Sep 13, 20193 min read

Dry mouth

Have you ever experienced dry mouth?

It can happen during moments of extreme anxiety, for example when you have to give a public speech, face an interview panel or experience a shocking event.

The dryness can stick your tongue to the roof of your mouth, make speaking and eating impossible.

For some people, dry mouth becomes their 'normal', everyday state. For all of our disinterest in, or embarrassment about saliva, it is a valuable body fluid. The lack of it is a very uncomfortable and distressing condition with profound impacts on every aspect of health.

The causes of dry mouth are many and varied.

It is important to get to the bottom of why your mouth is dry, so it can be properly managed. The most common causes are:

Dehydration - This is surprising common, even the land of the plastic water bottle. Some people avoid drinking water because the type of work they do prevents them from easily taking a toilet break. Other people do not like the taste of water and just refuse to drink it. No water = No saliva.
Mouth breathing - This is a common problem for people who have chronic upper respiratory tract infections and allergies. The mouth is designed to be an emergency 'back-up' breathing hole. Short term mouth breathing (say during bad colds and flu) is not a problem. Prolonged mouth breathing causes chronic dry mouth.
Snoring - This fits in to the previous point, but deserves its own mention. Snoring almost always happens with breathing through the mouth. For the 6-9 hours of sleep, the mouth is completely dehydrated. Sleep is when teeth are most vulnerable to decay.
Medications - Virtually every class of medication impacts negatively on saliva flow. Meds for blood pressure, depression, anxiety, weight loss, asthma, diarrhoea, epilepsy and pain killers cause dry mouth. Even over-the-counter antihistamines and cold & flu tablets cause dry mouth. When several medications are taken, the negative effects on saliva flow multiply.
Radiation to the head and neck and chemotherapy cause dry mouth - In the case of radiation it can take years to recover.
Smoking and vaping - both cause dry mouth through the effects of the nicotine and other compounds. They also encourage and 'train' people to breathe through their mouth when not smoking.
Medical conditions - Many conditions have dry mouth as a symptom. Diabetes, cystic fibrosis, Alzheimer's disease, Parkinson's disease and anaemia are characterised by poor saliva flow. Almost all of the autoimmune diseases cause dry mouth, including Sjögren's disease, sarcoidosis, rheumatoid arthritis and scleroderma.

The effects of dry mouth

Saliva is absolutely crucial to good oral health. The impacts of dry mouth are serious, debilitating and very difficult to manage. They include:

Aggressive tooth decay - This sort of decay is fast moving and attacks all tooth surfaces. If dry mouth is not managed, fillings will fail rapidly as more decay occurs around them.
Very high susceptibility to acid damage of teeth - acid from reflux or beverages damages the teeth of people with dry mouth very quickly.
Gum disease - the antibodies in saliva provide very strong protection against gum disease. Dry mouth accelerates this disease process, placing teeth at risk of loss.
Difficulty speaking - the dryness makes the mouth feels sticky. It subtly changes phonation and can make people feel uncomfortably self-conscious when they speak.
Difficulty eating and digesting food - Chewing and swallowing can become difficult, unpleasant and painful. Saliva is essential to start the process of digestion and to form food into a comfortable, easily swallowed mass (bolus).
Loss of taste sensation - Saliva helps us taste our food. Food can become so unappealing (when combined with the previous point) that people lose interest in eating altogether.
Increased risk of lip, cheek and tongue biting - Saliva keeps the mouth lubricated and stops the tongue, lips and cheeks from sticking to the teeth. This problem can become so bad that people experience constant mouth pain from ulcers.
Oral candidiasis - Candida is a nasty, opportunistic organism. It takes advantage of low saliva flow to set up colonies that are very dificult to eliminate. This creates a burden on the immune system, sets up conditions for spread of the infection to the gut and can cause painful ulceration in severe cases.

What to do about dry mouth

Consult with your doctor and your dentist. Simple tips to assist with this problem are:

Drink more water.
Drink less alcohol, tea and coffee.
Carry a very small spray bottle filled with water to pump into your mouth throughout the day.
There are a range of products on the market that moisturise the mouth. The most effective one is a slow release, xylitol based moisturising lozenge.