Saliva is essential to oral health. The most obvious and important function of saliva is in eating, for taste and to lubricate food helping in swallowing, and protect the mucosa, gums and teeth. Saliva is also essential for normal taste perception.

Dry mouth is a feeling of abnormal dryness in the mouth, often caused by a decrease in the saliva production. Dry mouth is not always a consequence of the aging process; it is a common and increasing problem affecting millions of people worldwide.

Causes

  1. Physiological – common during periods of anxiety, 
  2. Smoking , consuming alcohol or  caffeine. 
  3. Mouthbreathers may also have a dry mouth. 
  4. Advancing age due to a fall in salivary secretory. 
  5. Missing glands – Very rarely, children are born with missing salivary glands.          
  6. Drugs – mostly  in older people. Drugs like- analgesics ( pain killers) ,antihistamines(anti allergic) , blood pressure medication, anti depressants ,etc. 
  7. Irradiationfor cancer in the head and neck region-can produce profound dry mouth. Other sources of irradiation such as radioactive iodine used for treating thyroid disease may also damage the salivary glands causing dry mouth. 
  8. Dehydration – as in diabetes, chronic renal failure, hyperparathyroidism, fever. 
  9. Diseases of salivary glands .

Clinical features

The patient with dry mouth may have difficulty in:

  1. Swallowing — especially dry foods such as biscuits.
  2. Controlling dentures.
  3. Speaking, as the tongue tends to stick to the palate.
  4. Patients may also complain of unpleasant taste or loss of taste sensation, or halitosis (bad breath).
  5. Lipstick or food debris may be seen sticking to the teeth or soft tissues in such patients.
  6. Sore cracked lips

Complications :

  1. Dental caries (decay) — which tends to involve smooth surface such as the lower incisor region and roots.
  2.  Candidiasis (fungal infection)— which may cause a burning sensation or mucosa, tongue and gums. 
  3. Halitosis (bad breath)

Management of dry mouth:

  1. Drink enough water. Avoid dry or hard crunchy foods such as biscuits. Eat soft creamy foods , or cool foods with a high liquid content — melon, grapes. Pineapple has an enzyme that helps clean the mouth. Avoid spices.

2. Salivary substitutes, eg Artificial Saliva (salivex)

  1.  Stimulate saliva with:
  • Sugar-free chewing gums ( eg Orbit)
  • Drugs that stimulate salivation (eg pilocarpine) if advised by a specialist.

4. Avoid anything that may worsen dryness, such as:

  • Drugs, unless they are essential (eg antidepressants)
  • Alcohol (including in mouthwashes)
  • smoking
  • Caffeine (coffee, some soft drinks such as colas)
  • Mouthbreathing.

5. Protect against dental caries by avoiding sugary foods/drinks and by having regular dental checks.

6. Protect against thrush(candidiasis) , gum problems and halitosis by:

  • Keeping your mouth very clean as moist as possible
  • Rinsing twice daily with chlorhexidine (eg Chlorohex or triclosan )
  • Brushing or scraping your tongue
  • Keeping dentures out at night
  • Disinfecting dentures in hypochlorite (eg Dentural)
  • Using antifungals if recommended by specialist.

7. Protect the lips with a lip salve or petroleum jelly (eg Vaseline)

  1. Avoid hot dry environments — consider a humidifier for the bedroom