What is dry mouth or xerostomia?
Changes to the mucosa in the mouth are side effects of a number of illnesses. They can occur both as a result of the underlying disease or because of its treatment. Dry mouth is a known side effect of more than 400 medicinal products, and it can also be a result of radiotherapy, chemotherapy, autoimmune diseases or metabolic conditions. Older people too can suffer from dry mouth. This is usually caused by older people not taking in enough liquids
Changes to the mucosa in the mouth have a number of consequences for patients and can affect quality of life:
- Burning or painful sensations on the tongue
- Pain when eating
- Sense of taste is affected
- Trouble swallowing
- Difficulty speaking
- Accumulation of pathogens in the mouth
- Inflammation, dental caries, loss of teeth because of increased bacterial colonisation
The symptoms not only adversely affect quality of life but can also lead to other complications:
Acute inflammation of and ulcers in the oral mucosa (oral mucositis) and an infectious fungal disease (candidiasis or thrush) are common side effects of dry mouth.
Pain when eating can result in nutritional deficiencies which in turn usually leads to a general decline in health.
Frequently asked questions
There are different causes of dry mouth. Either, the amount of saliva is reduced because of underactivity of the salivary gland or there is a change in the composition of the saliva.
Human saliva is produced in the salivary glands. In a healthy person, all salivary glands taken together produce around 1.5 litres of saliva a day.
Radiation of the head and neck
Healthy cells can become damaged during radiation of the head and neck area. A temporary disruption or permanent damage to the function of the salivary glands can be the result.
Chemotherapy
Chemotherapy as part of cancer treatment can damage the mucous membranes, in particular those in the mouth. This can result in diseases of the oral cavity.
Autoimmune diseases
A number of autoimmune diseases can cause dry mouth. Besides rheumatoid arthritis, Sjögren syndrome is the most common rheumatic disease. As a result of this illness the activity of the lacrimal, salivary and mucous glands is decreased.
Metabolic disorders
In metabolic disorders (e.g. diabetes) autonomic nerve disorder can lead to dry mouth.
Side effects of medicinal products
Around 400 medicinal products cause dry mouth as a side effect. These include diuretics, antidepressants and analgesics (e.g. morphine). In general, this form of dry mouth will improve once the medicinal products are discontinued.
Insufficient intake of liquids
In particular in advanced age, people often experience less thirst and thus do not drink enough. In old age too, however it is particularly important to drink sufficient amounts of water; ideally around 3 litres a day.
Lifestyle too can have a significant impact on dry mouth. Alcohol, smoking or an extreme loss of fluids when exercising can lead to dry mouth.
For diagnostic purposes, physicians will question patients on their daily fluid intake and diet. Certain drinking and eating habits can cause dry mouth.
The safest diagnostic method is to measure the salivary flow rate. With this, physicians can determine how much saliva per minute is produced by the patient. The resting salivary flow rate and the stimulated salivary secretion are measured for this purpose. In order to stimulate saliva production for the examination, patients will chew sugar-free chewing gum for example. Physicians can also measure the secretion of the individual glands.
A physical exam is also necessary to arrive at a diagnosis for dry mouth. Here, physicians will check on the state of the oral mucosa and the salivary glands and look for anomalies in the oral cavity. In addition, they will examine patients’ eyes and nasal region and palpate the lymph nodes. Depending on the suspected cause for dry mouth, further examinations may be necessary. These may include an analysis of the salivary composition and its pH, an oral smear for pathogens, an X-ray or an image of the salivary duct using contrast agents.
If the saliva produced by patients themselves is not sufficient to keep their mouth dry for any amount of time several different remedies are available:
- Drink plenty of water and herbal or fruit tea
- Rinse mouth with water, herbal or fruit tea
- Let ice cubes made from e.g. pineapple juice slowly dissolve in your mouth
These methods usually only provide short-term relief.
A more lasting effect is achieved with the help of saliva substitutes, in particular those based on natural active substances:
Saliva natura is effective through extracts of the medicinal herb Yerba santa (“sacred herb”) and has properties similar to human saliva:
- It forms a protective, lubricating film on the oral mucosa.
- It helps with functions such as chewing, swallowing and speaking.
- The medicinal herb has water-retaining properties and thus prolongs its effectiveness.
- It improves the protection of the oral mucosa from pathogens, and the occurrence of secondary diseases can be reduced.
