dry mouth


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Dry Mouth

 

Definition

Dry mouth, known medically as xerostomia, is the abnormal reduction of saliva due to medication, disease, or medical therapy.

Description

Dry mouth due to the lack of saliva can be a serious medical problem. Decreased salivation can make swallowing difficult, can decrease taste sensation, and can promote tooth decay.

Causes and symptoms

Dry mouth, resulting from thickened or reduced saliva flow, can be caused by a number of factors: medications, both prescription and over-the-counter; such systemic diseases as anemia, HIV infection, or diabetes, manifestations of Sjögren's syndrome (as rheumatoid arthritis, lupus, chronic hardening and thickening of the skin, or chronic and progressive inflammation of skeletal muscles); infections of the salivary glands; blockage of the salivary ducts caused by stones or tumors forming in the ducts through which the saliva passes; dehydration; such medical therapies as local surgery or radiation; secretion reduction normally involved in the aging process; and emotional stress.

Diagnosis

The diagnosis of dry mouth is not difficult. The patient will state that his or her saliva is very thick or nonexistent. Finding the cause of dry mouth may be more difficult and require some laboratory testing. Salivary gland biopsy for stones or tumors should be performed if indicated.

Treatment

The treatment of dry mouth involves the management of the condition causing it. If dry mouth is caused by medication, the medication should be changed. If dry mouth is caused by blockage of the salivary ducts, the cause of the blockage should be investigated. When systemic diseases, such as diabetes and anemia, are brought under control dry mouth problems may decrease.
The use of caffeine-containing beverages, alcoholic beverages, and mouthwashes containing alcohol should be minimized. The drinking of water and fruit juices will decrease dry mouth problems. Chewing gum and lemon drops can be used to stimulate saliva flow. Bitters also can initiate salivary flow as long as the salivary glands and ducts are functional. Commercial saliva substitutes are available without prescription and can be used as frequently as needed. Use of a humidifier in the bedroom reduces nighttime oral dryness.
Dry mouth caused by the aging process or radiation therapy for cancer can be treated by such oral medications as pilocarpine (Salagen). Drugs that are given to increase the flow of saliva are known as sialogogues.

Prognosis

The prognosis for patients with xerostomia due to medication problems is good, if the offending agent can be changed. Dry mouth due to systemic problems may be eliminated or improved once the disease causing the dry mouth is under control. Persistent xerostomia can be managed well with saliva substitutes.

Prevention

A patient needs to ask his or her health care provider if any medication to be prescribed will cause dry mouth. Patients with persistent xerostomia need to practice good oral hygiene and visit a dentist on a regular basis; the lack of adequate saliva can cause severe dental decay. The salivary glands are very sensitive to radiation, so any patient scheduled for radiation therapy of the head and neck needs to discuss with the radiation therapist ways to minimize exposure of the salivary glands to radiation.

Resources

Books

Beers, Mark H., MD, and Robert Berkow, MD, editors. "Dentistry in Medicine." Section 9, Chapter 103 In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

Periodicals

Bruce, S. D. "Radiation-Induced Xerostomia: How Dry Is Your Patient?" Clinical Journal of Oncology Nursing 8 (February 2004): 61-67.
Nagler, R. M. "Salivary Glands and the Aging Process: Mechanistic Aspects, Health-Status and Medicinal—Efficacy Monitoring." Biogerontology 5 (March 2004): 223-233.
Pinto, A., and S. S. De Rossi. "Salivary Gland Disease in Pediatric HIV Patients: An Update." Journal of Dentistry for Children (Chicago) 71 (January-April 2004): 33-37.
Porter, S. R., C. Scully, and A. M. Hegarty. "An Update of the Etiology and Management of Xerostomia." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 97 (January 2004): 28-46.

Organizations

American Dental Association. 211 E. Chicago Ave., Chicago, IL 60611. (312) 440-2500. http://www.ada.org.
American Medical Association. 515 N. State St., Chicago, IL 60612. (312) 464-5000. http://www.amaassn.org.

Key terms

Salivary duct — Tube through which saliva is carried from the salivary gland to the mouth.
Salivary gland — Gland in which saliva forms.
Sialogogue — A medication given to increase the flow of saliva.
Xerostomia — The medical term for dry mouth.

dry mouth

A manifestation of salivary gland dysfunction with decreased secretion, characterised by dry, atrophic and/or inflammed oropharyngeal mucosa and salivary glands which eventually undergo fibrosis; it is most common in older women; it is associated with salivary gland dysfunction
Aetiology Sjögren syndrome, autoimmune disorders—systemic lupus, rheumatoid arthritis, scleroderma, systemic sclerosis, sarcoidosis—amyloidosis, hypothyroidism, RT 4000 cGy, drugs—e.g., atropine, antihistamines, amphetamines, anticholinergics, antidepressants (Prozac, Paxil, Zoloft, Xanax), valium, antihypertensives (Lopressor, Vasotec), opioids—thallium poisoning, fever, dehydration, mechanical—e.g., calculus in salivary duct—vitamin A deficiency, HIV-1, Candida infections, cancer, inadequate function of salivary glands (e.g., parotid glands)
Management Pilocarpine

dry mouth

Xerostomia Internal medicine A manifestation of salivary gland dysfunction with ↓ secretion, resulting in discomfort accompanied by dry, atrophic and/or inflammed oropharyngeal mucosa; the salivary glands become inflamed and eventually undergo fibrosis; it is most common in older ♀; it is associated with salivary gland dysfunction Etiology Sjögren syndrome, autoimmune disorders–SLE, rheumatoid arthritis, scleroderma, systemic sclerosis, sarcoidosis, amyloidosis, hypothyroidism, RT ≥ 4000 cGy, drugs–eg, atropine, antihistamines, amphetamines, anticholinergics, antidepressants–Prozac, Paxil, Zoloft, Xanax, valium, antihypertensives–Lopressor, Vasotec, opioids, thallium poisoning, fever, dehydration, mechanical–eg calculus in salivary duct, etc–eg, vitamin A deficiency, HIV-1, Candida infections, CA, inadequate function of salivary glands–eg, parotid glands Treatment Pilocarpine
References in periodicals archive ?
The results indicated that 20 percent of participants had no teeth, 64 percent had fewer than 21 teeth, a 54 percent of participants had gum disease, 29 percent of participants had at least two symptoms of dry mouth and 34 percent of participants rated their oral health as "fair to poor'.
These findings are comparable to the results of Al-Dwairi and Lynch3 who report a subjective feeling of dry mouth in 30% of their study subjects.
If possible, your doctor can adjust your dosage or switch you to an alternate drug that doesn't cause dry mouth.
2% rated the adhering discs as 'very effective', a higher percentage than any of the seven other types of remedies for dry mouth, including prescription drugs which came in second and were rated very effective by 7% of the respondents who had experience with them.
Burning mouth syndrome, another common side effect of dry mouth, is a neuropathic pain disorder that affects the tongue, lips, and palate.
While these factors primarily help dry mouth, growth within this category should outpace flagging sales of oral pain remedies and buoy the entire category, as it has in previous years.
According to the company, dry mouth, or xerostromia, affects about 25 million Americans, including older consumers and those who are taking certain prescription medications.
There are some special pills the dentist can prescribe to alleviate these symptoms It's imperative to see a dentist, a gum specialist or an oral medicine specialist as you may need to be tested for underlying disorders that are related to dry mouth
We are certain that anyone with minor dry mouth is going to love Luden's Moisture Drops," says Albert Hwang, vice president of marketing for Luden's.
Xerostomia, or severe dry mouth, is characterized by reduced salivary flow, which commonly affects patients receiving radiotherapy for head and neck cancer.
2), (3) Although psychotropic medications are not the only offenders, they comprise a large portion of the agents that can cause dry mouth.