Dry mouth is a common condition that can affect our oral functioning and quality of life.  It is a subjective symptom- meaning that there is no scale or measurement to describe how dry a person’s mouth is.  People can describe it as having the “pasties”, “cottonmouth” or “dry as a bone”.  However we describe it, dry mouth, or Xerostomia, affects around one in five people, and the incidence increases with age. There are many causes but the underlying issue is a decrease in the production of saliva.

Saliva is made of 99% water and 1% organic and inorganic substances. It provides essential functions such as lubrication, fighting infection as well as helping us to speak, swallow, and taste flavours.

Many medical conditions are associated with dry mouth. Sjögren syndrome is an autoimmune condition which affects the salivary glands (among other things). Rheumatoid arthritis, diabetes, renal disease, liver disease, and thyroid disease have also been associated. Medications are a common cause of dry mouth. Our lifestyle can have an impact as well. Smoking, consuming alcohol, and drinking beverages with caffeine can affect the flow of saliva. A study in the Journal of the American Geriatrics Society found that medications pose a significant risk for dry mouth, especially in older individuals. Drugs that have anti-cholinergic side effects put us at the greatest risk. This includes medications for overactive bladder, antidepressants, antihistamines, some blood pressure medications, and muscle relaxants.

So, what do we do?  One would deduce that since saliva is 99% water, drinking water is the solution. Unfortunately, while increasing water intake is good for general health and will reduce the chance of dehydration-induced dry mouth, its effects, like love, are fleeting. That 1% of other stuff in saliva is important as it contains enzymes and thickening agents which make saliva adhere to the mouth and fight infection. Lifestyle modifications include using bedside humidifiers; finding ways to reduce stress; and avoiding spicy and dry food, caffeinated or carbonated drinks, alcohol, smoking, and mouthwashes containing alcohol.

We can use medication to stimulate saliva production. Pilocarpine is a drug often used for severe dry mouth (such as in Sjögren syndrome). 1% malic acid or 3% citric acid in a spray also causes us to produce saliva as can gum and lozenges that contain xylitol.  Saliva substitutes like Biotene contain salivary enzymes and moisturizers.  They come in various forms such as spray, gel, and mouthrinse and have been shown to significantly reduce dryness.

So, while a dry mouth is a common condition, it is often overlooked. It can lead to serious problems, but it is treatable. Take care of yourselves and each other.

By Steve Bond BScPhm, RPh, CDE