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Mandy Knowles, Personnel Manager, Brighton.
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Dry Mouth

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Dry mouth (xerostomia) may be resultant of a number of causes. The mouth is supplied with saliva by pairs of major salivary glands and hundreds of tiny minor salivary glands situated all over the lining of the mouth. Sometimes these glands can become damaged. Alternatively the glands themselves may be normal, but the rate at which saliva is produced below normal levels. Dry mouth may also occur with diabetes, stress or depression. It can follow radiotherapy to the head and neck. The most common reason for a dry mouth is as a side-effect of prescribed medicines.

The main disease causing a dry mouth is called Sjögren's Syndrome (pronounced 'show-grunz'). This condition can either occur by itself, when it is known as primary Sjögren's Syndrome, or in secondary form alongside conditions such as rheumatoid arthritis. Because it will affect all salivary glands, both major and minor, the whole mouth will be drier. In both conditions, there is also dryness of the eyes, and there may be other symptoms such as tiredness. Both types of Sjögren's Syndrome can be investigated with blood tests, and sometimes a small biopsy of the minor salivary glands in the lower lip.

The most commonly prescribed medicines that cause a dry mouth are tablets used for treatment of blood pressure. The next most common are those used in the treatment of anxiety and depression, and antihistamines taken for hay fever and treatment of allergies. Inhalers used to treat asthma may also lead to dry mouth.

A dry mouth is often quite uncomfortable and may make eating more difficult. One of the functions of saliva is to help prevent tooth decay and gum disease so if you have a dry mouth you will be more prone to these issues. It is especially important for sufferers :
  • To limit their dietary sugars
  • To keep teeth very clean
  • To visit a dentist regularly
  • Use a fluoride mouthwash or an antibacterial mouthwash

If the sufferer wears dentures there is an increased risk of developing fungal infections of the mouth. To avoid this it is important to maintain the hygiene of the dentures. It may occasionally be necessary for the dentist or doctor to prescribe a medication to treat or prevent oral thrush.

If there is some loss of salivary gland function, then the flow of saliva can be increased by chewing gum or sucking a sweet – they should be sugar-free.

Keeping well hydrated will also help reduce the problems related to dry mouth. There are a number of saliva substitutes that can be bought from a pharmacy or prescribed by a dentist or doctor. Other saliva stimulants are available; these are mainly sprays, gels, tablets or pastilles.

There is a medication available (pilocarpine) which can stimulate salivary glands that still have some saliva-producing ability left. A doctor or hospital specialist can prescribe this. However, it has a number of side-effects which some people may find unpleasant.

If in doubt, consult a dentist or doctor.