Dry Mouth Can Be a Serious Problem

Harvey B. Simon, M.D.

Harvard Health Letters

Q. I hope you can help me with a very annoying problem. My mouth and throat are constantly parched, even though I carry a water bottle and sip from it constantly. I know it's a small problem compared to all the things you write about but it's very uncomfortable, and I'd appreciate any advice you can offer.

A. Call it dry mouth, and it sounds like little more than a nuisance -- but call it by its medical name, xerostomia, and it sounds fearsome. In most cases, dry mouth causes more discomfort than damage, but severe cases can lead to important complications. Dry mouth can rob you of the sense of taste, and it can make chewing slow and swallowing difficult. The combination may lead to malnutrition, and since saliva is important for dental health, tooth decay and periodontal disease can add to the problem.

First, be sure you're well-hydrated. It sounds like you drink plenty of water, but even without true dehydration, the membranes in your mouth and throat will be dried out if you breathe dry air through your mouth, especially at night. If that's your problem, nasal decongestants may help restore nose breathing, and a bedroom humidifier can add moisture to the air you breathe.

Medications are also common culprits. Drugs with anticholinergic properties cut down on the flow of saliva, producing a dry mouth. Common offenders include antihistamines, tricyclic antidepressants, antispasmodics, and certain drugs used for Parkinson's disease, overactive bladder, and chronic bronchitis. Take an inventory of your medications, but, even if you round up a few suspects, don't stop taking them until you check with your doctor.

Medical conditions are much less likely to be responsible for a dry mouth. Still, your doctor should check for oral Candida infection (thrush) and for problems that affect the salivary glands themselves, such as Sjogren's syndrome. But don't let all this make you nervous; in fact, anxiety is itself a contributor to dry mouth.

Even if you can't correct the underlying cause of dry mouth, you can do things to promote comfort. Chew sugarless gum or suck on sugarless candy to stimulate saliva flow. Avoid dry or very spicy foods. Drink plenty of water, but steer clear of alcoholic and caffeinated beverages. Try using artificial saliva, especially before meals. And don't forget regular dental care.

Your dry mouth is not life-threatening, but it certainly deserves your attention and care.

-- Harvey B. Simon, M.D., Editor, Harvard Men's Health Watch

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