Dear Doctor Column, August 6, 2007

Easing Dry Mouth

Question:

Lately, I've been noticing my mouth is so dry I'm having a hard time speaking and swallowing. I'm taking medication for hypertension, and I noticed that dry mouth is cited as one of the side effects. Besides dry mouth, the medicine works well for me. What can I do to improve this bothersome condition?

Answer:

When salivary glands in mouth aren't functioning properly, people can experience dry mouth. Symptoms include a sticky or burning feeling in the mouth, trouble speaking, chewing, swallowing, or tasting, cracked lips, a dry or tough tongue, and mouth sores or infections.

There are a number of reasons salivary glands might not produce enough saliva to keep your mouth wet. Everyone, especially older adults, experiences occasional bouts of dry mouth. Being nervous or stressed can cause dryness, but constant dry mouth is not normal for people of any age; the condition can be very uncomfortable and lead to serious health problems, including tooth decay and poor nutrition.

More than 400 medications can reduce production and flow of saliva from the salivary gland located below the jaw. Medications for high blood pressure, depression, urinary incontinence, and allergies often cause the condition, the National Institute of Dental and Craniofacial Research reports. Some types of chemotherapy can also cause dry mouth.

Depending on your body's reaction to the drugs, dry mouth caused by chemotherapy may occur only during treatment or persist for some time after therapy ends. Radiation therapy can permanently damage salivary glands and reduce salivary production, as can injuries to the head and neck.

Dry mouth is a frequent symptom of an autoimmune disease called Sjögren Syndrome, a fairly common condition affecting salivary and tear glands. For more information on Sjögren Syndrome, visit the National Institute of Health's (NIH) site. Parkinson disease, diabetes, and HIV/AIDS also can cause dry mouth.

Normal salivary production is an important part of health. Saliva helps you digest food, making it possible to chew and swallow. It also protects teeth from decay, helps heal mouth sores, and prevents infection by controlling bacteria in the mouth. If you have dry mouth most or all of the time, you should see your dentist or physician, who can help you determine the cause and treat the problem. If your medication is causing dry mouth, your physician may be able to resolve the condition by adjusting dosage or having you try another medication.

If your salivary glands are damaged, but still producing some saliva, there are medications that can increase salivary production. And there are formulations of artificial saliva, similar to artificial tears, that can help keep your mouth wet.

Tips to help combat dry mouth:

• Drink 8 to 12 cups of liquid a day. Lots of liquids will make chewing and swallowing easier. Sipping water or sugarless drinks during meals will also help, and may improve the taste of food.
• Eat soft moist foods that are cool or served at room temperature. Try blended fruits and vegetables, soft-cooked chicken and fish, thin cereals, popsicles, and smoothies.
• Avoid hard foods or those that stick to the roof of the mouth. Try moistening foods with broth, soup, gravy, or butter. Soak cake, cookies, and pies in milk.
• Avoid spicy or salty foods, which can cause pain in people with dry mouth.
• Avoid caffeinated beverage, such as coffee, tea, and soft drinks. Caffeine can dry the mouth.
• Avoid alcohol and tobacco, which also have a drying effect.
• Chewing sugarless gum or sucking on hard candy can promote saliva flow.
• Certain mouthwashes can cause dry mouth. Check with your doctor or dentist to make sure you are not using drying products.
• Keeping teeth healthy is especially important for people with dry mouth. Gently brush teeth at least twice a day with a soft-bristle toothbrush, floss daily, and rinse your mouth before and after meals with a mild mouth rinse (try mixing 1 quart of water, 1 teaspoon of salt, and 1 teaspoon of baking soda). Your dentist, whom you should visit for a check up at least twice a year, also can provide special fluoride solutions to help keep your mouth and teeth healthy.

Sources: NIH, American Cancer Society.

For more information on dry mouth, visit the NIHSeniorHealth Web site. The site offers short, easy-to-read information visitors can access in various formats, including large print and audio.