Brushing Up on Oral Health
It’s normal for your mouth to feel dry every once in a while, such as when you’re upset or under stress. But if your mouth frequently seems dry and sticky, you may have dry mouth, a condition that can lead to serious health problems.
Dry mouth, or xerostomia, happens when the salivary glands in your mouth don’t produce enough saliva to keep your mouth moist. It’s most often caused by medications, says Stephen Shuman, a professor at the University of Minnesota School of Dentistry and chair of the oral health work group of the Gerontological Society of America.
“More than 400 medications list dry mouth as a side effect,” Shuman says. “Some are meant to dry people out, like diuretics. Others aren’t meant to do that but just have that effect.”
Urinary incontinence drugs are the biggest culprit, according to a 2018 review in the Journal of the American Geriatrics Society. Other common causes are blood pressure medications, antidepressants, antianxiety medications, antihistamines, opioid pain medicines and inhaled bronchodilators.
Causes beyond your Rx
As many as 26 percent of men and 33 percent of women are believed to have dry mouth, according to the American Dental Association.
Dry mouth is especially prevalent in older adults. The biggest reason is that people age 60-plus take more medications than those who are younger, says Jennifer Hartshorn, a dentist who specializes in geriatrics and special needs at the University of Iowa.
Dehydration may also play a role, Hartshorn says, because your sense of thirst is blunted as you age.
Dry mouth can also be a sign of an underlying medical condition such as diabetes, HIV/AIDS, hepatitis C or an autoimmune disease called Sjögren's syndrome. And it is a common side effect for people undergoing radiation therapy or chemotherapy for cancer.
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Whatever the cause, dry mouth is not a normal part of aging, experts say. Saliva protects your mouth and teeth by maintaining a healthy mineral balance, diluting acid and washing away food and bacteria. Without saliva, bacteria can quickly attack, decaying teeth and infecting gums.
“You can have older adults who have done the exact same oral hygiene routine since they were young, and they’re suddenly getting cavities that they never had before,” Hartshorn says. “All that changed is [that they're taking] a new medicine that causes dry mouth.”
In addition to causing tooth decay, inadequate saliva can also diminish your sense of taste, give you bad breath, cause yeast infections or soft tissue problems, and make it difficult to swallow or speak.
Fortunately, experts say taking these steps can help alleviate dry mouth symptoms and keep the fluid flowing.
1. Talk to your doctor about changing your meds
If a drug is causing your dry mouth, your physician may be able to reduce or change your dose or switch you to another prescription that can treat your problem with less drying. Since dry mouth usually gets worse at night, sometimes just taking a medication earlier in the day can make a difference.
2. Increase your fluid intake
Taking small sips of fluoridated water or sucking on ice chips throughout the day will help moisturize your mouth, and drinking eight to twelve glasses of water daily helps ensure you stay hydrated. If you have trouble swallowing, try drinking milk with meals, Hartshorn says. It “contains a fat with moisturizing properties and can help you swallow and get food down,” she adds.
3. Chew gum or suck on sugar-free candy
Chewing sugar-free gum or sucking on sugar-free candy provides quick relief by keeping saliva flowing. One study found saliva production was seven times greater when patients chewed sugar-free gum compared with when they weren’t. Shuman suggests products with the sweetener xylitol because some studies have shown it can help protect against tooth decay.
4. Limit caffeine, alcohol and sugary drinks
Because alcoholic and caffeinated drinks are naturally dehydrating, they will exacerbate your symptoms, Shuman says. Watch out, too, for mouthwashes that contain alcohol; use one with fluoride instead. Avoid sugary drinks like soda and juice because they accelerate tooth decay.
5. Investigate saliva substitutes
Companies such as Biotène and Act sell a variety of over-the-counter products to moisturize the mouth that many patients find helpful, Shuman says. They are “formulated to have the viscosity and feel of saliva,” he explains. They come in different forms, including oral sprays, rinses, gels and tablets that slowly dissolve.
6. Run a cool mist humidifier
Adding moisture to the air helps cut down on mouth dryness while you’re sleeping, which is especially important if you sleep with your mouth open.
7. Choose the right toothpaste
To protect your teeth from decay, choose a toothpaste with fluoride. But you may want to avoid pastes that contain sodium lauryl sulfate, a common foaming agent, as well as those with chemicals for whitening or tartar control, as they may irritate your mouth and gums, Hartshorn says. Ask your dentist if you would benefit from a prescription-strength toothpaste with extra fluoride made for dry-mouth patients.
8. See a dentist regularly
Because you’re at higher risk for cavities with dry mouth, it’s important to be diligent about brushing and flossing, and to visit your dentist at least twice a year. To strengthen your teeth, your dentist might apply a fluoride varnish or fit you with fluoride trays, which you would fill with fluoride gel and wear on your teeth overnight. If you have a severe case of dry mouth, your dentist may prescribe a saliva-stimulating prescription such as pilocarpine hydrochloride (Salagen) or cevimeline hydrochloride (Evoxac).
Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation’s top consumer publications. Her work has appeared in Reader’s Digest, Real Simple, Prevention, The Washington Post and The New York Times.