A dry mouth every day or most of the time can be irritating and can cause:

  • Symptoms,
  • Diseases.

It can also be a symptom of certain diseases.
The medical term for dry mouth is xerostomia.

Biology of saliva
Saliva is produced by the salivary glands .
These glands secrete a liquid in the mouth that contains:

  • Water,
  • Electrolytes,
  • Mucus,
  • Enzymes .

Functions of saliva
Saliva plays many roles:

1. Lubricant and binder : Saliva mucus amalgamates (or mixes) chewed food effectively, creating a viscous cake that flows easily through the esophagus , without causing damage to the mucosa. ( Dechaume M, Goguel S, Poullain P. Human saliva: Physical properties, chemical composition, cytology, bacteriology, serological properties, role, Revue Stomatol )

2. Impregnate with water and make dry food soluble : to appreciate the food, the molecules contained in it must become soluble.

3. Oral hygiene : the oral cavity is constantly rinsed by saliva, which:

  • Removes food waste,
  • Keeps mouth relatively clean.

The flow of saliva decreases considerably during sleep and allows bacteria to accumulate in the mouth.
The consequence is bad breath in the morning.
Saliva also contains lysozyme, an enzyme that breaks down many bacteria and prevents infections . ( Dewar MR, The Saliva: A Short Review, with special reference to dental caries, Med J Aust ).

Saliva helps prevent cavities :

  • By limiting bacterial growth,
  • Removing food particles.

4. Beginning of starch digestion : salivary amylase (or ptyalin) is an enzyme that initiates the digestion of starch and converts it to maltose. ( Neilson CH, Terry OP, “The adaptation of the salivary secretion to diet.” Am J Physiol )

 

Signs and symptoms of dry mouth (xerostomia)

Signs and symptoms of xerostomia include:

  • Bad breath
  • Cheilitis –  inflammation and cracking of the lips
  • Cracked lips
  • Cracks and fissures of the oral mucosa (inner wall of the cheeks and lips)
  • Dysgeusia – bitter mouth or metallic taste
  • Fungal infections of the mouth, such as  candida
  • Sensation of taste changed
  • Lipstick tends to get your teeth dirty
  • Most common gingival diseases
  • More plaque and cavities
  • Swallowing and chewing problems – especially very dry and friable foods, such as cookies or cereals.
  • Problems using prosthesis – problems with prosthesis maintenance and wound formation
  • Sore throat
  • Sticky saliva
  • The skin at the corners of the mouth can tear or be painful.
  • Glossodynia – sore tongue
  • Great thirst, especially at night
  • Inflammation of the tongue, ulcers on the tongue
  • Language problems
  • Infection of the salivary glands

Causes of dry mouth

Dry mouth has several causes, including:

Side effects of certain medicines
Dry mouth is a common side effect of many prescription and over-the-counter medicines, including medicines used to treat:

Dry mouth can be a side effect of muscle relaxants and sedatives.

 

Side effect of certain diseases and infections
Dry mouth can be a side effect of certain diseases such as:

The stroke and Alzheimer’s disease can cause a perception of dry mouth, although the salivary glands function normally. Snoring breathing with open mouth may favor dry mouth.

Treatment for tumors and cancer
Side effect of certain medical treatments. Damage to the salivary glands (glands that produce saliva) can be caused by radiation therapy for head and neck or chemotherapy for cancer. This reduces the amount of saliva produced.

Aging
Age is not a risk factor for dry mouth alone.
However, the elderly usually take medicines that can cause dry mouth.
In addition, older people are more likely to have other diseases that can cause dry mouth.
At menopause there is less saliva production because it lowers the hormone estrogen.

Damage to nerves
An injury or surgery that causes nerve damage to the head and neck area can cause xerostomia .

Pregnancy
In the first months of pregnancy, the pregnant woman may feel dry mouth, although drinkingmore than usual.

Cigarettes or cigar smoke 
Smoking or chewing tobacco can increase dryness in the mouth.

 

Dry mouth in the morning

When awakening it is easier to have a dry and dense mouth because at night the body produces less saliva; in addition, sleeping with the mouth open makes the little saliva present dry.

 

Mouth dry when speaking or running

Activities such as running or talking are done with the mouth open and then it is normal to have a dry mouth.
It is advisable to keep a bottle of water close at hand when making presentations, especially on stage, because the most exciting situations can affect the salivary flow.

 

Diagnosis of dry mouth

To determine if the person is suffering from dry mouth, the doctor or dentist will examine the mouth and check the medical history. Blood tests, imaging tests such as magnetic resonance imaging or scintigraphy of the salivary glands or other tests that measure the amount of saliva that is produced (sialometry)
are sometimes necessary to identify the cause . For  diabetes , you need to check your blood glucose .

 

Treatment for dry mouth

Artificial
saliva Your doctor may prescribe a spray or a gel that acts as a substitute for saliva.
Each dose lasts a short time, therefore frequent application is required.

Saliva Stimulants
In some cases of dry mouth, the salivary glands are affected only in part and may be stimulated to produce more saliva.
A sugar-free gum can help increase the production and flow of saliva.

The pilocarpine is a medicine that can stimulate the salivary glands to produce more saliva. It may be prescribed if other measures have not helped much.
Generally, pilocarpine works well and quickly in most people with dry mouth caused by the side effects of a medication.
Pilocarpine is not very effective in treating people whose dry mouth is caused by radiation therapy .
Pilocarpine can cause side effects in some people, such as:

Side effects become less irritating as time goes by when the person’s body becomes accustomed to the medication.
Thus, a doctor may recommend a low dose at the beginning, to be taken for a while until the side effects subside.
The dose can be increased gradually in order to obtain the maximum benefit, but keeping the side effects to a minimum.

Pilocarpine should not be used normally if the person suffers from:

 

Lifestyle changes and natural remedies for dry mouth

When the cause of the problem can not be determined or can not be resolved, the following tips can help improve dry mouth symptoms and keep your teeth healthy:

  • Chewing sugarless chewing gum or sucking two sugarless flakes, although this remedy may cause other health problems because these products contain aspartame and other sweeteners or additives.
  • Eat foods that stimulate salivation.  The most suitable are citrus fruits: lemon, orange and grapefruit.
  • If there are no contraindications, fasting can help resolve diseases that cause dry mouth.
  • Limit caffeine intake . Caffeine can make the mouth dry.
  • Avoid candies and sugary or acidic foods  because they increase the risk of tooth decay .
  • Do not use a mouthwash that contains alcohol because alcohol can cause increased dryness.
  • Stop smoking or chewing tobacco.
  • Drink water or suck ice during the day to moisten your mouth or drink water in the meals to help chew and swallow.
  • Try over-the-counter saliva substitutes . There are products containing carboxymethylcellulose or hydroxyethylcellulose, such as Biotene mouthwash.
  • Avoid using over -the-counter decongestants and antihistamines because they can aggravate the symptoms.
  • Breathe through the nose , not the mouth.
  • Increase air humidity at night with an air humidifier for bedrooms.

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