Dry mouth is a condition that affects 1 in 4 adults in the UK.

Understanding more about the causes of the condition, its symptoms and care available will help you support and advise your patients, helping to reduce their discomfort. 

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• Condition
• Causes
• Symptoms
• Care

Condition

Having a dry mouth (xerostomia), means your patient will have the feeling of insufficient saliva in the mouth.  We can all experience a dry mouth occasionally, especially at times of stress, if we are upset or nervous.  However, for some patients it will be a regular experience and if not treated, can become extremely uncomfortable and have an impact on their oral health & quality of life.

Saliva plays several important roles when it comes to keeping our mouths healthy. In addition to its role in digestion, saliva helps to cleanse the oral cavity, facilitate oral processing and swallowing of food, maintaining a neutral pH and preventing tooth demineralisation.

Causes

While you are talking to your patients or reviewing their notes, it is worth trying to establish a medical history as this background could highlight a risk of dry mouth. It is commonly found in patients with the following conditions.

Patients on multi-medication (polypharmacy). Dry mouth is a side effect of more than 500 medications, both OTC and prescription, and the prevalence increases with each medication taken. When a patient is taking 3 or more medications it can lead to a 50% risk of developing the condition. Common medications with dry mouth as a side effect include antidepressants, antipsychotics and sedatives.

Patients having treatment for cancer. Patients who are having treatment for cancer, in particular head and neck cancer, are at significant risk of developing dry mouth. It is one of the most common side effects during and after radiotherapy treatment and can also be a temporary side effect of chemotherapy.

Patients with diabetes. Patients with high blood sugar levels are prone to experiencing dry mouth and it can lead to further oral health complications.

Patients with dementia. Dry mouth can be a side effect of certain medications taken for patients with dementia and Alzheimer’s.

Patients with depression. Antidepressants are one of the groups of medication most associated with the condition.

Auto-immune diseases. Patients with autoimmune diseases, such as Sjögren’s syndrome, may suffer from the condition. This is due to their body’s immune system attacking glands that secrete fluid, especially the saliva glands.

Symptoms

Your patients who are suffering will experience symptoms that impact their day to day lives and can cause them to potentially feel very self-conscious and embarrassed. Along with the impact that a reduction in saliva plays in our overall oral health, it will make a real difference to your patients in so many ways:

Speaking and swallowing
Patients with dry mouth may have trouble with swallowing, mastication and speaking due to a lack of moisture and lubrication in the oral cavity. In severe cases this may be noticeable during your conversation.

A change in sense of taste
Our taste is dependent on the production of saliva in our mouths so patients with dry mouth may find a change in their sense of taste. They may start to experience an intolerance towards spicy, salty or sour foods and drinks.

A rough, dry, desert-like tongue
Saliva also maintains the moisture of the tongue, so with a lack of salivary flow the tongue can become extremely dry, sore and red leading to a lot of discomfort for your patient, and sometimes even a burning feeling.

Tooth decay
Saliva helps maintain a neutral pH in the mouth and aids with food clearance therefore patients with dry mouth are at a higher risk of developing tooth decay. A lack of saliva can cause difficulties in buffering the acids caused by bacteria or ingested foods. Caries may occur on the incised or occlusal edges and in the cervical region.

Halitosis
The lack of natural cleansing by normal saliva volume and flow can cause patients to experience bad breath.

Cracked, peeling or atrophic lip
A lack of moisture can cause sores on the lips, split skin at the corners of the lips and cracked, dry lips.

Gum disease
As the salivary flow is reduced bacteria and plaque will not be flushed from the mouth and therefore more likely to attack the teeth and gums. This will lead to an increased risk of gum disease.

Care

All Oralieve products contain bioactive ingredients and enzymes which supplement the natural systems in saliva to provide effective and lasting relief. Oralieve products help promote a healthy and comfortable mouth.

Using products containing strong flavours or detergents may cause your patients' pain and discomfort. Many oral hygiene products contain SLS, which can irritate oral tissues. Oralieve products do not contain SLS, alcohol or strong flavours and have been tested and developed with dry mouth sufferers.

Why isn't water the best relief method?

It seems sensible to substitute saliva in the mouth with water, however water does not moisten and lubricate the oral mucosa and teeth adequately – something which is critical to providing relief for patients with dry mouth.  Saliva plays a larger role in the mouth than simply providing moisture.

Dry mouth is very rarely linked to systemic dehydration so consuming large volumes of water will not overcome the condition, only offer a temporary relief from the symptoms.  In fact, patients who use frequent sips of water to overcome their dryness frequently report a reduced sleep quality due to increased urination through the night.

Drinking excessive amounts of water can potentially reduce electrolytes and result in electrolyte imbalance, in severe cases this could lead to conditions such as hyponatremia – sodium in the blood is diluted and this overwhelms the kidney’s compensation mechanism.

For more information on the Oralieve range and how to order them, click here.