Xerostomia Or Dry Mouth

Definition:
Xerostomia (pronounced as zeer-o-STO-me-uh)  is the medical term for the subjective complaint of dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties, cottonmouth, drooth, doughmouth or des (like a desert). Xerostomia is also common in smokers.

Lack of saliva is a common problem that may seem little more than a nuisance, but a dry mouth can affect both your enjoyment of food and the health of your teeth. The medical term for dry mouth is xerostomia (zeer-o-STO-me-uh).
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Dry mouth can cause problems because saliva helps prevent tooth decay by limiting bacterial growth and washing away food and plaque. Saliva enhances your ability to taste and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

Xerostomia can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva’s remineralizing the enamel is no longer present, and can make the mucosa and periodontal tissue of the mouth more vulnerable to infection. Notably, a symptom of heavy methamphetamine use usually called “meth mouth” is largely caused by xerostomia which is worsened by the fact that methamphetamine at recreational doses can cause tight clenching of the jaw, bruxism (compulsive grinding of the teeth), or a repetitive ‘chewing’ movement like the user is chewing without food in the mouth.
Symptoms:
If you’re not producing enough saliva, you may notice the following signs and symptoms:

*Dryness in your mouth
*Saliva that seems thick, stringy
*Sores or split skin at the corners of your mouth
*Cracked lips
*Bad breath
*Difficulty speaking, swallowing
*Sore throat
*An altered sense of taste
*A fungal infection in your mouth
*Increased plaque, tooth decay and gum disease

In women, dry mouth may result in lipstick adhering to the teeth.

Causes:
Dry mouth has numerous causes, including:

*Medications. Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, decongestants, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson’s disease medications.

*Aging. Getting older isn’t a risk factor for dry mouth on its own; however, older people are more likely to be taking medications that may cause dry mouth. Also, older people are more likely to have other health conditions that may cause dry mouth.

*Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount produced. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production.

*Nerve damage. An injury or surgery that causes nerve damage to your head and neck area also can result in xerostomia.

*Other health conditions. Dry mouth can be a consequence of certain health conditions — or their treatments — including the autoimmune disease Sjogren’s syndrome, diabetes, Parkinson’s disease, HIV/AIDS, anxiety disorders and depression. Stroke and Alzheimer’s disease may cause a perception of dry mouth, even though the salivary glands are functioning normally. Snoring and breathing with your mouth open also can contribute to the problem.

*Tobacco use. Smoking or chewing tobacco can increase dry mouth symptoms.

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It may be a sign of an underlying disease, such as Sjögren’s syndrome, poorly controlled diabetes, or Lambert-Eaton syndrome, but this is not always the case.

Other causes of insufficient saliva include anxiety,  or the consumption of alcoholic beverages, physical trauma to the salivary glands or their ducts or nerves, dehydration caused by lack of sufficient fluids, excessive breathing through the mouth, previous radiation therapy, and also a natural result of aging, other conditions or factors not mentioned also can have the ability to cause dry mouth. The vast majority of elderly individuals will suffer xerostomia to some degree, although the most common cause is the use of medications. Output from the major salivary glands does not undergo clinically significant decrements in healthy older people and clinicians should not attribute complaints of a dry mouth and findings of salivary hypofunction in an older person to his or her age. The results of one study suggested that, in general, objective and subjective measurements of major salivary gland flow rates are independent of age, gender, and race. Furthermore, signs and symptoms of dry mouth in the elderly regardless of race or gender should not be considered a normal sequela of aging. Playing or exercising a long time outside on a hot day can cause the salivary glands to become dry as the bodily fluids are concentrated elsewhere. Xerostomia is a common side-effect of various drugs such as cannabis, amphetamines, antihistamines, and some antidepressants.

Diagnosis:
To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you’ll need blood tests and imaging scans of your salivary glands to identify the cause.

He or she will do the following:-
Evaluate the patient’s complaint of dry mouth by asking pertinent history questions: When did he first notice the symptom? Was he exercising at the time? Is he currently taking any medications? Is his sensation of dry mouth intermittent or continuous? Is it related to or relieved by a particular activity? Ask about related symptoms, such as burning or itching eyes, or changes sense of smell in or taste.

Next, inspect the patient’s mouth, including the mucous membranes, for any abnormalities. Observe his eyes for conjunctival irritation, matted lids, and corneal epithelial thickening. Perform simple tests of smell and taste to detect impairment of these senses. Check for enlarged parotid and submaxillary glands.  Palpate for tender or enlarged areas along the neck, too.

Treatment:
Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients who have endured chemotherapy usually suffer from this post- treatment. Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping non-carbonated sugarless fluids frequently, chewing xylitol-containing gum,[3] and using a carboxymethyl cellulose saliva substitute as a mouthwash may help. Aquoral or Pilocarpine may be prescribed to treat xerostomia. Non-systemic relief can be found using an oxidized glycerol triesters treatment used to coat the mouth. Drinking water when there is another cause of the xerostomia besides dehydration may bring little to no relief and can even make the dry mouth more uncomfortable. The use of an enzymatic product such as Biotene toothpaste, Biotene mouthwash, and Biotene dry mouth moisturizing liquid has been proven to reduce the rate of recurrence of dental plaque resulting from dry mouth. Of note is that Biotene does not significantly reduce the count of streptococcus mutans.

If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn’t cause a dry mouth. Your doctor may also consider prescribing pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.

Lifestyle and home remedies:
When the cause of the problem either can’t be determined or can’t be resolved, the following tips may help improve your dry mouth symptoms and keep your teeth healthy:

*Chew sugar-free gum or suck on sugar-free hard candies.
*Limit your caffeine intake. Caffeine can make your mouth drier.
*Avoid sugary or acidic foods and candies because they increase the risk of tooth decay.
*Brush with a fluoride toothpaste. (Ask your dentist if you might benefit from prescription fluoride toothpaste.)
*Use a fluoride rinse or brush-on fluoride gel before bedtime.
*Don’t use a mouthwash that contains alcohol because these can be drying.
*Stop all tobacco use if you smoke or chew tobacco.
*Sip water regularly.
*Try over-the-counter saliva substitutes. Look for ones containing carboxymethylcellulose or hydroxyethyl cellulose, such as Biotene Oralbalance.
*Avoid using over-the-counter antihistamines and decongestants because they can make your symptoms worse.
*Breathe through your nose, not your mouth.
*Add moisture to the air at night with a room humidifier.

Alternative medicine:-
Studies of acupuncture have shown that acupuncture may be helpful for people with dry mouth stemming from various causes. This procedure involves the use of fine needles, lightly placed into various areas of the body, depending on your area of concern. While this treatment looks promising, researchers are still studying exactly how this therapy works for xerostomia. You may click to see:->Acupuncture relieves symptoms of xerostomia


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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.mayoclinic.com/health/dry-mouth/HA00034
http://www.wrongdiagnosis.com/x/xerostomia/tests.htm
http://en.wikipedia.org/wiki/Xerostomia

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