Symptoms
Possible symptoms of dry mouth include:
- Dry oral mucosa, dry throat, hoarseness.
- Sticky, foamy feeling in the mouth
- Problems chewing, swallowing and speaking.
- Taste disorders
- Pain, burning of the mucous membrane and tongue, redness.
- Bad breath
- Dry lips, cracks at the corners of the mouth
Dry mouth can lead to demineralization of the teeth, tooth decay, infectious diseases, oral thrush, and lesions and ulcerations of the mucosa.
Causes
The cause of dry mouth is a reduced or absent salivary flow. The aforementioned complaints arise because saliva performs important tasks in the oral cavity. It protects against infection, moistens food, aids digestion, and mineralizes teeth. It is involved in chewing, swallowing and speaking. Typical causes and risk factors for dry mouth include:
- Dry mouth is often an adverse effect of medications, such as anticholinergics, beta2-sympathomimetics, antidepressants, anxiolytics, neuroleptics, first-generation antihistamines, and anticancer drugs.
- Dry air, especially in winter, in the mountains, due to air conditioning.
- Sjögren’s syndrome is a disease in which the immune system is directed against the salivary glands. It often affects middle-aged women.
- Sleeping with your mouth open.
- Age is a risk factor.
- Diseases of the nasopharynx such as a cold (temporary).
Other reasons:
- Stress, anxiety
- Many diseases, for example neuropathies, diabetes mellitus, sarcoidosis.
- Dehydration
- Radiotherapy
- Cancer
- Intoxicants, smoking
Diagnosis
Diagnosis is made in medical treatment based on the patient’s history, physical examination and with diagnostic tests (sialometry, laboratory methods).
Nonpharmacologic treatment
- Drink plenty of fluids.
- Suck moisturizing, sugar-free candies.
- Chewing sugar-free gum with the caries-inhibiting xylitol.
- Chewing is important for the stimulation of saliva flow.
- Avoid sugar and sweets because of the risk of tooth decay.
- Increase the humidity of the air with a humidifier.
- Avoid triggering and aggravating drugs.
- Breathe through the nose and not through the mouth.
- Use a lip balm against dry lips.
- Good oral hygiene to prevent tooth decay: brushing teeth (toothpaste with sufficient fluoride), interdental spaces, mouthwash, fluoride tooth gels.
Drug treatment
Saliva substitutes:
- Sprays, mouth gels, mouth rinses, and lozenges are commercially available that can be administered to replace the missing saliva. These contain, for example, various salts, cellulose derivatives, carbomer, xanthan gum, glycerin, sorbitol, and hyaluronic acid. Typically, these are medical devices.
Pharmaceuticals (Sialagoga):
- Anetholtrithione (Sulfarlem) and the parasympathomimetic pilocarpine tablets (Salagen) are two older agents available for stimulating salivation. In some countries, cevimelin is additionally approved and the literature mentions bethanechol, which is also a parasympathomimetic.
In Sjögren’s syndrome, additional immunomodulators and biologics are used.
