toothache, painful pressure behind the eyes, and bad breath. In addition to breathing through the mouth, people with sinusitis may exacerbate dry mouth by taking decongestants to help alleviate swelled sinus passages. Some of the ingredients that relieve congestion also inhibit salivary gland output as a side effect of decreasing mucous secretions. Decongestants help reduce swelled sinus passages, but they can also can lead to severe xerostomia.
Sjögren's syndrome: This fairly uncommon autoimmune disorder causes chronic xerostomia because the body erroneously attacks the salivary glands, damaging their ability to release saliva. Often associated with lupus, rheumatoid arthritis, and scleroderma, Sjögren's is diagnosed when certain criteria are met following testing of salivary gland functioning, detection of auto-antibodies in blood serum, and results of a salivary gland biopsy.
Sleep Apnea: This condition causes the airway to repeatedly become blocked, limiting the amount of air that reaches the lungs. In many cases, an apnea or temporary pause in breathing, is caused by the tissue in the back of the throat collapsing. Most people are unaware that they are having problems breathing and cannot judge the severity of the problem. The lack of oxygen forces the person to inhale suddenly, a movement that creates an extremely loud snoring sound which often awakens the individual and anyone else in the room. Repeated snoring episodes can cause severe xerostomia, which is often not relieved even after drinking water, chewing gum, or sucking on mints all day after an episode.
Other Health Conditions: In addition to the diseases mentioned above — HIV, Alzheimer's disease, Parkinson's disease, liver and kidney disease, anemia, hypertension, rheumatoid arthritis, endocrine disorders, and mumps can all cause dry mouth. Some of these conditions are life threatening, so it is important to discuss this symptom with your physician.
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.
Oral Health and Dry Mouth
When left untreated, reduced saliva flow can lead to numerous oral health problems, including:
- Dry Tongue and Throat
- Difficulty Eating
- Mouth Sores
- Halitosis (Bad Breath)
- Tooth Decay
- Oral Candidiasis (Thrush)
- Receding Gums
Dry Mouth Treatment
When the mouth is properly hydrated and free of food debris, the potential for gum and dental disease is greatly reduced. While brushing, flossing and rinsing at least two or three times a day may help alleviate dry mouth, the key is using the right products. Oxygenating mouthwashes, toothpastes, and rinses that are alcohol-free, sugar-free, and without any abrasive detergents, are essential to killing harmful oral bacteria.
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