AUGUST 01, 2006

Seniors More at Risk for Dry Mouth

Xerostomia, commonly known as dry mouth, affects approximately 30% of adults over the age of 65, according to Gretchen Gibson, DDS, MPH. Dr. Gibson stressed that dry mouth is not a normal consequence of aging. She recommended that patients who experience dry mouth for >2 consecutive weeks consult with their dentist. Although medication use is the most frequent reason for dry mouth, the condition may be the first sign of a systemic process or disease that can affect the entire body.

The 3 most common causes of dry mouth in seniors are medications, head and neck radiation, and Sjögren's syndrome. (Sjögren's syndrome is an autoimmune disorder in which immune cells attack and destroy the glands that produce tears and saliva; it is primarily seen in women).

Diabetes May Lead to Dry Mouth

Patients with uncontrolled diabetes and a blood sugar level of >200 mg/dL are more at risk for dry mouth. Individuals with both type 1 diabetes (juvenile diabetes) and neuropathy are more likely to develop the condition.

A study conducted by the University of Pittsburgh found that patients with juvenile diabetes had more symptoms of dry mouth and had impaired salivary flow rates. Furthermore, the patients with diabetes and neuropathy had increased signs of dry mouth and lower rates of salivary flow. The findings were published in Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, September 2001.

The study results also indicated that patients with diabetes who smoked and snacked often reported more dry mouth symptoms. Study investigator Paul A. Moore, PhD, said that neuropathy and decreased salivary flow are routine in patients with diabetes. He attributed it to a decreased responsiveness of the nerves that stimulate the production of saliva, which washes the sugar out of the mouth after eating.

Many Conditions Can Cause Xerostomia

Xerostomia (ZEE-roe-STOE-mee-uh) is the clinical name for dry mouth, which is a subjective feeling of dryness in the mouth. It can occur when the glands in the mouth and throat that make saliva—the salivary glands—do not make enough of it. Health care professionals have pointed out that xerostomia is not a disease but may be a symptom of many other diseases and conditions. When saliva production decreases and individuals experience dry mouth, the teeth and gums are at increased risk of tooth decay. Individuals also are more apt to experience illnesses that affect the soft tissues of the mouth, including thrush. Common causes of xerostomia include the following:

•Side effect of medication—Dry mouth is a potential side effect of numerous OTC and >400 prescription drugs, including pain relievers, decongestants, and antihistamines.

•Complication of diseases and infections—Diseases such as diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, and HIV can be linked with dry mouth. In addition, the condition is seen in patients with autoimmune diseases, including lupus and Sjögren's syndrome.

•Dehydration—Any condition that causes dehydration can lead to dry mouth. These conditions include fever, profuse sweating, vomiting, diarrhea, blood loss, or loss of water through the skin caused by burns.

•Radiation therapy and chemotherapy—Dry mouth is a frequent side effect of radiation therapy to treat head and neck cancer. Chemotherapy drugs used to treat cancer can make the saliva thicker, causing the mouth to feel dry.

•Nerve damage—Injury to the head or neck can damage the nerves that tell salivary glands to make saliva.

Tips to Keep the Mouth Moist

Dry mouth impacts an individual's quality of life by causing difficulty in speaking and swallowing and altering the sense of taste. Pharmacists, dentists, and other health care professionals have said that the symptom is treatable and is one that should be addressed. Treatment for dry mouth depends on what is causing the problem.

Experts recommend the following tips to combat dry mouth:

  • Drink water frequently to keep the mouth moist
  • Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow
  • Avoid drinks with caffeine (ie, coffee, tea, and some sodas) because they can dry out the mouth
  • Avoid tobacco or alcohol
  • Use an OTC oral moisturizer or saliva substitute
  • Use mouth rinses or mouthwashes that do not contain alcohol
  • Avoid spicy or salty foods because they may cause pain in a dry mouth, as well as drying out the mouth