Saliva and Dry mouth
Xerostomia, or dry mouth, is not so much a disease but rather a symptom of disease. It often is a result of medications that a person is taking. There tends to be an increase in xerostomia with age, but many feel that is due to the medications older people tend to take.
Normal saliva flow is based upon complicated chemical and nerve reactions. When the mouth or taste buds are stimulated and or smell is stimulated, the body produces or shuts off saliva production.
Functions of Saliva
There are many things that saliva does for us. It keeps the mouth from being too acidic which can cause cavities. It functions to remove food debris, lubricate the tissues, prevent wounds, and it is antimicrobial to boot.
Problems due to xerostomia
Anything that impairs the functions of sailva, will cause problems. Tooth decay can soar in the mouths of people without healthy saliva. Dry foods can be difficult to eat and swallowing in general may be tough. Oral ulcers and oral fungal infections, like candidiasis may flourish. Bad breath is likely to be more common as saliva plays an important role is cleansing the body of dead tissue that add to the volatile sulfur compounds (VLC’s) responsible for bad breath.
Medications responsible for dry mouth
Many different types of drugs can cause dry mouth. They include diuretics, antihistamines, anorexiants, antihypertensives, antipsychotics, anti-Parkinson agents, anticholinergics, antidepressants, and sedatives. Other drug classes that commonly cause xerostomia include antiemetics, antianxiety agents, decongestants, analgesics, antidiarrheals, bronchodilators and skeletal muscle relaxants.
Oral Cancer and radiation therapy
Radiation as a way of treating cancer cells in the mouth, can cause permanent damage to salivary cells impairing the ability to produce saliva. Often these patients will describe a thick ropey saliva and a difficulty with swallowing. Occasionally the damage is temporary and sometimes there is an improvement over time. Oral Hygiene is critical for these patients.
Treatment of Dry Mouth
Unfortunately, if the underlying cause can not be addressed we need to deal only with the symptom. Symptomatic treatment typically includes four areas: replacing lost secretions, increasing existing saliva flow, control of dental caries and specific measures such as treatment of infections.
Advice to patients with xerostomia
• Review the self-care measures discussed earlier in this article (with emphasis on minimizing caffeine and smoking).
• Give suggestions about good oral hygiene.
• Encourage adequate fluid particularly water intake, avoiding caffeine and sugar-containing products and alcohol.
• For her allergic rhinitis, suggest nonsedating antihistamines and avoidance of products containing decongestants.
• Quit smoking.
• Consider the use of an artificial saliva and/or OTC saliva stimulant.