Dry mouth, or xerostomia, results when glands in the mouth don’t make enough saliva. Teeth, gums, and other soft tissues inside the mouth need saliva to stay healthy. A dry mouth is not a happy mouth. Ideally, the human body adjusts the output of saliva to keep things properly moist in there. Kind of like the way a thermostat keeps a home at a comfortable temperature. The human ‘spit-o-stat’, however, sometimes doesn’t work perfectly. One outcome of this is dry mouth. There are quite a few causes of dry mouth, which we’ll discuss shortly. First, however, let’s see how saliva is made. Let’s see what happens when there’s not enough of it. There’s more to it than just a little discomfort. Xerostomia, or dry mouth, increase the risks for several types of oral health issues.
The saliva glands in the mouth are controlled by the autonomic nervous system. That means they run on auto-pilot, around the clock, as the heart does. We don’t have to think about increasing or decreasing saliva output. Rather, it just happens, responding to changing conditions.
During waking hours, with nothing special going on, the output of saliva is normally at a “resting” level. Enough to keep things moist and well-oiled in there. These glands respond to things like appetizing smells and chewing by increasing production up to ten times that resting level. Scientists estimate that a healthy adult produces about a quart of saliva every day. Production drops to very low levels during sleep.
Saliva is about 99% water. However, the remaining one percent has quite a few interesting and important ingredients. Some of these are electrolytes including sodium, potassium, and bicarbonate. There are natural antibiotics, too, and anti-microbial enzymes. A handful of enzymes, proteins, hormones, and even a natural pain-killer round out the list. Spit is not simple stuff. It’s not just that there are dozens of active ingredients. The body also adjusts the mix of these in response to changing conditions. Saliva, it turns out, has many jobs to do. That’s why dry mouth is a problem for oral health.
WHAT SALIVA DOES
As has been noted, adequate levels of saliva keep things inside the mouth well-oiled. This is literally true. Saliva acts as a lubricant. It protects all the soft tissues in there from damage while talking, chewing, and swallowing. Moreover, this lubrication is what keeps food from sticking to the insides of the cheeks or to the throat lining.
Saliva is also the first digestive juice food comes into contact with on it’s way to the stomach. Digestion begins in the mouth. Starches, especially, are broken down into sugars by enzymes in saliva. Fat digestion begins in the mouth, too. Babies rely heavily on saliva’s role in breaking down fats in their mouths.
Some of saliva’s other duties include stimulating cell growth and regeneration, keeping mouth acidity levels optimal, and facilitating the sense of taste.
And then, there are saliva’s critical roles in supporting dental health.
SALIVA, TEETH, AND GUMS
Saliva is nature’s way of brushing and flossing teeth. First, it physically rinses food bits off tooth surfaces. In addition, the various anti-biotic and anti-microbial chemicals in saliva suppress the growth of the bacteria that cause decay. Saliva also keeps mouth acidity in a range which inhibits the breakdown of enamel and encourages its rebuilding. It further assists enamel rebuilding by supplying key building materials like calcium and phosphates.
What’s good for the teeth is good for the gums, too. Saliva’s germ-killing action helps prevent gum diseases like gingivitis. It delivers an Epidermal Growth Factor (EGF) that stimulates cell growth. This is key to replacing worn and damaged gum tissue with new material.
In summary, adequate saliva levels are a strong force against tooth decay, cavities, and gum disease. But how much is enough? Well, too much is a problem in its own right. After all, drooling isn’t convenient, hygienic, or attractive. The focus here is on dry mouth, however, so the proper question is: How little is too little? How dry is too dry?
SYMPTOMS OF DRY MOUTH
Asking what the symptoms of dry mouth are sure does seem like answering the question at the same time. Yes, a dry mouth is a symptom of dry mouth. However, in bona fide cases, there are almost always more symptoms. These include frequent thirst, dry throat with hoarseness, difficulty swallowing, and difficulty speaking, chewing, and even tasting. The tongue may be reddish and raw. Mouth sores and cracked lips are common, too. So are cracks in the corners of the mouth.
The simplest cause of dry mouth is dehydration. A dried-out body means a dried-out mouth. Drilling down into the causes of dehydration, we find it’s an effect of diseases that come with high fever, vomiting, or diarrhea. Heavy work or exercise in hot weather is a common cause. Whatever the specific reason for it, dehydration is the result of the body expelling more water than it’s taking in.
Medications are a common cause of dry mouth. The list of meds that are known to promote dry mouth as a side effect is, well- long. Many hundreds of items! The most widely-prescribed antidepressants and blood pressure pills, allergy meds, and cold pills are implicated. So are many antibiotics. Popular “recreational” substances, too, can cause dry mouth. Tobacco, alcohol, marijuana, and methamphetamine do.
More innocently, aging is associated with lower saliva production. Recent research, however, indicates it may not be aging per se that’s the cause. It may be we see more dry mouth in older patients because they have more diseases and take more meds. At any age, mouth breathers are more at risk. So are victims of trauma that damages nerves involved in the control of saliva production. Finally, a number of diseases can cause dry mouth. Some of these are diabetes, anemia, rheumatoid arthritis, Alzheimer’s, Parkinson’s, and stroke.
RESPONDING TO DRY MOUTH
As previously noted, dry mouth means some loss of the critical services saliva performs for oral health. It increases the risks of decay, cavities, and gum disease. Therefore, it calls for intervention and correction.
The specific interventions, of course, depend on the cause(s). In some cases, such as dehydration, it may be as simple as drinking more water. Where medication is the issue, a doctor may be able to prescribe a different drug that’s better in this regard. In contrast, a chronic disease like diabetes is there to stay. The choice to continue use of recreational substances is the patient’s.
Sometimes the particular causes of a patient’s dry mouth are such that they can’t be eliminated or mitigated. Then, the focus has instead to be on adapting. Your Lake Worth dentist can help you upgrade your emphasis on preventative dental health measures. Steps can include more frequent checkups, avoiding mouthwashes with alcohol, and dental sealants. There are prescription drugs that stimulate saliva production.
The important thing is to treat dry mouth as a health problem. It’s not just an annoyance. Patients should keep dentists informed about the medications they take. Finally, it’s important for patients to make dentists aware of any dry mouth symptoms they have. These may not be seen during a typical dental appointment.