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What is Dry Mouth?

Dry Mouth or Xerostomia is not a disease in itself, but can be a symptom of certain diseases.
It can negatively affect a patient’s quality of life-impacting on eating habits, nutritional health, speech, taste, tolerance to dental prosthesis (such as dentures) and can increase the likelihood of dental decay.

What are the causes of Dry Mouth?

[link to Causes of Dry Mouth webpage]
Dry Mouth can result from a number of causes, such as the use of certain drugs (such as anti-hypertensives, tricyclic anti-depressants, analgesics, tranquilizers, diuretics and anti-histamines); inflammatory conditions such as Mumps, TB, Sarcoidosis and Sjögren’s Syndrome; obstructions such as salivary stones; conditions such as dehydration, diabetes, cardiac and renal failure, toxic goitre, menopause and senility; nutritional causes such as Vitamin A and iron deficiency; cancer treatment such as chemotherapy and radiotherapy and psychiatric causes.

What can be done to relieve Dry Mouth?

  • The lack of saliva can have a profound effect on the mouth and the teeth.
  • There are a number of things you can do to relieve the symptoms:
    Sip / drink water frequently.
  • Stimulate saliva with sugar-free gum (such as Xylitol), diabetic sweets, Salivix or SST if advised.
  • Keep your mouth clean, paying special attention to the teeth.
  • Use an artificial saliva (Artificial Saliva, Glandosane, Luborant) or saliva substitute (such as Orthana or Oral Balance-Biotène).
  • Use an antiseptic mouthwash (such as Corsodyl or Biotène).
  • Avoid alcohol-based mouth rinses.
  • Spray a water and glycerine solution into your mouth, mixed in a small aerosol bottle.
  • Always take water or non-alcoholic drinks with meals.
  • Avoid anything that worsens the dryness, such as certain drugs (see above), alcohol, smoking, caffeine and mouth-breathing.
  • Protect against dental decay by using a Fluoride mouth rinses / gels (such as Fluorigard), regular dental checks, avoiding sugary foods / drinks and sticky food.
  • Protect against Thrush & Halitosis by your mouth very clean and moist, rinsing twice daily with chlorhexidine (Corsodyl, Chlorhex or Eludril) or Triclosan (Plax), brushing or scraping of tongue, keeping dentures out at night and soaked in hypochlorite (eg Miltons or Dentural) and use of anti-fungals (if prescribed by your clinician).
  • Protect the lips with a lip salve or petroleum jelly (eg Vaseline).
    Consider a humidifier in the room.

You can also make dietary changes to help the condition – blended and mixed foods are easier to swallow.

Eat hard cheeses instead of soft cheeses and use sucralose in place of sugar. Avoid spicy, hard crunchy or dry foods. Take small bites and eat slowly. Pineapple has an enzyme that helps clean the mouth.

Drugs such as pilocarpine or cevimeline are sometimes prescribed but these drugs have many side effects that many people can not tolerate.

(Adapted from the Eastman Dental Institute, Oral Medicine Clinic – Dry Mouth – 10 steps towards managing a dry mouth. My thanks to Prof Scully for updating me regarding this).

Key_Points_for_Patients_-_Dry_Mouth
Key_Points_for_GDP_s_-_Dry_Mouth

Useful Articles & Websites

Biotène products available from www.biotene.co.uk

Xerotin products available from www.SpePharm.com

BioXtra products available from www.bioxhealthcare.com

Aquoral products available from www.aquoral.com

Table comparing the various saliva substitutes & preparations used to treat dry mouth / xerostomia 

British Sjögren’s Syndrome Society

Sjögren’s Syndrome Online Community

Oral Cancer Foundation

Challacombe Scale

American Dental Association – Dry Mouth

Eastman Dental Institute, Oral Medicine Clinic – Dry Mouth – 10 steps towards managing a dry mouth

Eastman Dental Institute, Oral Medicine Clinic – Dry Mouth Patient Information Sheet

NIAMS, National Institutes of Health Public Health Service & U.S. Department of Health and Human Services. Questions & Answers about Sjögren’s Syndrome

Oral Diseases 2002. Current Issues in Sjögren’s Syndrome

Oral Diseases 2002. Drug Effects on Salivary Glands – Dry Mouth

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004. An update of the ætiology and management of xerostomia

JADA 2007. For The Dental Patient…Oral Moisturizers. Products that can help relieve Dry Mouth

Vital, Spring 2009, Managing Xerostomia

BDJ 2011. Treating Patients with Dry Mouth – General Dental Practitioners’ Knowledge, Attitudes & Clinical Management

BDJ 2012. Sjögren’s Syndrome; An Update for Dental Practitioners

Dental Update 2012. Oral Medicine 4. Dry Mouth & Disorders of Salivation

Evidence-Based Dentistry 2012. No strong evidence that any topical treatment is effective for relieving the sensation of dry mouth

Cochrane Collaboration 2013. Interventions for the Management of Dry Mouth. Non-Pharmacological Interventions (Review)

Prim Dent J 2015. Dry Mouth & Sjögren’s Syndrome – An Overview

Singapore Dent J 2015. Dry Mouth – An overview

AFP 2016. Dry Mouth – Xerostomia & Salivary Gland Hypofunction

Dent Update 2016. Antimuscarinics in Older People – Dry Mouth and Beyond

JADA 2016. Managing Dry Mouth

Cochrane Database of Systematic Reviews 2017. Pharmacological interventions for preventing dry mouth & salivary gland dysfunction following radiotherapy

Biotène Patient Leaflet

Oral Health Matters. Dry Mouth (Xerostomia)