What is dry mouth (xerostomia)? What causes dry mouth?
What are the signs and symptoms of Xerostomia (dry mouth)?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign. The signs and symptoms of xerostomia may include:- Bad breath
- Cheilitis - inflammation and fissuring of the lips
- Cracked lips
- Cracking and fissuring of the oral mucosa (inner lining of the cheeks and lips)
- Dryness in the mouth
- Dysgeusia - taste disorders
- Fungal infections in the mouth, such as thrush
- Glossodynia - painful tongue
- Increased need to drink water, especially at night
- Inflammation of the tongue, tongue ulcers
- Lipstick sticking to teeth
- More frequent gum disease
- More tooth decay and plaque
- Problems speaking
- Problems swallowing and chewing - especially dry and crumbly foods, such as crackers or cereals.
- Problems wearing dentures - problems with denture retention, denture sores and the tongue sticking to the palate.
- Sialadenitis - salivary gland infection
- Sore throat
- Sticky saliva
- Stringy saliva
- The skin at the corners of the mouth may split, or be sore.
What are the causes of xerostomia (dry mouth)?
- Anxiety disorders
- Depression
- HIV/AIDS
- Parkinson's disease
- Poorly controlled diabetes
- Sjogren's syndromes
- Sleeping with the mouth open
- Snoring
- Stroke and Alzheimer's disease - more likely to cause a perception of dry mouth.
Diagnosing xerostomia (dry mouth)
The doctor or dentist will probably examine the patient's mouth and review their medical history. Blood tests and imaging scans of the salivary glands may also be ordered.Sialometry - this is a simple office procedure that measures the flow rate of saliva. Collection devices are placed over the parotid gland or the submandibular/sublingual gland duct orifices, and saliva is stimulated with citric acid.
Saliography - this is radiographic examination of the salivary glands and ducts after the introduction of a radiopaque material into the ducts. It may be useful in identifying salivary gland stones and masses.
Biopsy - a small sample of salivary gland tissue is taken. Often used in the diagnosis of Sjogren's syndrome. If malignancy (cancer) is suspected the doctor may also order a biopsy.
Many healthcare professionals report that often the visual condition of the oral mucosa (inner lining of the cheeks and lips) does not correlate to the subjective feeling of "dry mouth" by the patient - even though the patient complains of severe dry mouth, the oral mucosa appears to be moist. Less frequently, it may be the other way round; the oral mucosa appears dry but the patient does not complain of dry mouth symptoms.
What are the treatment options for xerostomia (dry mouth)?
Treatment for xerostomia depends on several factors, such as whether the patient has an underlying condition or disease, or is taking certain medications that may be causing dry mouth.Ideally, the underlying cause is found. This does not always happen. If it is found steps need to be taken to minimize its effect.
Medications - if the dry mouth is thought to be caused by a medication, the doctor will either alter the dosage or prescribe another drug which is less likely to cause dry mouth.
Stimulating saliva production - a medication may be prescribed, such as pilocarpine (Salagen) or cevimeline (Evoxac), to stimulate the production of saliva.
Experts say that symptomatic treatment for dry mouth typically includes four areas:
- Increasing the flow of saliva
- Replacing lost secretions
- Controlling dental caries
- Some specific measures, such as treating infections.
Sipping fluids (non-carbonated, sugarless), chewing xylitol-containing gum, and using a carboxymethyl cellulose saliva substitute as a mouthwash may help.
Mouthwashes which contain alcohol should be avoided, because they may worsen dry mouth symptoms.
The patient should conduct a daily mouth examination, looking out for unusually colored patches, tooth decay or ulcers. Anything unusual should be reported to their doctor or dentist.
The patient should not wear dentures during sleep. The dentures must be kept clean by overnight soaking.
Individuals with xerostomia should avoid:
- Sugary foods or drinks
- Acidic foods or drinks
- Dry foods
- Spicy foods
- Astringents
- Excessively hot or cold drinks.
Caffeine consumption should be kept to a minimum.
Chewing or smoking tobacco should be avoided.
Eating such foods as carrots or celery may help with residual salivary gland function.
Breathing - breathing through the nose does not dry the mouth, while breathing through the mouth does.
Humidity - a humidifier can add moisture to a bedroom. This may help reduce dry mouth symptoms that develop during sleep.
Written by Christian Nordqvist
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