dry mouth

We need saliva to eat, speak, swallow, remove debris from teeth and to protect gingiva (bleeding gums). Dry mouth or xerostomia (severely reduced saliva) is a common condition, which affects about one in four people and is most commonly caused by prescription drugs. It can occur at any time for a variety of reasons and, fortunately for some, can be reversible.

With limited saliva (the mouth’s most important natural defence against the risk of caries), one of the key problems faced by people with dry mouth is dental decay.

For more information, visit www.drymouth.info

Dry mouth is a reduction in salivary flow which produces dryness of the mouth.

Individuals usually detect dry mouth when the flow of saliva decreases to around half the normal unstimulated rate. This decrease in saliva flow can be because of interference of blood supply to the salivary gland, damage to its secretary function or interruption of stimuli, all of which result in hypofunction of the salivary glands. The glands source their fluid from the circulating blood, process it and secrete it into the mouth.

• Problems with eating, speech and swallowing
• Loss of taste
• Dental decay
• Ulceration
• Infection
• Gum inflammation
• Sore tongue
• Thrush or other yeast (candida) infections
• Soreness, discomfort and distress
• Bad breath
• Frothy saliva
• Difficulty wearing dentures, particularly upper dentures
• The oral mucosa can become thin and shiny
• The tongue may become smooth, cracked or fissured
• Surfaces in the mouth may stick to each other and be more susceptible to damage from food and dentures

• Dehydration
• Infection
• As an after-effect of surgery
• Endocrine disorders such as diabetes mellitus
• Smoking
• Anxiety and depression
• Old age
• Breathing through the mouth, particularly throughout the night
• Radiation (radiotherapy) to head and neck
• Dysfunction of the immune system, like HIV/AIDS
• Neurological disorders, including Parkinson’s disease
• Certain medications, especially those for depression, hayfever, nausea and high blood pressure (dry mouth is most commonly associated with xerogenic drugs including certain hypertensives and drugs with sympathomimetic actions)
• Rheumatoid conditions such as rheumatoid arthritis
• People seriously deficient in saliva may suffer from Sjorgen’s syndrome, a condition which not only affects the oral cavity but induces dryness of the eye membranes, nasal lining, respiratory tract and vagina

• Analgesics
• Anti-histamines
• Anti-hypertensives
• Anti-anxiety agents
• Diuretics
• Appetite suppressants

• Clean teeth and gums at least twice a day with fluoride toothpaste and mouthwash
• Sip water or sugarfree drinks
• Suck ice
• Eat fresh fruit and vegetables to stimulate salivary flow
• Chew ORBIT Complete sugarfree gum to stimulate saliva and help reduce the risk of dental decay
• Avoid alcohol, including mouthwashes containing alcohol
• Have sugary foods and drinks less often
• Use salivary substitutes such as sprays, lozenges and gels
• Use topical fluorides
• Use chemical plaque control
• Visit your dentist regularly to prevent and detect decay
• Increase fluid intake whilst eating
• Consult a dietician about the types of food to try and those to avoid
• In a controlled study in Sweden, acupuncture was found to be effective in patients with dry mouth
• Chewing ORBIT Complete sugarfree gum increases salivary flow in patients with xerostomia by up to seven times and, for people with at least some salivary activity, gum has been shown to be the preferred option.

Patients with little or no responsive salivary gland tissue will need salivary substitutes. For those with some glandular activity, saliva stimulants may induce some saliva production.

Artificial saliva:

• Artificial salivas are available in a variety of forms including sprays and lozenges and have been incorporated into swab sticks and reservoirs in dentures
• Mucin is a normal constituent of saliva and the mucin-based artificial salivas appear to be more effective and better tolerated than the carboxmethylcellulose based ones

Saliva stimulants:

• Sugarless sweets containing citric and malic acid chemically induce saliva production, but care must be taken that the acidic content does not result in the dissolution of the tooth enamel
• Glycerin, often used in combination with lemon, has been recommended as a saliva substitute. However, it can itself cause a dry mouth
• Chewing ORBIT Complete sugarfree gum increases salivary flow

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