My Mouth Feels Dry: Why It’s Happening and How to Manage It

Dry mouth occurs due to a lack of saliva in the mouth. It can be due to medical conditions, drug side effects, or dehydration. For some, a dry mouth might be associated with mild discomfort; for others, it can cause difficulties in eating and talking. Read on to learn how to manage it.

Why is saliva important?

The three major salivary glands (parotids, submandibular, and sublingual) secrete saliva in the body. These glands are paired and responsible for 90% of the saliva produced. The saliva is emptied into the mouth via ducts.

Saliva consists of water (a primary ingredient) and valuable proteins, minerals, electrolytes, buffers, and enzymes. Saliva helps to:

• Maintain clean teeth and gums. It washes away food and debris.
• Aid digestion. Saliva breaks down food via enzymes like amylase.
• Moisten and lubricate. It helps in chewing, swallowing, and talking.
• Prevent cavities. Saliva strengthens the surface of your teeth by supplying large quantities of calcium, fluoride, and phosphate ions.
• Fight off oral bacteria. Lysozyme and lactoferrin in saliva have antibacterial properties.

A lack of saliva is usually manifested as a dry mouth (also known as xerostomia) and can be the root cause of many health issues.

Symptoms of a dry mouth

If you have a dry mouth, you may encounter the following symptoms:

What causes a dry mouth?

A dry mouth is a symptom — the cause behind it can vary. Some common causes include:

• Side effects of medicines. Many drug classes, including anticholinergics, antidepressants and antipsychotics, diuretics, antihypertensives, sedatives and antianxiety agents, muscle relaxants, painkillers, and anti-allergy drugs can cause dry mouth as a side effect. Studies confirm that more than 500 medications have been linked to dry mouth.
  
• Dehydration. Dry mouth can reflect severe dehydration. Dehydration can be due to excess water loss from the body (diarrhea, vomiting, blood loss) or lack of water intake.
• Sjögren syndrome. Sjögren syndrome is an immune disorder commonly found in women over 40. It is characterized by eye and mouth dryness.
• Other diseases. Some diseases like rheumatoid arthritis, thyroid disorders, primary biliary cirrhosis, poorly controlled diabetes, and end-stage renal disease can cause dry mouth.
• Autoimmune disorders. Autoimmune disorders like systemic lupus erythematosus can affect the salivary glands and reduce flow.
• Habits. Some tendencies, like mouth breathing, especially at night, can dry out the mouth.
• HIV/AIDS. HIV infection can affect saliva composition and change its consistency.
• Sudden fear, stress, or anxiety. At the onset of these feelings, you can experience temporary dry mouth.

Risks of having a dry mouth

A dry mouth can trigger certain diseases. As salivary production decreases, you are at increased risk of oral diseases, particularly cervical caries, gum inflammation, periodontal disease, bad breath, and fungal infections like oral thrush (candidiasis). If you have dentures, you may experience difficulty holding them in the mouth. Saliva helps to digest foods. Its enzymes help to break down foods into simple forms. It also moistens the mouth and throat and helps to swallow a food bolus. Lack of saliva can lead to excess acids in the stomach and increase the risk of reflux disease.

Who is prone to developing dry mouth?

Xerostomia affects 30% of people over the age of 65 and up to 40% of patients over 80. Older people who suffer from hypertension, diabetes, thyroid problems, and kidney disease and are on multiple medications are more prone to developing dry mouth. Head-neck cancer patients are vulnerable to salivary tissue damage, ultimately causing a dry mouth. Post-menopausal women are also at risk of developing a dry mouth.

How can dry mouth be treated?

Treatment of dry mouth targets patient awareness, relief from the symptoms, and managing the underlying disease condition.

• Professional help. Speak to your physician or pharmacist, or read the information that comes with your prescription, to see whether dry mouth is a possible adverse effect. If dry mouth is due to medications, your doctor may switch you to an alternative medicine. It's recommended to consult your doctor before you stop taking medication.
• Saliva substitutes. Also known as artificial saliva, these are made up of carboxymethylcellulose, glycerin to increase viscosity, sorbitol, xylitol, and calcium and phosphate ions and make up for the lack of saliva in the mouth. Saliva stimulants are another effective way to treat symptoms of dry mouth. The FDA has authorized pilocarpine and cevimeline hydrochloride for use in dry mouth.
• Fluoride varnish. Depending on the caries status, your dentist may recommend applying fluoride varnish to your teeth. They may also advocate using prescription fluoride toothpaste in addition to your usual toothpaste.
• Self-care tips. Every two hours, chew on a piece of sugarless gum or suck on a piece of sugarless hard candy for 5 to 10 minutes. This can stimulate your salivary glands, resulting in a more consistent moisture flow in your mouth.
• Maintain oral hygiene. Fluoride pastes and rinses can help to reduce the risk of cavities.
• Suck on ice cubes/ice chips. The ice gradually melts in your mouth and keeps your mouth moist.
• Keep yourself hydrated. Sip water with meals and between meals.
• Avoid tobacco, caffeine, and tea. Reduce fermentable carbohydrate consumption, particularly sticky items like cookies, bread, potato chips, gum, and sweets.
• Visit your dentist regularly. It is critical to schedule any essential dental care as soon as possible, since oral problems can proceed more quickly if you have a dry mouth.

Other than the preventive and protective measures, recent research focuses on glandular regeneration and gene therapy — two evolving fields where researchers attempt to repair and regenerate damaged salivary glands at the cellular level. These novel therapies are in their initial stages and can revolutionize how dry mouth is managed.