Symptoms
Symptoms, social implications for sufferers, and causes
Dry mouth may be much more common than you think, 17-29% of adults experience dry mouth.
Dry mouth may be due to a lack of saliva flow to the mouth – hyposalivation – or it can be a subjective perception of having a dry mouth – Xerostomia – or both. Either way, it is not a trivial condition: it can be painful, sufferers report a serious affect on their quality of life and it can lead to increased dental caries and candidiasis.
Millions of Americans are affected by dry mouth, especially women, older people and those using any of the 400 commonly-prescribed drugs that list dry mouth as a side effect.
Patients will usually complain of soreness in the mouth, impaired taste, difficult or painful eating – especially dry or spicy food – and waking up regularly during the night. Many also suffer feelings of self-consciousness and embarrassment.
Visually, you will notice the mucosal tissues becoming red and parched. The inside of the mouth may be sticky, with cracking at the corners of the mouth, the tongue may appear reddened too, or take on a ‘pebbled’ appearance. Halitosis is another symptom, and oral infections such as candidiasis.
Causes from medication
Over 400 frequently prescribed drugs are associated with dry mouth. Taking more than one medication may increase this risk.
Certain kinds of drugs are more prone to causing dry mouth. The most commonly implicated are tricyclic antidepressants, antipsychotics, benzodiazepines, atropinics, beta-blockers and antihistamines. Most are prescription, but over the counter drugs that can cause dry mouth include antihistamines, decongestants, cough and cold remedies, analgesics and anti-nauseants.
Causes from cancer treatment
Xerostomia has been ranked as the third most distressing symptom of therapy for head and neck cancer. Surgery, radiotherapy and chemotherapy can all cause symptoms, and sometimes the effects are permanent.
Radiotherapy causes the most damage to the salivary glands. In the first week after radiotherapy saliva flow reduces by 95 per cent, and ceases almost entirely within five weeks. Two thirds of radiotherapy patients who survive three years are still suffering from Xerostomia. Chemotherapy also reduces saliva flow, but the affects are relatively short-lived.
Causes from disease
Dry mouth can be a symptom of several diseases, and is often seen alongside other reduced secretions such as dry skin, dry eyes, blurred vision and vaginal itching.
Sjögren’s Syndrome – a disease where the body’s immune system attacks salivary glands and tear ducts – is one of the greatest causes of dry mouth. It is estimated to affect seven million Americans, 90 per cent of them women, with an average age of 50. Other diseases known to cause dry mouth include rheumatoid arthritis, systemic lupus erythromatosis and sarcoidosis.
Diabetes is another common cause of dry mouth and hyposalivation. This could be due to the body excreting water through increased urination, or from some underlying metabolic or hormonal problem.
A growing problem
Incidence of dry mouth will grow over the coming years due to:
1. An aging population: The first of the post-war baby-boomers reach their 65th birthday next year, but an aging population will be no statistical blip; by 2050 one in five of the US population will be over 65, and one in twenty over 85. Older people take more medicines, are more likely to suffer disease, and experience dry mouth as a natural process of aging.
2. Obesity: With one in three Americans obese, greater use of medicines are likely to raise incidence of dry mouth.