Xerostomia or more commonly known as Dry Mouth is a change in the amount of saliva present or a change in the quality of saliva. It is estimated that adults suffering from dry mouth between 10%-40% of the adult population between 19-88 years of age. In most cases, your professional team of oral care providers will evaluate and notice the reduction of salivary flow before the patient notices symptoms.
Symptoms of xerostomia will present as difficulty with swallowing food without the use of liquids, changes in taste, difficulty talking, or possible burning or discomfort within the oral cavity. If left untreated many patients experience a decrease in their quality of life which can lead to depression. Other conditions include; oral candidiasis, malnutrition, a decreased pH, and a significant increase in plaque accumulation and dental decay. There are many tools a dental professional uses to gather the necessary data to support the diagnosis of xerostomia. Patient's can help their provider by providing an accurate medical and surgical history, bringing an updated medication list, and presenting any concerns at the beginning of the dental appointment.
A healthy saliva flow aids in keeping the oral cavity tissues healthy in numerous ways such as:
Moisten the oral cavity to aid in chewing and swallowing food
To support the transportation of microbial colonies
To buffer the oral pH. In a healthy mouth, it takes about 30 minutes to buffer the acidity of any acidic beverages or food you ingest such as grapefruit, limes, coffee, Oj, or seltzer water.
Contain enzymes known as amylase and lipase. Amylase is responsible for breaking down carbohydrates and lipase breaks down fats.
Contain minerals and vitamins such as vitamin C
Essential for the function of chewing, swallowing, tasting, and speech
Rinsing away loose food debris and bacteria
There are many causes of xerostomia including but not limited to:
Polypharmacology (the use of many prescription medications)
A wide range of common medications include antacids, high blood pressure medications, inhalers, decongestants, antidepressants, and diuretics.
Radiation of the head or neck
Chemotherapy or other cancer medications
Sjogren's syndrome (autoimmune)
Diabetes
Rheumatoid Arthritis
Hypertension
Hepatitis C
Mouth breathing
Dehydration and smoking
Illicit drug use
There is a wide range of products available that are useful in managing dry mouth. Things to consider when seeking over-the-counter products are the pH and the types of sugars present in the product. Dental professionals recommended using an oral product that falls into the neutral pH category of 7, or as close as you can get to it. It is helpful to remember that bacteria feed off of sugars. This is why I recommend checking the ingredients of "sugar-free' gums, likely you will discover other sugars present such as mannitol or sorbitol. It is also recommended for patients suffering from dry mouth to avoid products with alcohol such as mouthwashes.
Many studies have determined that xylitol reduces plaque formation and bacterial adherence (i.e., is antimicrobial), inhibits enamel demineralization (i.e., reduces acid production), and has a direct inhibitory effect on the bacteria mutants streptococci which is known to cause dental decay. Xylitol has been approved by the FDA for use as a sweetener and can be found in many forms such as gums, gels, lozenges, powder form for cooking, nasal sprays, and oral sprays. Green Tea has also been proven effective in the treatment of dry mouth. The MighTEAflow product was founded by a dental professor at Augusta University formally known as the Medical College of Georgia, here in Georgia.
Recommended products for the management of dry mouth (pH range 6.16-8.52).
Prescription medications (pilocarpine or cevimeline)
I hope this helps,
J
Sources:
Billings RJ, Proskin HM, Moss ME. Xerostomia and associated factors in a community-dwelling adult population. Community Dent Oral Epidemiol. 1996 Oct;24(5):312-6. doi: 10.1111/j.1600-0528.1996.tb00868.x. PMID: 8954216.
Janakiram C, Deepan Kumar CV, Joseph J. Xylitol in preventing dental caries: A systematic review and meta-analyses. J Nat Sci Biol Med. 2017 Jan-Jun;8(1):16-21. doi: 10.4103/0976-9668.198344. PMID: 28250669; PMCID: PMC5320817.
De Rossi SS, Thoppay J, Dickinson DP, Looney S, Stuart M, Ogbureke KU, Hsu S. A phase II clinical trial of a natural formulation containing tea catechins for xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Oct;118(4):447-454.e3. doi: 10.1016/j.oooo.2014.06.015. Epub 2014 Jul 5. PMID: 25240992.
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