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A Spoonful of Oral Medicine

Dr Amanda Phoon Nguyen

BDSc (UniMelb), MRACDS (GDP), DClinDent (Oral Med) (UWA), MRACDS (OralMed), Cert ADL, FOMAA, FPFA, FICD

Oral Medicine Specialist

Perth, Western Australia

Welcome to A Spoonful of Oral Medicine, where I dish up bite-sized chunks of oral medicine targeted toward health professionals!

This does not constitute personalised medical advice. Please do not use images without credit.


Please enjoy, and I do hope to hear from you! 

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Dry Mouth (Xerostomia) – Causes and Treatment





Dry mouth, also called xerostomia, is a common complaint. Research shows that approximately 30% of adults report a dry mouth at some point in their life. However, it’s important to remember that xerostomia is subjective, meaning it’s based on how dry your mouth FEELS. But, it is not to be confused with salivary gland hypofunction, which is objective (your mouth shows signs of having less saliva). In order to diagnose salivary gland hypofunction, special tests must be performed. However, this article will focus on the causes and management of a dry mouth, which is a symptom for both xerostomia and salivary gland hypofunction.


Causes of a Dry Mouth

There are numerous reasons, but the most common reasons are:

  • Dehydration

  • It can be a side effect of taking medications

  • Head and neck irradiation from cancer therapy

  • Lifestyle factors (smoking, drinking lots of alcohol or coffee)

  • Systemic conditions, such as Sjögren’s syndrome and Type 2 diabetes

  • Idiopathic (which means we don’t know why you have a dry mouth)

Why is Saliva Important?

  1. Helps with digestion of food

  2. Protects teeth from decay

  3. Prevents infection by controlling bacteria and fungi in the mouth

  4. Lubricates the mouth, and helps you chew & swallow

Potential Treatment for Dry Mouth

Things you can do at home:

  • Remain well hydrated and drink plenty of water

  • Avoid caffeine, such as coffee or tea

  • Avoid sugar-containing drinks

  • Use sauces to moisten food, and sip water throughout eating. This will make chewing and swallowing easier. Also, it may also improve the taste of your food

  • Avoid smoking, chewing tobacco or alcohol

  • Be aware that spicy or salty foods may cause pain in a dry mouth

  • Consider using a humidifier at night, which will add moisture to your room

  • If you wear dentures, good denture hygiene and removing your dentures at night is very important


Things you can purchase at a supermarket or pharmacy:

  • Chew sugar-free gum to stimulate your saliva. Moreover, some sugar-free gums contain xylitol, which can help prevent cavities. However, please avoid chewing gum if you often get a sore jaw, or you’ve been diagnosed with Temporomandibular Joint Dysfunction

  • Xylimelts​ are little tablets that you can stick inside your mouth to stimulate saliva and prevent dental decay, they usually last for 4-6 hours. As a dental specialist, I have put them to the test and found that they are comfortable, gluten-free, pH neutral AND they taste good. Ideally, you want to use them before bed, when dry mouth symptoms can be the most uncomfortable. Plus, once you put these tablets in your mouth, you’re less likely to snack on unhealthy treats before bed, which is a big bonus for your diet. Click here to learn more about Xylimelts

  • Moreover, try using salivary replacement products Oral 7 mouthwash/gel or oral lubricants such as Biotene

  • Oral 7 products have antimicrobial and antibacterial enzymes that mimic protective factors that are naturally found in saliva, however, its availability might be limited around the world.


Treatment options to discuss with your dentist, oral medicine specialist or doctor

  • Sialogogues are drugs that help promote the secretion of saliva. Pilocarpine is an example of this drug

  • Try discussing your list of medications with your doctor and check to see if anything can be modified to help reduce your dry mouth symptoms. However, never make adjustments to your medications without consulting the prescribing practitioner first

  • Electrostimulation/ TENS, is a procedure which may help salivary glands produce more saliva. Once again, it’s something you will need to discuss with your doctor or oral medicine specialist

Dry Mouth & its Link to Tooth Decay

Unfortunately, a dry mouth is a dangerous mouth as it can increase your risk of tooth decay. However, regular dental visits, good oral hygiene, the use of fluoride toothpaste and a low-sugar diet can help prevent tooth decay. Below is a list of things you can do at home if you suffer from a dry mouth, and want to avoid tooth decay:


Conclusion

If you have severe dry mouth, please see your doctor or dentist for a thorough examination to find the cause and create a tailored treatment plan.

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