Dry Mouth

General Information
Excessive dryness of the mouth can cause difficulty with talking and swallowing and can irritate or exacerbate gum disease, which results in tooth loss. Dry mouth is not a result of an aging process, but it may be a consequence of diseases related to aging or the treatment of these diseases.

Patients are usually well aware of dry mouth, but no external signs serve as clues to the presence of the problem. Caregivers should remember that patients with impaired general awareness owing to dementia, medications, stroke, or other problems who seem to be having trouble chewing and swallowing dry food, often needing to drink while chewing a mouthful of food, may be experiencing dry mouth syndrome. Hoarseness and difficulty speaking at length also may be complaints. Oral ulcerations, furrowing of the mucous membranes, and dental caries (cavities) are later features. Saliva is important in the maintenance of proper mineralization of the teeth.

Dry mouth is a side effect of many drugs—so many drugs (more than 400) that it is hard to anticipate which ones will cause significant dry mouth in any given patient. Many of these medications are a part of the management of problems of aging, such as Parkinson’s disease, depression, and hypertension. A few diseases, including infections and tumors, can cause dry mouth as well.

Important Points in Treatment
Management may include adjusting medications to lessen the drying effects in the mouth. Some medications may need to be maintained because they are essential components of the treatment of other serious diseases. Treatment of diseases that can cause drying can be helpful.

A few drugs can effectively stimulate salivary secretions without bothersome side effects. Salivary substitutes are of limited help. Careful dental hygiene including regular, frequent cleaning can help to prevent caries and tooth loss. Often the use of fluoride mouth wash may help retard the development of cavities.

Notify Our Office If ...

• The patient has any evidence of dry mouth. Caregivers should remember that if general awareness is impaired by dementia, medications, stroke, or other problems, no external signs serve as a clue to the presence of the problem.