Xerostomia





Xerostomia is a medical condition characterized by dry mouth due to reduced or absent saliva because the glands that produce it don’t work properly. Having a dry mouth can affect the health of your teeth and it can affect the quality of your life in general. Saliva prevents tooth decay by washing away food remains and bacteria from the tooth surface, so limits dental plaque accumulation. Saliva has also other functions that affect speech, taste, dietary habits, halitosis etc. Usually the first sign for people who suffer from dry mouth syndrome is the destructive dental caries or periodontal disease they have.They also have high risk to lose their teeth even at early age. Some people who wear dentures and suffers from xerostomia may have problems with denture retention, denture sores etc. Low saliva production can also cause inflammation and fissuring of the lips (cheilitis), inflammation of tongue and oral mucosa, oral candidiasis, salivary gland infection etc.

 

xerostomia Xerostomia

Xerostomia can cause big problems, so it needs to be treated as soon as diagnosed. To treat it is important to know what caused it. Xerostomia is not a disease but in most cases is a symptom of other diseases or a complication of medication used for these diseases. Causes of dry mouth syndrome might be:

  • Diseases- Diabetes, Sjorgen syndrome, HIV/AIDS and Parkinson’s disease can cause malfunction of the salivary glands and so on dry mouth.
  • Excessive breathing through the mouth- because of wrong habits or problems of the upper respiratory tract some people breath throw their mouth causing desiccation of the mouth with all its consequences.
  • Other conditions- like anxiety, physical trauma to the salivary glands or nerves, dehydration can cause insufficient saliva production.
  • Chronic alcohol drinking and smoking- they can enhance dry mouth symptoms.
  • Aging- Getting older might cause problems to your glands like with  all the other organs, so they may secrete less saliva. Thirst and your perception of thirst may also change because thirst receptors in your brain become less responsive to your body’s need for fluids.
  • Different treatments- These are the main cause for dry mouth, like the ones used for cancer, chemotherapy and radiation therapy which can damage salivary glands, decreasing saliva production. Medications used in different diseases can also cause xerostomia like: antidepressants used for depression and anxiety, antihistamines, amphetamines, high blood pressure medication, drugs for urinary incontinence etc.

Treating  xerostomia is not as easy as it seems, because even after finding out what caused it, this doesn’t always mean you can remove the cause. If the cause is the medication you’re using to treat a certain condition than your doctor might change the type of medicine or at least reduce the dosage if possible.  Generally the desiccation caused by xerogenic drugs don’t cause irreversible destruction of the parenchyma that forms the salivary glands so reducing the dose or stop using the drug stops the symptoms of drug induced xerostomia. But most of the time there is nothing that your doctor can do about reducing or removing medications for the drug induced xerostomia, so the only thing he can do is to give you some simple measures to help stimulate saliva production, relieve you from the symptoms of dry mouth and preventing it’s complications.

  • Pharmacological methods- Your doctor might prescribe you pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.
  • Masticatory stimulants- Using foods that require mastication can help you stimulate saliva production. You may use apples, carrots, celery etc. Sugarless chewing gums or sugarless tablet can help a lot both for stimulating saliva and avoiding the halitosis caused by it.
  • Electrical Stimulation- using intra oral electronic stimulator of saliva.
  • Chemical Stimulants- Using solution like Mouth-Kote or Optimoist which contain citric acid that as you know stimulates saliva production (just like lemon does).
  • Oral moisturizers or salivary substitutes- Using artificial saliva substitute might help you get some relief from xerostomia symptoms. They are used to improve comfort and make eating easer. A properly balanced saliva substitute product should be of neutral pH and contain electrolytes to make the composition similar to that of natural saliva, coating the mouth with a film and helping to protect the mucous membrane. They also contain salivary enzymes which help your natural defenses and reduce bacteria colonization. Saliva substitutes are applied topically as spray during the day as often as needed. Moisturizing gels instead are better if used during sleep to better protect your mucosal tissue, and they can also be used for removable dentures to increase retention.

If you suffer from xerostomia you should take really good care of your teeth, take care of your oral hygiene, use fluoride pastes and even fluoride gel during the night ours to prevent tooth decay. You should also use a fluoride rinse.

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