Singapore Dental Health blog

Xerostomia
Lack of saliva is a common problem, but a dry mouth can affect both your enjoyment of food and the health of your teeth. The medical term for dry mouth is xerostomia (zeer-o-STO-me-uh).

Dry mouth can cause problems because saliva helps prevent tooth decay by limiting bacterial growth and washing away food and plaque. Saliva enhances your ability to taste and makes it easier to swallow. In addition, enzymes in saliva aid in digestion. Although the treatment depends on the cause, dry mouth is often a side effect of medication. Dry mouth may improve with an adjusted dosage or a new prescription.

Signs and symptoms that you have xerostomia:

• Dryness in your mouth
• Saliva that seems thick, stringy
• Sores or split skin at the corners of your mouth
• Cracked lips
• Bad breath
• Difficulty speaking, swallowing
• Sore throat
• An altered sense of taste
• A fungal infection in your mouth
• Increased plaque, tooth decay and gum disease
• In women, dry mouth may result in lipstick adhering to the teeth.

When to see a doctor
If you've noticed persistent dry mouth signs and symptoms, make an appointment with your family doctor or your dentist.
Dry mouth has numerous causes, including:

• Medications. Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, decongestants, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson's disease medications.
• Aging. Getting older isn't a risk factor for dry mouth on its own; however, older people are more likely to be taking medications that may cause dry mouth. Also, older people are more likely to have other health conditions that may cause dry mouth.
• Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount
• produced. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production.
• Nerve damage. An injury or surgery that causes nerve damage to your head and neck area also can result in xerostomia.

• Other health conditions. Dry mouth can be a consequence of certain health conditions — or their treatments — including the autoimmune disease Sjogren's syndrome, diabetes, Parkinson's disease, HIV/AIDS, anxiety disorders and depression. Stroke and Alzheimer's disease may cause a perception of dry mouth, even though the salivary glands are functioning normally. Snoring and breathing with your mouth open also can contribute to the problem.
• Tobacco use. Smoking or chewing tobacco can increase dry mouth symptoms.
What can be done

• Write down any symptoms you're experiencing, including any that initially may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all prescribed medications, vitamins, supplements and over-the-counter medications that you're taking.
What to expect from your doctor

Your doctor or dentist is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor or dentist may ask:
• When did you first begin experiencing symptoms?
• Have your symptoms been continuous, or occasional?
• Have you started taking any new medications recently?
• Do you smoke or chew tobacco?
• Does anything improve your symptoms or stimulate your saliva flow?
• What, if anything, appears to worsen your symptoms?
What you can do in the meantime
Try frequently sipping water or chewing sugar-free gum to increase your saliva. Also, be sure to brush your teeth regularly to help prevent cavities. If you use tobacco, quitting will likely improve your signs and symptoms.

To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you'll need blood tests and imaging scans of your salivary glands to identify the cause
If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn't cause a dry mouth. Your doctor may also consider prescribing pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.
When the cause of the problem either can't be determined or can't be resolved, the following tips may help improve your dry mouth symptoms and keep your teeth healthy:
• Chew sugar-free gum or suck on sugar-free hard candies.
• Limit your caffeine intake. Caffeine can make your mouth drier.
• Avoid sugary or acidic foods and candies because they increase the risk of tooth decay.
• Brush with a fluoride toothpaste. (Ask your dentist if you might benefit from prescription fluoride toothpaste.)
• Use a fluoride rinse or brush-on fluoride gel before bedtime.
• Don't use a mouthwash that contains alcohol because these can be drying.
• Stop all tobacco use if you smoke or chew tobacco.
• Sip water regularly.
• Try over-the-counter saliva substitutes. Look for ones containing carboxymethylcellulose or hydroxyethyl cellulose, such as Biotene Oralbalance.
• Avoid using over-the-counter antihistamines and decongestants because they can make your symptoms worse.
• Breathe through your nose, not your mouth.
• Add moisture to the air at night with a room humidifier