By: Jean Johnson for Dental1
“I can’t even lick my finger to test the wind these days. But it’s nothing all that new, I had a bout with this dry mouth business before,” recounts Jim Anderson of Seattle. Anderson is, as he puts it, “an old Norwegian,” who lives with his wife in the city’s Scandinavian section. In this part of town, rafts of colorful fishing boats like the one Anderson and his sons own dot the wharves where they bring in daily catches of sea scallops, ling cod and shrimp.
“Ya. It was 20 years ago I guess that I took a fall out there on the boat. The decks were wet like they get. We try to keep them safe, but you know how it goes sometimes,” Anderson said. “So down it was that I went, and the next thing I knew we were motoring in so I could get to the hospital.
“That was where I got so thirsty. Just couldn’t get enough water. I was so darn dry I still remember it – especially now that I’m having it again to some degree,” he said. “The nurses said it was the pain medicine they were giving me. They must have been right, because as soon as they turned me loose and I got off those drugs, I got back to normal.”
The problem these days, though, is that Anderson knows he won’t be going back to normal since the drugs he takes for his high blood pressure – and that have brought on a dry mouth once again – are with him for life. “That’s what my doctor says. I’m pretty much stuck, don’t you know. A person can’t monkey around with high blood pressure unless they want a stroke.
“He did try various medicines on me when I griped about being thirsty, but now here we are right back at the beginning with the first drug, since it seems to be the best. He fiddled with the dosage for a while too, but now he says I’m just sort of stuck between a rock and hard place.
“It hasn’t been too bad this time around – not nearly as bad as it was in the hospital with my back. And on the teeth score since I know you want to hear about that, for me, since I have dentures, I don’t have to worry so much. Wouldn’t you know, though, that even with your teeth gone you’re still not out of the woods.
“Now it’s my gums, they tell me. Without enough saliva I guess everything in the mouth takes a beating. So, if it’s not one thing, it’s another,” Anderson said. “All I know is that I drink a lot of water because I am thirsty all the time. And I do brush my gums since the dentist said to and my wife keeps after me.”
|Tips for keeping your teeth healthy from the National Institute of Dental and Craniofacial Research|
Remember, if you have dry mouth, you need to be extra careful to keep your teeth healthy.
Gently brush your teeth at least twice a day.
Floss your teeth every day.
Use toothpaste with fluoride in it.
Avoid sticky, sugary foods. If you do eat them, brush immediately afterwards.
Visit your dentist for a check-up at least twice a year. Your dentist might give you a special fluoride solution that you can rinse with to help keep your teeth healthy.
What is Dry Mouth? How does Dry Mouth relate to Oral Health?
Also known as xerostomia (zeer-o-STO-me-uh), dry mouth is a condition marked by decreased saliva and increased thirst. Symptoms can include a sticky, dry feeling in the mouth as well as trouble chewing, swallowing, tasting or speaking. People with dry mouth can experience a burning feeling, sometimes localized in the tongue. It is also common, according to the National Institute of Dental and Craniofacial Research (NIDCR), to have a dry feeling in the throat, cracked lips, a dry or rough tongue, mouth sores, and an infection in the mouth.
Healthy adults produce around three pints of saliva daily, secretions that keep the oral cavity well hydrated. Saliva makes it easier to talk, taste food, and swallow. But of greater interest here, saliva is one of the body’s natural defenses for teeth.
According to the Academy of General Dentistry (AGD), saliva “plays a major role in preventing tooth decay by rinsing away food particles, neutralizing harmful acids, providing enzymes to help digest food, and keeping oral tissues healthy.” The AGD’s fact sheet adds that “a decrease in saliva puts patients at risk for cavities, gum disease, and discomfort since foods that are consumed adhere to the teeth longer. Without saliva, you would lose your teeth much faster.”
In other words, saliva rinses the teeth and without it they are more prone to decay. The same is true for the gums. As the NIDCR adds, saliva “prevents infection by controlling bacteria and fungi in the mouth.”
Causes of Dry Mouth
We’ve all experienced stressful times when our mouth grows dry and our palms get sweaty. Beyond these temporary manifestations, though, sustained conditions in which insufficient saliva is produced can stem from a range of medical conditions.
Side effects from medicines like Anderson’s rank first as causes of dry mouth. More than 400 different drugs can inhibit saliva secretion from the salivary glands, with medicines for high blood pressure and depression at the top of the list.
Antihistamines, anti-diarrheals, muscle relaxants, drugs for urinary incontinence and Parkinson’s disease medications have also been shown to cause dry mouth, according to the Mayo Clinic. The AGD adds that tranquilizers and diuretics are sometimes to blame.
Patients being treated for cancer can also develop dry mouth. On the one hand, chemotherapy drugs can render saliva thicker and cause the mouth to feel dry. On the other hand, radiation therapy to the head and neck region can damage the salivary glands if they are exposed.
Some diseases can affect the salivary glands, according to the NIDCR. Sjögren’s Syndrome, diabetes, HIV/AIDS, and Parkinson’s disease are the most common culprits. Sjögren’s Syndrome is an autoimmune disease in which the body’s immune system mistakenly attacks its own moisture-producing glands. The syndrome affects four million Americans, and the average age of onset is the late 40s. Nine out of 10 patients are women.
Alzheimer’s patients who have had a stroke may experience dry mouth as well. And although aging does not necessarily give rise to decreased saliva production, dry mouth can develop with age.
Ways to Manage Dry Mouth
The first step in dealing with dry mouth is to alert your physician. Although in the case of Anderson nothing helped, many patients benefit when their physicians either lower the dose of the medication they take or find a different type of drug to treat their condition. Also, there are various medicines that can be used to stimulate saliva production if the source of the problem is in the salivary glands themselves.
Sipping water regularly, including during meals, is one way to keep the mouth hydrated, although as Anderson observes, no one had to tell him to drink more because his thirst took care of that. He also – and the literature confirms this as appropriate – avoids drinks that are diuretics: Alcohol and anything with caffeine in it such as coffee, tea, and some carbonated sodas.
Chewing sugarless gum and sucking on sugarless candies can also help, although it is best to avoid lemon varieties since the acid can increase the possibility of tooth decay. Similarly, the AGD advises avoiding citrus fruit juices like orange, tomato and grapefruit. The academy also advises against tobacco use and suggests steering clear of overly salty foods as well as dry foods like toast or crackers.
Finally, the AGD points out that the individual’s dentist as well as his or her physician should know about any dry mouth he or she is experiencing. The organization emphasizes, however, that sometimes patients might not realize that dry mouth is an issue and thus will fail to mention it to their dentist.
“Your dentist will want to know if you have difficulty swallowing, difficulty with speech, oral soreness, or a dry throat. Help your dentist diagnose the problem by recognizing the symptoms associated with dry mouth.”