DRY MOUTH WATCH

Pharmacy Times, Volume 0, 0

Seniors More at Risk for Dry Mouth

Xerostomia, commonly known as dry mouth, affectsapproximately 30% of adults over the age of 65, according toGretchen Gibson, DDS, MPH. Dr. Gibson stressed that drymouth is not a normal consequence of aging. She recommendedthat patients who experience dry mouth for >2 consecutiveweeks consult with their dentist. Although medicationuse is the most frequent reason for dry mouth, the conditionmay be the first sign of a systemic process or diseasethat can affect the entire body.

The 3 most common causes of dry mouth in seniors aremedications, head and neck radiation, and Sjögren's syndrome.(Sjögren's syndrome is an autoimmune disorder inwhich immune cells attack and destroy the glands that producetears 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 bothtype 1 diabetes (juvenile diabetes) and neuropathy are more likelyto develop the condition.

A study conducted by the University of Pittsburgh found thatpatients with juvenile diabetes had more symptoms of dry mouth andhad impaired salivary flow rates. Furthermore, the patients with diabetesand neuropathy had increased signs of dry mouth and lowerrates 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 whosmoked and snacked often reported more dry mouth symptoms.Study investigator Paul A. Moore, PhD, said that neuropathy anddecreased salivary flow are routine in patients with diabetes. Heattributed it to a decreased responsiveness of the nerves that stimulatethe production of saliva, which washes the sugar out of themouth after eating.

Many Conditions Can Cause Xerostomia

Xerostomia (ZEE-roe-STOE-mee-uh) is the clinicalname for dry mouth, which is a subjective feeling ofdryness in the mouth. It can occur when the glands inthe mouth and throat that make saliva—the salivaryglands—do not make enough of it. Health care professionalshave pointed out that xerostomia is not a diseasebut may be a symptom of many other diseasesand conditions. When saliva production decreases andindividuals experience dry mouth, the teeth and gumsare at increased risk of tooth decay. Individuals also aremore apt to experience illnesses that affect the soft tissuesof the mouth, including thrush. Common causesof xerostomia include the following:

•Side effect of medication—Dry mouth is a potentialside effect of numerous OTC and >400 prescriptiondrugs, including pain relievers, decongestants,and antihistamines.

•Complication of diseases and infections—Diseasessuch as diabetes, anemia, cystic fibrosis,rheumatoid arthritis, hypertension, and HIV can belinked with dry mouth. In addition, the condition isseen in patients with autoimmune diseases,including lupus and Sjögren's syndrome.

•Dehydration—Any condition that causes dehydrationcan lead to dry mouth. These conditionsinclude fever, profuse sweating, vomiting, diarrhea,blood loss, or loss of water through the skincaused by burns.

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

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

Tips to Keep the Mouth Moist

Dry mouth impacts an individual's quality of life by causing difficultyin speaking and swallowing and altering the sense of taste.Pharmacists, dentists, and other health care professionals havesaid that the symptom is treatable and is one that should beaddressed. Treatment for dry mouth depends on what is causingthe 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 stimulatesaliva 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 adry mouth, as well as drying out the mouth