Dry mouth: everything you need to know about xerostomia

Approximately 10% of the general population and 25% of the elderly suffer from dry mouth syndrome, also known as xerostomia, which means that they do not have enough saliva in their mouths. Nutrident.fr explains the functioning of the salivary glands and the means to remedy the problems of dry mouth.

How the salivary glands work

The salivary glands are located around the mouth and throat. They make saliva that is pumped into the mouth along tiny canals called salivary ducts.

The salivary glands include:

• the parotid gland located in front of the ear and behind the angle of the jaw;
• the submandibular located under the tongue on both sides of the jaw;
• the sublingual located in the bottom of the mouth;
• minor salivary glands found in various places around the mouth, including inside the cheeks and throat

A constant flow of saliva keeps the mouth moist at all times. Chewing and swallowing food increases the flow of saliva, and even just looking at and thinking about appetizing foods can cause an increase in saliva flow.

The protective role of saliva

Having enough saliva keeps your mouth healthy, because saliva :

• Contains components that directly attack the bacteria that cause cavities;
• Has antifungal properties;
• Helps destroy viruses;
• Neutralizes the acids produced by dental plaque;
• Contains phosphorus and calcium, essential substances for the continuous remineralization process that rebuilds toothenamel;
• Moistens the food, which allows a comfortable swallowing and prepares for digestion;
• Help in the formation of particular sounds in speech;
• Stimulates the sensations inside the mouth and allows, for example, to feel pain, texture and taste of food.

Dry mouth syndrome and tooth decay

Poor oral hygiene and a sugary diet tend to cause cavities on the biting surfaces and between the teeth. Dry mouth syndrome causes a different pattern of tooth decay that begins along the gum line and, in some cases, the gums recede and expose the underlying tooth layer, dentin.

Unlike enamel, dentin offers less resistance to acids and decay tends to be rapid. Decay of the exposed dentin is called root caries. Decay can also be seen on the lower front teeth which are normally well protected by the saliva produced under the tongue.

What are the symptoms of dry mouth?

Dry mouth results in thick, stringy saliva, a rough, dry tongue that tends to stick to the roof of the mouth and dry, cracked lips.

As a result, you may have problems chewing or swallowing, especially hard foods, mouth ulcers, high levels of tooth decay and bad breath.

The repercussions also affect the rest of the body with dry and itchy eyes, dry nose and throat, reduced sense of smell and digestive problems.

Causes of dry mouth syndrome

There are many causes of dry mouth. To start, you need to drink enough fluids every day to keep yourself hydrated.

Taking certain medications (and drugs) is responsible for dry mouth. The most common are antihistamines, anti-hypertension drugs, sedatives, analgesics, antidepressants. Some cancer treatments such as chemotherapy or radiation therapy can temporarily reduce the ability of the salivary glands to produce saliva.

Cigarettes and alcohol are harmful to saliva production, as is cocaine use.

Bacterial or viral infections of the salivary glands can cause inflammation and restrict saliva production.

Sjögren's syndrome is a common autoimmune disease that primarily affects the eyes and salivary glands, but can also affect the sweat glands. Other diseases including AIDS, amyloidosis, cerebral palsy, diabetes, Parkinson's disease, primary biliary cirrhosis and lupus reduce saliva formation.

The obstruction of the salivary ducts by tiny pebbles – called stones – formed by minerals in the saliva can lodge in the salivary ducts and restrict the flow of saliva.

Nerve problems also influence saliva production, as the function of the salivary glands is controlled by the facial nerves. Injury or surgical damage to these nerves can reduce saliva production

Habitual mouth breathing in the case of a constantly blocked nose or sinuses, or hormonal changes due to pregnancy or menopause are also common factors.

How to diagnose dry mouth syndrome

The diagnosis of dry mouth syndrome begins with a physical examination of the oral cavity and teeth.

The saliva test involves rolling up the lower lip and patting it dry. It should normally moisten again within 30 seconds.

Treatment of dry mouth syndrome

Logically, the treatment depends on the cause. If you are on medication, your doctor may change it. He or she may also prescribe antibiotics and antifungal medications in case of infection.

If it is a question of salivary stones, surgery is required.

Saliva substitutes or saliva promoters are available in the form of toothpastes, mouthwashes, chewing gums and lubricating sprays made from mucin, carboxymethylcellulose and glycerol esters.

In addition to these treatments prescribed by the dentist, change some of your behaviors. Eat chewy foods to stimulate saliva flow, chew foods thoroughly before swallowing, drink more water.

On the other hand, avoid crunchy foods that can hurt your mouth, acidic foods and drinks, such as soft drinks, citrus fruits and juices, to protect your tooth enamel, limit sweet foods and drinks or avoid them altogether.

Slow down or stop smoking, alcohol, caffeinated drinks and spicy foods. Chew sugar-free chewing gum between meals to promote saliva flow.

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