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Dry Mouth Treatment

 


Causes of Xerostomia

Signs and Symptoms

Consequences

Treatment





Do you suffer from a dry mouth? Do you often wake up at night with a dry mouth or throat? Are you continually licking your lips or drinking fluids in an effort to moisten your mouth? If so, you may be suffering from xerostomia.

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Xerostomia, more commonly known as dry mouth, is a significant condition resulting from poorly functioning salivary glands. When there is not enough saliva in your mouth, it can be difficult to eat and speak properly. Saliva lubricates and protects your mouth and teeth, and a reduction in saliva can lead to an array of oral health problems. While xerostomia affects nearly 25 percent of adults 65 years of age and older, rates can reach as high as 50 percent in some elderly populations. Xerostomia, however, is not simply a result of the normal aging process. Certain medical conditions and prescription medications lead to salivary gland hypofunction, causing a reduction in saliva output. Xerostomia should never be ignored because lack of adequate saliva can be detrimental to your oral health and overall wellbeing.



If you believe you may be suffering from dry mouth, it is time to seek treatment at the Kurpis Center for Advanced Dentistry. We recognize the warning signs of xerostomia and know how to treat patients suffering from this condition. We offer a treatment regimen to address the problems associated with dry mouth and work to protect your mouth from the side effects of reduced saliva. Come in for an evaluation and learn what our doctors can do to help manage your dry mouth.

Causes of Xerostomia


There are numerous oral and systemic conditions that can cause changes in both the amount of saliva produced and the composition of the saliva. Local conditions affecting mainly the oral cavity can cause salivary gland hypofunction. These include tumors, sialoliths (calculus build-up in the salivary ducts or glands), abnormalities of the salivary ducts, poorly developed salivary glands, and radiation damage following cancer treatment. In fact, xerostomia is the most common complication associated with radiation therapy to the head and neck. Following radiation treatment, dry mouth first occurs due to an inflammatory reaction. Later on fibrous tissue develops around the salivary glands and the condition becomes permanent. The degree of damage to the salivary glands depends on the amount of the gland that was exposed to the radiation and the dose of radiation received.


Systemic conditions affecting the entire body can also cause xerostomia. Examples include nerve damage, dehydration, sympathetic nervous system responses, inflammation caused by infection, hormonal imbalances (such as during pregnancy and menopause), and autoimmune diseases (such as Sjogren's syndrome). Other conditions including anxiety, depression, bulimia, diabetes, thyroid disease, hypertension, lupus, cystic fibrosis, cerebral palsy, Bell's palsy, endocrine disorders, scleroderma, and nutritional deficiencies can cause xerostomia.


Xerostomia is a common side effect of numerous prescription medications, and more than 400 medications reportedly cause dry mouth. This occurs because many medications alter the neural pathways that stimulate salivary gland secretion. Others produce vasoconstriction of the salivary glands. The most common xerostomia-inducing medications are antihypertensives, antidepressants, anticholinergics, antipsychotics, anorexiants, analgesics, decongestants, and bronchodilators. Others include antiemetics, statins, antianxiety agents, diuretics, skeletal muscle relaxants, amphetamines, and majiuana. Even over-the-counter cold medicines and antihistamines can cause dry mouth.

Reductions in salivary flow are dose dependant for many of these medications. This means that the greater the dose of the medication, the more likely a person is to experience dry mouth. Taking more than one medication at a time may also increase the risk.

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The good news is that dry mouth caused by medications is not always permanent and can often be reversed if the medications are decreased or discontinued.

Signs and Symptoms

 

Saliva is an essential lubricant for the mouth. It enables us to more easily chew and swallow our food without it sticking to the tissues in our mouth. Saliva plays an essential role in our ability to taste foods, and it lubricates our mouth so we can speak properly. There are enzymes in saliva that begin the breakdown of food before it enters our digestive tract. Saliva is also rich in antibodies and antimicrobial agents which protect our teeth from decay, our gums from periodontal disease, and our mouth from infections. Adequate salivary flow is an important factor in maintaining a healthy oral cavity.

These are some of the many signs and symptoms that are suggestive of xerostomia:

Having a dry mouth or throat, especially at night
Constantly licking lips, mouth feels sticky and dry
Thick, “ropey” saliva
Lack of pooled saliva in the floor of the mouth
Difficulty chewing certain foods, especially those that are dry or spicy
Difficulty swallowing
Difficulty speaking
Increased need to drink fluids
Hoarseness
Feeling of soreness or burning of the mouth and/or tongue
Cracking and fissures of the tongue and mucosa
Cracking at the corners of the mouth or the lips
Blisters and mouth sores
Pebbled, lobulated tongue
Shiny and red tongue and cheeks
Distortion of taste, food not tasting like it used to
Unusual or exaggerated awareness of the oral cavity
Waking up more frequently in the middle of the night
Dentures no longer stay in place
Bad breath
Increase in plaque levels around teeth
Increase in decay of the teeth
Periodontal disease and tooth loss
Oral fungal infections
Salivary gland infections

Consequences


Xerostomia, if left undiagnosed and untreated, can lead to many serious complications in the oral cavity. Dry mouth can cause enamel demineralization, increased plaque levels, and a significant increase in the incidence of decay. Rampant caries (cavities) are often seen on the roots of the teeth cusp tips, and under crown margins.


Patients with xerostomia have numerous other oral complications, including reddened, fissured, lobulated tongues, gingivitis, apthous ulcers (canker sores), halitosis (bad breath), mucositis (inflammation of the oral mucosa), and cracked, bleeding tissues.

Decreased salivary flow predisposes the mouth to bacterial, viral, and fungal infections. In particular patients can develop an overgrowth of Candida Albicans, causing fungal infections such as candida or angular cheilitis. These infections are especially prevalent in patients that wear dentures, and in patients suffering from dry mouth following radiation or chemotherapy treatment.


Dry mouth also makes it difficulty to chew and swallow, and decreases the sense of taste. This can lead to poor nutrition.

Treatment

Many people do not realize they are suffering from xerostomia, and often do not experience symptoms of dry mouth until there is a 50% reduction in saliva output. Therefore it is important to come in for regular dental screenings. Frequent dental examinations, cleanings, and x-rays are important to remain proactive. An undiagnosed and untreated dry mouth can have a significant impact on the health of your oral cavity and your overall quality of life.

Once it has been determined that you are suffering from xerostomia, there are many things that the dentists at the Kurpis Center for Advanced Dentistry can do to help alleviate your symptoms. If your dry mouth is caused by medication, we can speak to your physician about changing the dose or brand of your medications. There are often other medications that can be substituted for those that are causing the dry mouth. If your dry mouth is caused by poorly functioning salivary glands, we can consult with your physician about prescribing a medication that can help the glands to work better and produce more saliva. Medications such as Pilocarpine (Salagen) and Cevimeline (Evoxac) can reduce the symptoms of dry mouth and increase salivary secretion in many patients. These medications, however, are not approved for the treatment of medication-induced xerostomia.

Finally, we can create a treatment regimen that can reduce the discomfort and relieve the symptoms of xerostomia. After taking a detailed medical history, performing a dental examination including an oral cancer screening and digital x-rays, and completing a periodontal examination, we will design a treatment regimen specifically tailored to your individual needs. Your program may include regular dental examinations and cleanings, repair of teeth with existing cavities, synthetic saliva to aid in speech, chewing and swallowing, fluoride treatments to help reduce the incidence of cavities, and oral rinses to soothe the dry mouth and remineralize existing cavities. In addition, we will teach you simple lifestyle tips to help improve your symptoms and prevent complications from dry mouth.

If you are suffering from dry mouth, do not ignore the warning signs any longer. Please call us at 201-447-9700 to schedule an evaluation.

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