Dry mouth or xerostomia is a common condition characterized by a decrease in the amount of saliva produced by the salivary glands.

This symptom can be caused by a variety of factors, including medications, systemic diseases or radiation treatments. Dry mouth can affect patients’ quality of life and increase the risk of dental caries and oral cavity infections.

In this article, we take a closer look at the causes, symptoms and treatment options for xerostomia.

Causes of xerostomia

The sensation of dryness of the oral mucosa can be caused by a variety of factors, including medications, systemic diseases or radiation treatments. Medications that can cause xerostomia include antidepressants, antihistamines, diuretics and drugs used to treat high blood pressure and Parkinson’s.

Certain systemic diseases, such as diabetes, hypothyroidism and Sjogren’s syndrome, can lead to xerostomia.

In addition, radiation treatments for head and neck cancer can affect the salivary glands and cause xerostomia.

Symptoms of xerostomia

Symptoms of xerostomia can range from mild to severe and may include dryness or “burning mouth” sensation, difficulty swallowing or speaking, unpleasant tastes and smells, tooth decay or inflammation of the oral cavity. Patients with xerostomia may also experience an increase in mucus production or thick, viscous saliva.

Treatment of xerostomia

Treatment of xerostomia focuses on managing symptoms and improving patients’ quality of life. Treatment options may include:

1. Medication management: Patients should discuss with their doctor the medications they are taking and explore options for changing or reducing their dosage to reduce xerostomia symptoms.

2. Hydration: Patients should drink plenty of water and use sugar-free gums or candies to stimulate saliva production.

3. Avoiding substances that can cause dry mouth: Alcohol, tobacco and spicy or dry foods can aggravate xerostomia symptoms and should be avoided.

4. Use of oral lubricants: There are a range of products available that can be used to moisturize the mouth and improve the comfort of patients with xerostomia. These can include mouth sprays, gels and oral lubricants.

5. Use of drugs to stimulate saliva production: Some drugs, such as pilocarpine and cevimeline, may be prescribed to stimulate saliva production in the salivary glands.

6. Saliva replacement therapy: In severe cases of xerostomia, patients may be eligible for saliva replacement therapy, which involves administering a saliva replacement solution via a spray or pump.

Everyone can experience dry mouth at least once in their life. Some situations such as stress, insufficient hydration, agitation or depression can cause such changes.

But a mouth that is dry most of the time is unpleasant, uncomfortable and causes many local pathological changes.

Symptoms

• Feeling that the mucous membranes are sticking to each other, to the teeth or to food found in the oral cavity

• Problems with chewing and phonation

• Burning sensation in the mouth

• Cracked lips

• Dry tongue with white streaks on the surface

• Possible ulceration of mucous membranes

A dry oral cavity prevents the efficient and physiological performance of everyday activities such as chewing food and speaking.

Saliva also plays an important role in cleaning dental surfaces. Reduced amounts of saliva cannot provide the function described above, so a patient’s susceptibility to caries increases exponentially.

Caries due to saliva deficiency is rapidly progressive and spreads over large areas of teeth.

Left untreated, this deviation from normal can lead to oral mucosal lesions which, if left untreated and unbalanced, can become over-infected, with serious consequences for the whole body.

Determinants

Dry mouth occurs when the salivary glands no longer perform their secretory function at optimal capacity. There are a number of reasons why this may occur:

• Medication used to treat general conditions: it is estimated that there are several hundred drugs whose side effect includes a reduction in the amount of saliva secreted by the salivary glands. The most numerous are drugs prescribed for high blood pressure and antidepressants. It is advisable to consult the doctor who prescribed this therapy if dryness of the mucous membranes occurs, in order to replace the drug in question with one from another class but with similar effects.

• General pathologies: diseases such as Sjogren’s syndrome, AIDS or diabetes are responsible for reduced salivary flow.

• Chemotherapy and radiotherapy: if the salivary glands are exposed to radiation during radiotherapy or if the drugs used in chemotherapy increase the viscosity of saliva, the effects are to reduce the amount of saliva.

• Salivary gland damage: trauma, tumors or calcifications that compress the salivary ducts reduce the amount of saliva, with the effects mentioned above.

Treatment

Treatment of dry mouth syndrome can be simple or complicated, depending on the cause. The doctor can determine the reason and institute the appropriate treatment.

If the cause is drug-induced, the current treatment may be replaced by one with fewer side effects.

If the salivary glands are malfunctioning, they should be operated on to stimulate saliva production or to remove the obstruction from the duct.

Artificial saliva products are available to maintain the optimal intraoral environment.

As a patient, fluid intake, especially water, can be intervened upon and should be increased. Liquids such as coffee, carbonated drinks and teas can dry out the oral mucosa.

Using chewing gum after meals also stimulates salivary flow.

Conclusion

Xerostomia or dry mouth can be an uncomfortable condition and affects patients’ quality of life. It is important to discuss your symptoms and available treatment options with your doctor. In general, medication management, hydration, avoidance of substances that aggravate symptoms, and the use of oral lubricants or medications that stimulate saliva production can help relieve xerostomia symptoms.