Ask the Dentist: Dry Mouth
Does your mouth feel dry? Do your lips and tongue feel cracked?
Dry mouth is a common problem which affects 10 per cent of the general population and 25 per cent of older people. Dry mouth is usually a symptom of an underlying issue such as side effects from medications, medical treatment, salivary gland issues, or diet and lifestyle problems. If dry mouth is left untreated, it can eventually lead to tooth decay, tooth loss, and oral infections inside the mouth. Treatment and management of dry mouth can include adjusting medications, hydrating regularly with water, improving oral hygiene, changing our diet, using saliva substitutes or even surgery if there are salivary gland issues.
If you do have dry mouth, we recommend having a chat with your General Practitioner (GP) and visiting your family dentist for a dental check up to work out what is causing your dry mouth and how to treat and manage it.
In this article, we will explain questions such as what are the effects of dry mouth?, what are the causes of dry mouth?, what medications are likely to cause dry mouth? why is saliva important?, what should I discuss on dry mouth with my GP, pharmacist and dentist? and what are some practical tips on managing dry mouth?
What is Dry Mouth?
Dry Mouth is a symptom of an underlying issue. It might be due to an objective decrease in saliva from your salivary glands , or it might be a subjective feeling of dryness in your mouth called xerostomia, or it might be both.
What are the Effects of Dry Mouth?
Teeth Problems
tooth loss and pain
tooth decay (dental caries)
gum disease (periodontal disease)
Eating Problems
difficulty with eating, chewing and swallowing
changed or reduced ability to taste food
loss of appetite
poor nutrition (malnutrition) leading to poor quality of life
Throat Problems
sore throats and hoarse voice
difficulty with speaking
throat infections (pharyngitis or laryngitis)
General Problems in Mouth
oral infections inside the mouth such as fungal candidiasis
problems with wearing dentures and sore gums from dentures
bad breath (halitosis)
dry lips and cracked lips
burning feeling of the lips and tongue
poor sleep due to dry mouth
What are the Signs and Symptoms of Dry Mouth?
thick, sticky or stringy saliva
dry, rough or cracked tongue
feeling like the tongue sticks to the roof of the mouth because its dry
having trouble chewing or swallowing food
regular bad breath
regular mouth ulcers
dry and cracked lips
oral fungal infections
lots of general tooth decay in the mouth
feeling a tingly, burning sensation on the tongue, lips and in the mouth
dentures feeling loose due to low saliva flow
Note: Not everyone might know they have a dry mouth. It may even come as a surprise to you when your GP or dentist tells you about it.
What causes Dry Mouth?
There are a wide range of causes for Dry Mouth - some are short term that can be fixed quite easily, and others are longer term, which may need to be carefully managed. Causes of dry mouth include:
medications – a large contributing factor to dry mouth especially in the older population are medications. It can be over the counter non prescription medications or it can be medications prescribed by your GP or specialist. The more medications you take, the higher the likelihood you may experience dry mouth. These medications include antidepressants, antihistamines, some blood pressure medications, some eye drops, cough medicines, cold and flu medicines, pain relief medications (pain killers), medications for urinary problems, and some inhaled medications like asthma puffers. Illegal drugs like cocaine can also cause dry mouth
dehydration – not having enough fluid intake can cause your saliva to thicken and cause dry mouth. Other causes of dehydration may include excessive exercise, extreme heat or medical conditions such as blood loss, diarrhoea or kidney failure
infection – your salivary glands and ducts may be undergoing inflammation and be blocked or restricted if you have a bacterial or viral infection of the salivary glands (e.g mumps)
salivary duct obstructions – sometimes the saliva ducts may be blocked and obstructed because of saliva stones forming from the minerals in the saliva
medical diseases/conditions – particular medical conditions may increase the likelihood of dry mouth and they include AIDS, amyloidosis, cerebral palsy, diabetes, Parkinson’s disease, primary biliary cirrhosis and lupus. One to point out in particular is Sjogren’s syndrome – this can be a common autoimmune disease that decreases the production of fluids in the eyes, salivary glands, and sweat glands
nerve problems – the saliva glands are controlled by the facial nerves and so if there is any trauma, or damage to these nerves, you may experience a reduction in saliva
cancer treatments – some treatments such as chemotherapy or radiotherapy (especially if they are directed at the head and neck region) may temporarily reduce saliva production from your salivary glands
mouth breathing – this may be a serious underlying problem which affects your breathing and sleep. Repeated nasal congestion, blocked sinuses, regular mouth breathing are best investigated by a trusted Ear Nose Throat Specialist (ENT Specialist) to assess your situation. It may be as problematic as sleep apnoea.
Why is Saliva Important?
it helps protect the teeth from bacteria that cause tooth decay and tooth loss
it helps protect the gums from bacteria that cause gum problems
it contains both phosphorus and calcium, which play an important role of tooth remineralisation. This actually helps to strengthen the enamel of the tooth and helps with protecting the teeth against tooth decay
it helps prevent fungal infections
it helps to fight viruses
it neutralises and buffers the acids produced by bacteria and plaque
it lubricates the food we chew and eat to help with swallowing
it helps with making particular sounds when speaking
the lubrication of the mouth, lips and tongue helps in the tasting food and experiencing the texture of food.
Who should I speak with about Dry Mouth?
It is highly recommended that you speak with both your GP AND your dentist.
General Practitioner (GP)
If you have dry mouth, you should talk to your GP to discuss your medications, medical conditions and lifestyle.
They might suggest for you to have a Home Medicines Review. This is a free service where a a specially trained pharmacist comes to your home and reviews your medications. In conjunction with your pharmacist or specialist, they may be able to adjust the dose or change your medications to help manage or reduce your dry mouth
Your GP or pharmacist may be able to advise you on taking medications earlier in the day rather than at night. Our our saliva production is lowest at night when we sleep
Dentist
Dry mouth increases your risk of getting tooth decay and other teeth and gum problems.
Regular 6 monthly visits to the dentist can ensure that your teeth, dentures and gums stay healthy.
Your dentist can also give you advice about how to help manage dry mouth and which products are best to use
Good oral health is important for your overall health because it provides you with better ability to eat nutritious foods to stay healthy
Even if you have dentures, it is important to have regular 6 monthly dental check ups.
If you are a war veteran and have a Department of Veteran Affairs DVA Gold Card - you may be eligible for free dental treatment. When making an appointment, ask your dentist whether they provide dental services for DVA Gold Card holders. In most cases you won’t have to pay anything out-of-pocket expenses for your dental treatment.
If you are anxious or nervous about seeing a dentist - please let us know when making your appointment with us. Our staff and dentists are specially trained to help you relax and feel comfortable with any dental treatment that you may need.
How Do I Treat Dry Mouth? Practical Tips to Manage Dry Mouth
Set Good Oral Hygiene Habits
Brush your teeth for 2 minutes twice a day with fluoride toothpaste
Use dental floss daily (it doesn’t matter what type of floss you use)
Rinse your mouth with alcohol free (no alcohol) mouthwash.
Diet
Reduce your intake of sugary and acidic foods and drinks such as fruit juice, cordials, fizzy drinks, soft drinks, alcohol, sports drinks and energy drinks.
Increase your intake of water - you should talk to your GP about how much water to drink. This may vary from person to person and be dependent on your medications, time of year (weather), and how active you are
Sip on plain tap water
Suck small pieces of ice or spray water into your mouth.
Eat foods that require chewing to help increase saliva production,
Chew on sugar-free chewing gum or sugar-free lollies between meals.
Day to Day
Use a water-based lip balm or lip moisturiser if your lips are dry.
Carry a bottle of water around with you
Smoking
Smoking can not only cause dry mouth but it will heavily affect your teeth and gums and cause serious long term damage.
If you do smoke, please talk to your GP or pharmacist about the options for quitting. You can find support by contacting the national smoking Quitline on 13 7848 or visit www.quitnow.gov.au
Dry Mouth Products
You can visit your local dentist or chemist to discuss products for dry mouth. There are specialised toothpastes, mouthwashes or antibacterial gels for dry mouth that might help. One of those brands include Biotene by GSK
Medications
Discuss with your pharmacist or GP to see what medications can be adjusted or changed
If you use inhalers like asthma puffers, please discuss with your pharmacist or GP about your inhaler technique. Use a spacer device and rinse your mouth with water immediately after each use.
We hope you’ve enjoyed this blog by Dr Kenneth Chan from Capstone Dental.
If you found this article helpful, please share it with your family and friends. We firmly believe in educating our patients to help them understand how to achieve good oral health. Are you looking for modern and gentle dentist who will look after you and your family?
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