Insufficient oral secretion is caused by a condition called xerostomia. A reduction in the amount of flow of saliva, which may occur for various reasons, causes the balance of the mouth to be upset, and contributes to dental disease. There are a number of reasons why saliva may be reduced or why its flow varies. These include age, prescription drugs, anxiety and acute illness.Saliva production and flow diminish with age, certain drugs used for allergies, asthma, depression, diabetes, epilepsy, high blood pressure, inflammatory conditions, infertility, nausea and Parkinson’s disease. Many people will have experienced a dry mouth associated with panic – perhaps before a dental appointment or public speaking.
Diarrhea and vomiting can cause dehydration, resulting in a reduction in saliva production. Infectious diseases such as mumps (inflammation of the parotid gland) have the same effect. Dryness in the oral cavity may also be due to mouth breathing at night, or in people with a malocclusion (bad bite) or chronic sinus problems. Also, there could be calcified stones, which are stored in the salivary ducts.
When one has Sjogren’s syndrome, which is associated with autoimmune conditions, such as rheumatoid arthritis, the lubrication of mucous membranes is drastically reduced. Patients often complain of dry eyes as well as a dry mouth. Radiotherapy (for cancer) to the head and neck usually causes a reduction in salivary flow. This can also happen in menopausal women.
In some patients, their salivary flow never returns to normal and they suffer greatly from the effects from a permanently dry mouth. The consequences include an increased risk for tooth decay. In the elderly, root caries can be associated with xerostomia ( which can cause plaque build-up) when gingival recession is present. The root surface does not have enamel protection and is prone to demineralization (softening).
A chronically dry mouth can lead to gingivitis which sometimes culminates in gum disease because a reduction in salivary flow diminishes the self-cleansing ability of the mouth when the tongue has no lubrication to help remove stagnating food debris. Additionally, fungal and yeast infections may occur due to their proliferation leading to sore tongue (it sticks to the roof of the mouth usually at night). It is not unusual that insufficient saliva causes “mouth burning “sensation, ulceration, (particularly in radiotherapy patients) and speech difficulties.
The way to manage a dry mouth depends on its cause. For patients with chronic illness, who need to continue with their drug treatments, it may not be possible to remove the cause so therapy is usually symptomatic. All patients should be advised to maintain excellent oral hygiene. They should not use a toothpaste which contains the foaming agent sodium lauryl sulphate that tends to dry the mouth. Recommended toothpastes are Sensodyne Promanel or Biotene.
Other measures to combat a chronically dry mouth include: a diet high in fresh fruit and vegetables which simulates flow; chewing sugar-free gum ( containing xylitol) ; frequent sips of water or unsweetened drinks (non-alcoholic); sucking small ice chips; lubricating the mouth with non-virgin olive oil and artificial saliva available by prescription.