Xerostomia Relief Agents

Xerostomia is the medical term for dry mouth and generally refers to a chronic condition. According to a review of studies published in a 2003 issue of the Journal of the American Dental Association (JADA), about 17 to 29 percent of people have xerostomia. The disorder is generally more common in women. Xerostomia has many causes and can lead to negative health effects. Several options are possible to provide relief.

Medicinal Causes

• The most common cause of xerostomia is the use of drugs, according to the JADA. Drugs associated with xerostomia include amphetamines, antidepressants, antihistamines, antipsychotics, decongestants and marijuana. Additionally, xerostomia is a common complication in patients who have undergone radiation therapy to the head or neck and in people who have complications from bone marrow transplants. Chemotherapy also can lead to xerostomia.

Disease Causes

• Chronic xerostomia can be caused by disease, such as Sjogren's syndrome, an autoimmune disorder involving dry mouth and dry eyes. Sjogren's syndrome often occurs along with another autoimmune disorder, such as lupus or rheumatoid arthritis. Xerostomia also is reported by people with diabetes, particularly those who have trouble controlling their blood sugar levels.

Complications

• Xerostomia is uncomfortable, and tends to cause bad breath and difficulties with speaking, chewing and swallowing. It can lead to dental cavities, because saliva has a protective effect on tooth enamel. Chronic dry mouth also causes pain and irritation for people wearing dentures. Oral yeast infections and other gum infections can occur due to lack of saliva.

Primary Treatment

• The primary treatment involves determining the underlying cause and correcting it if possible. However, correcting the problem may not be possible unless xerostomia is caused by medications that people are able to avoid using, such as antihistamines and decongestants. A lower dosage also can help. The older antidepressants, or tricyclics, have a worse effect on dry mouth than the newer ones do. Tricyclics include amitriptyline (Elavil), amoxapine (Asendin) and imipramine (Tofranil). The newer antidepressants are selective serotonin reuptake inhibitors (SSRIs) including citalopram (Celexa), fluoxetine (Prozac) and sertraline (Zoloft).

Symptomatic Treatment

• People with xerostomia can try regularly sipping water or other sugarless fluids, or holding ice chips in the mouth. Chewing sugar-free gum or sucking on sugar-free candy also is beneficial, particularly if the gum or candy contains the artificial sweetener xylitol, which inhibits bacterial growth in the mouth. Saliva substitutes containing carboxymethyl cellulose can provide relief. They are available in various brands of lozenges, mouth rinses, spray and swab sticks. These products not only help dry mouth but can stimulate the salivary glands to produce more saliva. Xerostomia patients should avoid mouth rinses containing alcohol, which can make the condition worse.

Alternative and Medicinal Treatment

• The 2003 JADA article cites three studies indicating that acupuncture is beneficial for treating xerostomia. Some drugs can stimulate salivary gland secretions, such as pilocarpine (Salagen) and cevimeline (Evoxac). Another option is oxidized glycerol triesters (Aquoral), which is used to coat the mouth.

Considerations

• Patients with xerostomia should be rigorous about oral hygiene to avoid cavities and gum infections. Regular brushing and flossing is important, along with rinsing the mouth after eating. These people should avoid eating sugary or starchy foods unless they can brush immediately after. The dentist may recommend placing a dental sealant on teeth and applying topical fluoride. Fluoride also can be provided in chewable tablets, gels, lozenges and mouth rinses.