Dry mouth

Dry Mouth occurs as a result of an inadequate flow of saliva
from the salivary glands into the mouth.

DESCRIPTION

Saliva is a fluid that is secreted continuously into the mouth
by the salivary glands. Just enough saliva is secreted to keep the
mucous membrane (skin tissue lining the mouth) moist. When food
enters the mouth, more saliva is secreted, which lubricates the
food so it can easily move around the mouth, form into a ball, and
be swallowed. Saliva is made up of 99.5% water and the remaining
0.5% is comprised of sodium, potassium, chloride, bicarbonate,
phosphates and other organic substances such as urea, uric acid,
antimicrobial proteins and the digestive enzyme, amylase.

Amylase is important to the digestive process, as the chemical
breakdown of food into smaller fragments for digestion begins with
this digestive enzyme in the mouth. It is also necessary as a means
of dissolving food so that it can be tasted. The enzyme, lysozyme,
is also found in the saliva in small quantities and helps to
destroy bacteria in the mouth and limit fungal and viral growth.
This protects the Mucous membrane against infection and protects
the teeth from decay. Saliva has a buffering effect on acids
produced by bacteria in the mouth. Without adequate saliva to bathe
the teeth, rapid dental decay often occurs. Dry Mouth may also
cause a plaque build-up, gum disease and bad breath.

AGEING

Recent studies indicate that ageing itself does not cause Dry
Mouth. Ageing does not cause less saliva to be produced or problems
to occur with the salivary glands. If an older person has a problem
with Dry Mouth, it is considered to be a result of that person’s
medical condition or a possible side effect of medication.

POSSIBLE CAUSES

• Medical conditions such as Sjogren’s syndrome.
• Medication. There are a number of medications which may cause
  Dry Mouth, including pain killers and antibiotics.
• Stress.
• Breathing through the mouth.
• Dieting.
• Talking or singing for a long time.
• Depression.
• Diabetes.
• Radiation.
• HIV.

SIGNS AND SYMPTOMS

Patients with Dry Mouth usually have trouble swallowing dry
foods and need to sip fluid while trying to swallow. The person may
have a very Dry Mouth and lips when eating and have difficulty
speaking at length. Other signs of Dry Mouth include a sudden
increase in the number of dental cavities and/or gum disease in the
person.

TREATMENT OPTIONS

As with all conditions, your Doctor should be consulted to
diagnose and treat this condition. 

Your Doctor may suggest some medication or alter your current
medication if it is causing severe Dry Mouth.

DIET HINTS

• It is important to maintain a healthy diet, even if Dry Mouth
  makes eating difficult.
• If Dry Mouth is a problem, is it advisable to eat small,
  regular meals of foods which are moist and easy to digest (e.g.
  fruit, vegetables, fish, soft grains).
• Avoid sugary foods such as lollies, cakes, biscuits, soft and
  sports drinks. Try to include foods in the diet which are low in
  sugar to help prevent tooth decay. 
• Limit foods with high acid levels, including oranges and
  grapefruit.
• Foods such as carrots and celery are ideal snacks for a person
  with Dry Mouth, as these are wholesome and moist and massage the
  gums which helps to keep them healthy.
• Limit your intake of caffeine (coffee, tea, chocolate and cola
  drinks).
• Use bland, non-spicy sauces in cooking.
• Sucking ice blocks and sugarless lollies may provide some
  relief from Dry Mouth. Healthy ice blocks can be made by freezing
  fruit juice and pulp. 
• Try to drink at least 6 to 8 glasses of fresh water each day.
  Take frequent sips of water.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. Saliva substitutes from your Pharmacy may help to relieve the
   symptoms of Dry Mouth. These include carboxymethylcellulose gels,
   salivary peroxidase products and mouthwashes. Alcohol based
   mouthwashes are not recommended, as they may have a drying
   effect.
2. Ask your Pharmacist for advice about medications which help to
   stimulate the flow of saliva, such as bethanechol chloride and
   pilocarpine. Pilocarpine as a 1% eye solution, one or two drops
   under the tongue, has been shown to increase saliva production in
   some patients.
3. If you have any queries regarding the dosage and/or side
   effects of your medication, ask your Pharmacist for advice.
4. Patients who are prone to Dry Mouth should be encouraged to
   consult a dentist at least three times a year for the early
   treatment of cavities.
5. It is very important for every person to have a thorough dental
   hygiene routine. Brushing after meals helps to remove bacteria
   which can cause decay. Flossing regularly helps maintain healthy
   teeth and gums and prevent infections.
6. Sugarless chewing gum, available from your Pharmacy, stimulates
   the flow of protective saliva to the teeth and gums. 
7. Ask your Pharmacist about a water-spray bottle which can be
   used to lubricate the mouth while eating.
8. If the diet is inadequate, consider some nutritional
   supplements. Vitamin C, bioflavonoids and zinc play an important
   role in maintaining healthy gums, preventing infections and
   promoting the body’s ability to heal wounds. 
9. If you suffer from Dry Mouth, inform your Doctor or Pharmacist
   before taking antihistamines (both first generation (e.g. Avil,
   Polaramine, Phenergan) and second generation (e.g. Claratyne,
   Hismanal, Telfast).