Dry mouth

Definition and Symptoms

To describe what the patient refers to as "dry mouth", doctors prefer to use the terms xerostomia or dry mouth .

Whatever you call it, dry mouth is an unpleasant condition caused by a lack of saliva. This deficit can alter the perception of the normal taste of food, make speech difficult and predispose to dental caries. The saliva, in fact, is able to buffer the acidity of the mouth and contains some substances with antimicrobial action.

Dry mouth can also make swallowing difficult, while digestive processes do not suffer particular negative consequences (the lack of intervention of salivary amylase is amply compensated by pancreatic amylase). In addition to the dryness of the oral mucosa, the patient can complain of sore throat, chapped lips, constant thirst, difficulty speaking, bad breath, gum disease and fungal infections of the mouth (see oral thrush or thrush).

Causes

Diet

Having a dry mouth from time to time is a completely normal phenomenon, often the result of a slight dehydration caused by too much sweat, insufficient fluid intake or excessive ingestion of alcohol or salty foods. Remember that in normal conditions the salivary glands they produce and secrete about one to one and a half liters of saliva per day.

Medicines

In addition to food, dry mouth can have iatrogenic origins, that is linked to the intake of certain medicines.

The list of offending drugs is quite long and includes in particular pharmaceutical products used for the treatment of depression, anxiety, Parkinson's disease, obesity (sibutramine, phendimetrazine, amphetamine derivatives), urinary incontinence and cancer (chemotherapy), but also narcotics, antihistamines - decongestants, antihypertensives (diuretics), antidiarrheals and muscle relaxants.

Smoking and Narcotic

Tobacco (smoked or chewed), physical exercise by mouth breathing, and talking or singing for too long, can aggravate the feeling of dry mouth.

In other cases, the drying up can be caused by the abuse of drugs, such as marijuana, cocaine, ephedrine and amphetamines, or alcohol (which has a dehydrating effect on the body).

Diseases and Disorders

A nasal obstruction (septal deviations, allergic rhinitis, nasal polyposis, etc.), which forces the patient to breathe through the mouth, can make it parched like the conditions listed above.

Among the diseases responsible for dry mouth Sjogrens syndrome stands out, followed by common diabetes and insipid diabetes, mumps (mumps), cystic fibrosis and psychological disorders (depression and anxiety); the sensation of dry mouth can also be felt by patients with Parkinson's disease or who have suffered a heart attack.

When dry mouth is accompanied by excessive sweating and marked thinness, it can indicate a thyroid disease called hyperthyroidism.

Dry mouth can also be caused by injury to the salivary glands, for example due to trauma to the head, surgery or localized radiotherapy to the neck and head (in which case the injury may be irreversible).


For further information: Dry Mouth: Causes and Symptoms "

Diagnosis

To diagnose xerostomia, the doctor or dentist carefully examines the patient's medical history and symptoms; a "careful inspection of the oral cavity and palpation of the neck and cheeks - possibly associated with blood tests or imaging techniques (diagnostic imaging) - will eventually help him to identify the origins of the problem. At home, dry mouth can be" diagnosed "by ingesting crackers or dry rice: if you have difficulty chewing or swallowing the test is considered" positive ".

Treatment

The treatment of xerostomia is personalized in relation to the causes of origin. For example, the doctor may decide to discontinue certain medicines and replace them with others. Oral rinses with special mouthwashes, application of artificial humectants in spray (Xerotin, Secriva), capable of mimicking the effect of saliva (especially useful before meals) and the adoption of other palliative measures considered secretory-stimulants (chewingum or sugared almonds, strictly sugar-free), represent a generalized intervention strategy. The patient, for his part, must maintain adequate oral hygiene and correct any so-called spoiled habits, abolishing smoking, trying to breathe with the nose instead of the mouth, increasing the intake of liquids and humidifying the rooms in which he is staying.

When the salivary glands are healthy, the treatment of dry mouth can make use of special scialagogue drugs, such as anetholtrithione (Sulfarlem) and pilocarpine (Salagen), which increase the flow of saliva.


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