A Dental Death Valley by Deborah Southard How to conquer cottonmouth print article      send to a friend

Dry mouth, or xerostomia, is characterized by decreased salivary flow that can be worsened by dry air, breathing through the mouth, and smoking.  Symptoms include an extremely dry mouth, sores at the corners of your lips, difficulty swallowing and speaking, halitosis (bad breath), burning or tingling of the tongue, changes in taste, and difficulty chewing.

Dry mouth can be caused by a variety of contributing factors.  The most common are over-the-counter and prescription medications such as blood pressure drugs, anti-depressants, antihistamines, decongestants, anti-diarrhea medications, sedatives, diuretics, and anti-inflammatory drugs. (For a complete list you can visit the California Dental Hygienists' Association's (CDHA) Web site at cdha.org/articles/drymouth.htm.)

Dry mouth can also be caused by radiation therapy for head and neck cancers, which can lower saliva production.  Disorders such as Sjogren's syndrome, a disease that is characterized by a lack of moisture throughout the body, also contribute to dry mouth.

Why worry?

According to the CDHA, dry mouth is the hidden cause of gum disease and tooth loss in 3 out of 10 adults.  This is because the lack of saliva in your mouth allows harmful bacteria to proliferate and accelerate decay.  If this describes you, your dentist or dental hygienist will be able to suggest a number of ways to combat the situation.

Most treatments involve increasing the flow of saliva in order to control dental decay.  In the event that saliva flow cannot be restored, there are other options to help keep your mouth free of cavities and gum disease.  

The first thing your dentist will do is inquire about any medications you are taking.  If you are taking one that is known to cause dry mouth, the dentist can consult with your physician to see if there is an alternative drug or dosage that can be prescribed.  However, if you are taking a variety of medications, this may not solve the problem.  "We see xerostomia particularly with older patients, who tend to be on more medications," notes Dr. Matthew Messina, DDS, consumer advisor for the American Dental Association (ADA).

In the event that you cannot solve the dilemma with a change in medication, you'll need to make sure that you are taking good care of your teeth.  The lack of saliva in your mouth creates a breeding ground for harmful bacteria and you run an increased risk for cavities and gum disease.  Your dentist may prescribe a fluoride rinse or gel that will increase tooth resistance to bacterial plaque.  Rinses and gels should be used at bedtime and should not be swallowed.  You should also avoid sugar, as it will contribute to dental decay. "Dry mouth doesn't make the dentistry any harder, but it does make the patient prone to more decay and they tend to have increased dental needs because they don't have the buffering and washing-action of the saliva on the teeth," says Dr. Messina.

In addition to practicing good oral hygiene, there are several things you can do to stimulate the production of saliva.  Try chewing sugarless gum or sucking on sugarless candies.  "But don't use sugar-based mints or lozenges, since these can increase tooth decay rate." Dr. Messina adds.  Also, be careful that you don't consume too many candies with sorbitol (an artificial sweetener); it can cause diarrhea.  If your mouth is not sore, just dry, try eating tart foods like sugar-free sour candies or dill pickles.  Also, make sure you have some sort of liquid to sip on throughout the day, such as milk, juice, or water.

Your dentist may also recommend an artificial saliva that will substitute for your natural saliva.  "Someone is only going to use these if they are really very, very dry," notes Dr. Messina.  "People will use them before they go to bed at night and if they wake up in the middle of the night." 

So remember, dry mouth is not something you have to live with, just something you have to deal with.  Hopefully it can be resolved with a change in medication, but if not, you'll have to take extra special care of your teeth, which is something you do anyway.