How to Handle Dry Mouth

What is dry mouth?

Dry mouth is the condition of not having enough saliva, or spit, to keep your mouth wet. Everyone has dry mouth once in a while -- if they are nervous, upset, or under stress. But if you have dry mouth all or most of the time, it can be uncomfortable and lead to serious health problems. Though many older adults have dry mouth, it is not a normal part of aging.

Saliva helps digest food and helps us chew and swallow. Saliva is involved in taste perception as well. Each of these functions of saliva is hampered when a person has dry mouth.

Why Saliva is Important

Saliva does more than keep your mouth wet. It protects teeth from decay, helps heal sores in your mouth, and prevents infection by controlling bacteria, viruses, and fungi in the mouth.

How Dry Mouth Feels

Dry mouth can be uncomfortable. Some people notice a sticky, dry feeling in the mouth. Others notice a burning feeling or difficulty while eating. The throat may feel dry, too, making swallowing difficult and choking common. Also, people with dry mouth may get mouth sores, cracked lips, and a dry, rough tongue.

What Causes Dry Mouth?

People get dry mouth when the glands in the mouth that make saliva are not working properly. Because of this, there might not be enough saliva to keep your mouth healthy. There are several reasons why these glands, called salivary glands, might not work right.

Medicines and Dry Mouth

More than 400 medicines, including some over-the-counter medications, can cause the salivary glands to make less saliva, or to change the composition of the saliva so that it can't perform the functions it should. As an example, medicines for urinary incontinence, allergies, high blood pressure, and depression often cause dry mouth.

Diseases That Can Cause Dry Mouth

Some diseases can affect the salivary glands. Dry mouth can occur in patients with diabetes. Dry mouth is also the hallmark symptom of the fairly common autoimmune disease Sjögren's syndrome.

Sjögren's syndrome can occur either by itself or with another autoimmune disease like rheumatoid arthritis or lupus. Salivary and tear glands are the major targets of the syndrome and the result is a decrease in production of saliva and tears. The disorder can occur at any age, but the average person with the disorder at the Sjögren's Syndrome Clinic of the National Institute of Dental and Craniofacial Research (NIDCR) is in his or her late 50s. Women with the disorder outnumber men 9 to 1.

Cancer Treatments and Dry Mouth

Certain cancer treatments can affect the salivary glands. Head and neck radiation therapy can cause the glands to produce little or no saliva. Chemotherapy may cause the salivary glands to produce thicker saliva, which makes the mouth feel dry and sticky.

Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.

Treatment for Dry Mouth

Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage.

If your salivary glands are not working right but can still produce some saliva, your dentist or physician might give you a medicine that helps the glands work better. Your dentist or physician might also suggest that you use artificial saliva to keep your mouth wet.

Do's and Don'ts

Do's

  • Do drink water or sugarless drinks often. That will make chewing and swallowing easier when eating.
  • Do chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow.
  • Do use a humidifier at night to promote moisture in the air while you sleep.

Don’ts

  • Don't consume drinks with caffeine such as coffee, tea, and some sodas. Caffeine can dry out the mouth.
  • Don't use tobacco or alcohol. They dry out the mouth.

Gene Therapy Research for Salivary Gland Dysfunction

Scientists at NIH’s National Institute of Dental and Craniofacial Research (NIDCR) are exploring the potential use of gene therapy to treat salivary gland dysfunction. The idea is to transfer additional or replacement genes into the salivary glands of people with Sjögren's syndrome and cancer patients whose salivary glands were damaged during radiation treatment. The hope is that these genes will increase the production of saliva and eliminate the chronic parched sensation that bothers people with dry mouth conditions.

NIDCR recently completed a clinical study, a research study in humans, on gene therapy for radiation-damaged salivary glands. The study showed that gene therapy can be safely performed in salivary glands and that it has the potential to help head and neck cancer survivors with dry mouth. Read NIDCR’s news release to learn more about the study’s findings. Based on the promising results of this trial, similar clinical trials are planned in the near future.

Research on Sjögren’s Syndrome and Other Diseases Affecting Salivary Glands

NIDCR is also conducting clinical trials to study new approaches for improving salivary flow in patients with Sjogren’s syndrome. Such studies include testing the effectiveness of a monoclonal antibody as well as a corticosteroid to see whether either of these treatments helps improve salivary flow. Other studies are focused on learning how diseases such as diabetes, auto inflammatory diseases, and granulomatous diseases cause salivary gland dysfunction. Such studies could one day lead to better ways of preventing and treating salivary gland conditions.

To stay abreast of any new studies on gene therapy and salivary gland function, visit ClinicalTrials.gov. ClinicalTrials.gov lists all federally and many privately funded clinical trials in the U.S. and around the world; the web site is updated frequently.

Keep Your Mouth Healthy

If you have dry mouth, you need to be extra careful to keep your teeth healthy. Saliva helps protect teeth from decay. But without enough saliva, you may be more likely to develop tooth decay or other infections in the mouth. Here are some tips for keeping your mouth healthy.

Tips for a Healthy Mouth

  • Brush your teeth with an extra-soft toothbrush after every meal and at bedtime. If brushing hurts, soften the bristles in warm water.
  • Floss your teeth gently every day. If your gums bleed and hurt, avoid the areas that are bleeding or sore, but keep flossing your other teeth, and see your dentist as soon as possible.
  • Always use toothpaste with fluoride in it. Most toothpastes sold at grocery and drug stores have fluoride in them.
  • Avoid sticky, sugary foods. If you do eat them, brush immediately afterwards.
  • Do not use mouthwashes with alcohol in them. Alcohol can dry out the mouth.
  • If you have dry mouth, visit your dentist for a check-up at least twice a year. Your dentist might suggest you use a prescription-strength fluoride gel (which is like a toothpaste) to help prevent dental decay. He or she may also apply fluoride varnish to your teeth to help prevent decay.

Original article by NIHSeniorHealth