Dry Mouth (Xerostomia)

A recent review by the Cochrane institute found that as for a treatment for dry mouth -whatever works for you!
With well over 400 commonly used medications associated with dry mouth, along with aging, it isn't surprising that dentists are asked for advice in this area.
This Cochrane review looked at over 900 references and found 36 studies that meet their investigative criteria. There were 39 different interventions trialed in these studies (from Aloe vera gel to Canola oil to Vitamin C chewable tablets). The reviews found the small sample of the studies and the bias of the study designs meant that no meaningful conclusions could be drawn.
One of the interesting aspects of this review discussion was the reminder that xerostomia included the 'perception' of a dry mouth even with normal salivary flow.
If you have a dry mouth and think you have tried everything - this review may give you other ideas to experiment with!

Causes of a dry mouth

• There are more than 500 medicines that list dry mouth as a potential side effect.
• Sjogrens Syndrome, HIV/AIDS, diabetes, Parkinson's disease and other illnesses can all cause dry mouth.
• Radiation therapy. You can damage salivary glands if they are exposed to radiation during cancer treatment.
• Chemotherapy can make saliva thicker, causing the mouth to feel dry.
• Nerve damage via injury to the head or neck can damage the nerves that tell salivary glands to make saliva.

What might help if you have a dry mouth

• Frequent sips of water is the simplest treatment for a dry mouth. Carry a drink bottle wherever you go. Sipping water during meals makes swallowing easier and improves the taste of food.
• Milk may give a lubricating effect.
• Try using olive oil to moisten your mouth.
• Sugar-free chewing gum is a cheap way of attempting to increase saliva production. This has also been shown to help to prevent dental decay. Chewing gums are being developed incorporating substances which help to prevent dental decay.
• Try sugar free lollies but beware the sweetner may cause diarrhoea in some people.
• Avoid drinks with caffeine, such as coffee, tea, and some sodas. Caffeine can dry out the mouth. Also avoid alcohol and smoking as these dry the mouth.
• Try using a humidifier at night.
• Glycerine and lemon mouthwash can be used to try and stimulate saliva production. Beware that acid in the lemon mouthwash can cause erosion of teeth.
• Synthetic saliva substitutes : Ask your pharmacist. These are often packaged as a pump spray. Most of these products are available in small quantities and some patients find that this is a problem because of the need for frequent prescriptions.

Preventing dental problems caused by a dry mouth

• Antiseptic mouthwashes may help keep your mouth clean and reduce the number of bacteria that cause tooth decay and gum disease. The most effective antiseptic mouthwashes contain chlorhexidine e.g. Savacol (ask the dentist where to get some)
• Dentures should be left out at night and cleaned using a proprietary denture cleanser. Constant wearing of dentures may lead to candidal infection (a form of thrush) under the denture. This can be treated so see the dentist for advice.
• Use a high concentration fluoride toothpaste or a fluoride mouthrinse

Try our dry mouth quiz!

More information about Saliva
Treatment of a dry mouth is quite complex because saliva is a very interesting fluid.

• Everytime you swallow you leave a small amount of saliva in your mouth.
• Some people with normal amounts of saliva feel they have a dry mouth.
• You have the most saliva in your mouth at 5.00 p.m. at night and the least at 5.00 a.m. in the morning. Shift workers and midnight 'snackers' have to be very careful with what they eat or drink because they will be more likely to get decay.
• Be careful who you spit on. Your saliva carries lots of information about you and there is enough DNA in the saliva of a licked envelop to identify you!
• There is such a great difference in the type, consistency and amount of saliva produced that it is very difficult to define what is "normal".
• When you swallow you always leave a small (residual) amount of saliva in your mouth.

Saliva consist of -water, mucus, electrolytes and organic micro- and macro-molecules.
It is important because:

• it helps digest food
• it protects teeth from decay
• it prevents infection by controlling bacteria and fungi in the mouth
• it makes it possible for you to chew and swallow