Dry Mouth (Xerostomia)

Dry mouth (also known as xerostomia) is the sensation that there is insufficient saliva in the oral cavity.

Without saliva it would be very difficult to chew, swallow food and talk. Saliva helps the digestion process and also prevents infections by controlling the bacteria found naturally in the mouth. Saliva also prevents tooth decay.

Almost everyone at some stage in their life is likely to suffer from oral dryness. The vast majority of cases is as a result of side effects of medications i.e. antibiotics and antidepressants.

It could be through drinking alcohol, snoring and stress or as a result of anaesthetic following an operation. Auto-immune diseases such as Sjögrens, Lupus or HIV prior to diagnosis will often start with dry mouth symptoms. Almost all people undergoing radiation treatment to the head and neck area will experience a sore and dry mouth.

Those people that may be unaware they have diabetes or badly managed diabetes are also likely to suffer. Similarly people with hypertension, heart disease or who have experienced a stroke. The increasing population diagnosed with Alzheimer’s disease may also feel oral dryness, not just as a result of the disease but because of the medication being taken to manage the symptoms.

This is a really subjective opinion as many people will react differently to medication or treatments that can cause a dry mouth. It is not unusual for dentists or hygienists to see what looks like a moist pink mouth only to have the patient complain of constant dryness, despite no outward evidence.

Common symptoms are the tongue sticking to the inside or palate of the mouth – especially at the point of waking. People often find it hard to converse for long periods of time and have to constantly drink water. Others can’t eat certain things like bread or acidic foods as they stick to the oral cavity and get stuck in the throat understandably causing great distress. Sadly many people state that their taste is distorted so things don’t have the expected flavour and altered taste can often deter people from trying or eating food.

Other more obvious symptoms include dry and cracked lips, painful tongue, difficulty with denture retention, unable to wear make-up – especially lipstick as it dries and cracks, denture sores and sticky or stringy saliva.

Sadly, in extreme cases people can suffer all day and all night. It varies hugely and may also only be more noticeable at certain periods i.e. taking a drug for hay fever in spring/summer, or if people are stressed, smoke, haven’t got diabetes under control and are generally dehydrated.

Most people notice their dry mouth towards the end of the day and after cleaning teeth (SLS – sodium lauryl sulphate – which makes the toothpaste foam will enhance oral dryness). It seems more evident first thing in the morning because any saliva production naturally slows down when people are not talking, chewing or swallowing and if people have been snoring or mouth breathing throughout the night.

The most common cause of dry mouth is drug side effects. Other reasons for oral dryness is cancer treatments, using oxygen (COPD), struggling for breath (asthma or any respiratory disorder), auto-immune diseases (Lupus, Bechet’s, HIV/AIDS), long term degenerative diseases (MS, Parkinson’s, Motor Neuron), people with renal disorders or those with a liquid restriction (so they perceive thirst), not able to consume anything orally (PEG or NG fed), rheumatoid arthritis or something as simple as mouth breathing, smoking, stress, anxiety and bad breath.

Many people become anxious when they realise that dry mouth could be something they have to live with for the rest of their life. Until it is something you have experienced yourself it is hard to imagine just how debilitating a dry mouth can be. It can have a huge impact on the way people carry out their day to day routine and many people stop having a social life altogether because eating out is fraught with hazards.

Most people with xerostomia will carry water with them and may change their food habits. Most will need to eat more pureed food and add a lot of sauce or gravy to their meals. It may also take much longer to consume a plate of food, so by the time they have finished, the meal will be cold and others at the table may have completed their meal half an hour sooner.

Managing dry mouth and any pain or soreness associated with it will enhance quality of life.

To a degree drinking water will help. But it has to be noted that the condition of dry mouth is simply that – it has a little to do with thirst – but many people are not thirsty they simply have a constant sensation of dryness, so drinking water won’t necessarily help.

However, taking small sips of warm water and swallowing slowly may be beneficial and shouldn’t wash down any access saliva from the glands. Avoiding drinks or liquids that contain alcohol i.e. mouthrinses and hot drinks with caffeine will also enhance any saliva flow.

It is not unusual for dry mouth symptoms to be the cause of undetected diabetes.

Xerostomia can be the cause as well as the symptom of high blood sugar, therefore it can exacerbate the side effects of diabetes. Oral thrush can also develop in a mouth with low saliva levels due to the high glucose in saliva making it resistant to infection.

Managing dry mouth to provide long term comfort can be achieved by the Gengigel Spray or Gengigel Gel which will adhere to the oral cavity and provide instant relief. The natural active ingredient (Sodium Hyaluronate) will help balance the oral flora and prevent infection. After cleaning teeth swish the mouth with Gengigel Mouthrinse to further boost healthy gums and reduce redness and inflammation.