Dry mouth is an experience that everyone has had at one time or another and could fix by drinking. But what if the mouth remains permanently dry or even other symptoms such as pain when chewing, swallowing or speaking are added? Then the medical profession speaks of xerostomia or dry mouth.
What is dry mouth?
In cases where dry mouth is a symptom that occurs over a long period of time and cannot be remedied by hydration, it is called xerostomia, pathological dry mouth. Dry mouth refers to the subjectively perceived dryness of the oral cavity due to insufficient saliva production or insufficient enzymes in the saliva. If there is no longer enough saliva in the oral cavity, important functions of saliva fail, resulting in a disturbance of the sense of taste. In addition, the oral cavity cannot be adequately cleaned and protected due to the lack of enzymes, leading to complications such as dental problems, bad breath, pain or frequent inflammation in the oral cavity. In cases where dry mouth is a symptom that occurs over a long period of time and cannot be resolved by hydration, it is called xerostomia, pathological dry mouth, which should be discussed with a doctor.
Causes
The causes of dry mouth are varied and cause either decreased saliva production or altered saliva composition with the absence of important enzymes that protect the oral cavity. Easily remedied, and therefore harmless, causes of dry mouth are lack of fluids and frequent, prolonged mouth breathing, for example, during [colds]]en. Dry mouth can also occur as a side effect of medications. Diuretics, psychotropic drugs, anticholinergics, antiallergics, antihypertensives, and atropine are known as causative drugs. The risk of disease increases with the number of medications taken, especially in older patients and poorer general health. Thus, xerostomia affects approximately 40 percent of those over 60 years of age. Other causes of xerostomia include impaired chewing function triggered by oral mucosal or dental diseases, fungal infections and oral thrush,
Autoimmune and metabolic diseases, such as Sjögren’s or diabetes mellitus, emotional stress and mental illness,
Adrenal gland dysfunction and salivary gland disorders. Radiation and chemotherapy treatments can also trigger dry mouth.
Diseases with this symptom
- Diabetes mellitus
- Oral thrush
- Sjögren’s syndrome
Diagnosis and course
Since dry mouth can have various causes, patients should first consult a general practitioner. This will ask about the probable causes and other complaints. In addition, two examinations are necessary to make a diagnosis:
1. measurement of salivary flow rate, the most informative examination method. The physician defines saliva production at rest and after stimulation. 2. the examination of salivary glands and lymph nodes, oral mucosa and oral cavity. If no definite cause can be found after this examination, further diagnostic procedures follow. These include examination of saliva in the laboratory, a pathogen smear from the oral cavity, and X-ray examinations of the cranial region. In some cases, X-rays of the salivary ducts with contrast media will be necessary. A blood test may be performed to rule out other possible causes of dry mouth. Depending on the diagnosis, the general practitioner will refer to the appropriate specialist. With early examination and diagnosis, complications such as dental problems can usually be stopped, as these are the basis of good therapy for xerostomia.
Complications
Dry mouth results from heavy smoking, for example. Chronic bronchitis can develop as a result of high nicotine consumption. As a result, the airways become clogged and the affected person gets less air. In addition, as a result, the lungs can become overinflated and thus develop emphysema, which worsens the shortness of breath. This condition is also known as COPD (chronic obstructive pulmonary disease) and is associated with a high mortality rate in Germany. Nicotine also breaks down the lungs, so this also promotes shortness of breath. It also increases the risk of developing lung cancer.Dryness in the mouth can also occur in the context of Sjögren’s syndrome. In addition, 5 percent of those affected develop lymph node cancer (malignant lymphoma) in the course of their disease. Diabetes can also cause dry mouth. The secondary diseases are feared. Diabetes causes blockage of smaller vessels and arterioles, resulting in a lack of blood supply, especially to the eye and kidneys. This can result in blindness of the affected diabetic (diabetic retinopathy) if the disease is not treated early. Weakness can also occur in the kidneys, which can subsequently end in failure (diabetic nephropathy). Nerves may be affected in the foot that no longer transmit pain signals, allowing an ulcer to develop because it is often not detected.
When should you see a doctor?
People who permanently suffer from dry mouth should see an appropriate doctor. Anyone who forgoes a visit to the doctor at this point is taking a great risk. Food intake is severely impaired, since the necessary saliva can no longer properly decompose ingested food. In addition, there is pain when swallowing and injuries to the mucous membrane can also occur. Infections can develop very quickly from injuries to the mucous membrane, as bacteria and viruses can easily multiply in affected areas. Anyone who suffers from a dry mouth should therefore ensure strict and meticulous oral hygiene. Generally speaking, anyone with a permanently dry mouth who seeks treatment at an early stage is definitely on the safe side. In this way, serious underlying diseases can be detected early enough so that appropriate medication can be prescribed. If there is already an inflammation in the oral cavity, a visit to the doctor is inevitable. Under certain circumstances, an abscess may form which, if left untreated, can cause blood poisoning. Of course, in such a case there is an acute danger to life, so that a visit to the doctor should not be put on the back burner. A doctor can very quickly find out the cause of dry mouth and treat it accordingly.
Treatment and therapy
Dry mouth can only be treated symptomatically. The therapy depends on the cause, so triggering underlying diseases must be treated, and is to ensure adequate fluid intake. Sour drinks, sweets or chewing gum that stimulate salivation can be helpful, and the mouth should also be rinsed regularly with water or sugar-free tea. If a medication is causing the xerostomia, the attending physician must decide whether it can be discontinued or replaced. If these measures do not help, the patient can get relief from dry mouth with mouth rinses, mouth gels or mouth sprays. In addition, there are artificial saliva solutions that have a similar composition to natural saliva and contain salivary enzymes, which are important for protecting the oral cavity.
Outlook and prognosis
Dry mouth can be managed without medical treatment with adequate fluids as well as saliva-stimulating foods. Sucking a piece of candy or chewing gum are considered stimulant options to help stimulate saliva flow and counteract dry mouth. In the case of persistent dry mouth caused by medication, the symptoms are relieved when the patient stops taking the medication. Medication should not be discontinued on the patient’s own initiative. Consultation with the attending physician is necessary. If diseases of the salivary glands or the oral mucosa are responsible for the dry mouth, there is a good chance of recovery. Medical treatment leads to the desired success in most patients. If a lymph gland disease is present, the prognosis for dry mouth depends on the disease at hand. A viral infection or inflammation is treated with medication and normally leads to a complete recovery within a few weeks. In the case of cancer, there is a good chance of recovery if diagnosis and treatment are carried out at an early stage. In the case of a late stage or spread of the cancer, there is a danger to life. If dry mouth is caused by heavy smoking, there is a regeneration of saliva flow with the cessation of nicotine consumption.The same happens with the consumption of alcohol or other stimulating substances.
Prevention
Dry mouth cannot be prevented to a sufficiently protective degree. However, the patient should remain in close contact with his or her practitioner to discuss proper medication and dosage. In addition, regular dental check-ups are essential to detect and treat any dental problems that arise in good time. In this way, dry mouth cannot be cured, but its progression can be halted with inflammation of the mucous membranes and dental problems.
What you can do yourself
A dry mouth can be due to various causes. Accordingly, there are different interventions that can be integrated into everyday life to counteract the problem. A dry mouth can be significantly influenced by diet. First and foremost, it is important to drink enough fluids to keep the mucous membranes in the mouth moisturized. Water and tea are recommended. Acidic teas such as mallow or rosehip have a particularly stimulating effect. Foods such as fruit, soups and liquid dairy products can also promote salivation. It is important to chew frequently during meal intake. The more often you chew, the more saliva production is stimulated and the less dry your mouth will be. There are foods that deprive the oral mucosa of moisture. These include alcohol, coffee and very strongly spiced foods. These should therefore be avoided as far as possible. Between meals, it is advisable to chew sugar-free chewing gum or suck sugar-free sweets. These also stimulate saliva production. In addition to dietary factors, the ambient air also influences the dryness of the mucous membranes. It is important to ventilate regularly at home and at work to counteract dry ambient air. Furthermore, it is necessary to spend enough time in the fresh air. Smoking should be avoided as much as possible. Nicotine inhibits blood circulation and has a negative effect on saliva production.
