You’ve been working really hard all morning and its getting close to lunch time suddenly you smell the most delicious aroma. Your tummy starts to rumble, your thoughts turn to food and your mouth starts to water, becoming slippery with saliva – unless you have dry mouth syndrome. Dry mouth syndrome is basically a lack of saliva. It is not a disease but a symptom of disease or dysfunction. There may be a problem with the salivary glands located in the mouth, an auto immune disease, poor dental hygiene or you could simply be not drinking enough fluids. Another name for dry mouth is xerostomia.
A bit about saliva
As mentioned before, when anticipating food our salivary glands step up their production of saliva. Have you ever seen a dog drool in anticipation of a juicy piece of meat? This is their saliva glands kicking in.
There are saliva glands located in the mouth and throat. They consist of:
- parotid – located behind the junction of the jaw, at the front of the ear
- submandibular – found under the tongue on both sides of the jaw (mandible)
- sublingual – located in the floor of the mouth
- minor salivary glands – these are located in various positions around the mouth, including the inner cheeks and throat.
Saliva contains water, enzymes and salts and salivary glands squirt just enough saliva on foods to moisten it and begin the digestion of carbohydrates. This moistened product, once masticated(chewed) and coated with saliva then easily passes down the oesophagus to continue digestion in the stomach.
This is not the only role of saliva!
Saliva isn’t just released at the thought or smell of food. The saliva glands are continuously releasing saliva to ensure the mouth is moist at all times.
Saliva protects the teeth and inside of the mouth, oesophagus and stomach from substances that may cause harm. This includes bacteria, fungus and viruses. A lack of saliva increases the acidity in the mouth allowing acid-producing bacteria to survive and flourish. These bacteria found in our mouth and from the foods we eat are the same ones that can cause tooth decay.
Saliva is able to neutralise acid-producing bacteria.
This is why dry mouth can be associated with dental carries. It has been found the teeth recede from the gum in a dry mouth exposing ‘dentin’ which is much more vulnerable to bacterial attack, causing decay.
Saliva contains the mineral phosphorus and calcium that support the remineralisation of our teeth, rebuilding the enamel to prevent decay.
Saliva also helps us with speech and allows us to better experience the taste and texture of foods eaten
Causes of Dry Mouth
There are many different reasons or causes of reduced or deficient saliva production. Some can be short term, but other conditions might require longer term treatment. Some causes include:
Sjogren’s Syndrome
Sjogren’s Syndrome is an autoimmune disorder (an immune system dysfunction) that is recognised by its symptom of dry mouth and dry eyes. This disorder affects the fluid secreting components of the body such lacrimal ducts in the eyes, the lubrication of joints and the salivary glands in the mouth and throat.
Salivary Stones (Sialolithiasis)
This is the most common salivary gland disease. Accumulation of calcium salts can sometimes block the release of saliva causing pain and swelling and sometimes leading to infection. Found mainly in the submandibular glands, these stones can occur when stasis occurs in patients who are debilitated, dehydrated, have reduced food intake, or take anticholinergics. Treatment consists of hydration, oral antibiotics, warm compresses, massage and medication to promote the secretion of saliva. Surgery may be needed in some cases.
Medications
Some medication may have a side effect of dry mouth. It is best to discuss this with your doctor to find out if your medication is the problem and provide an alternative if available
Lack of fluids
Some medical conditions can lead to dry mouth such as blood loss, diarrhoea and kidney failure.
Not drinking enough fluids can lead to a thick, dry mouth.
Mouth breathing
Breathing through the mouth can dry out the mouth.
This may be happening due to a blocked or stuffy nose as can happen with allergies or upper respiratory infection. Inhalations of eucalyptus, sweet orange, myrtle, and lemon oil have been found to clear mucus in conditions of respiratory diseases such as bronchitis and rhinosinusitis allowing for nose breathing. Herbal medicine such as Pelargonium sidoide and Sambucus nigra may help with the symptoms of upper respiratory infections.
Infections – can be bacterial or viral. Bacterial infections most commonly effect people who are suffering from chronic illnesses, are not drinking enough fluid, have poor dental hygiene and people who smoke. Blockages of the salivary ducts can also lead to infection. Viruses such as the mumps virus can affect the salivary glands.
Dental Hygiene concerns
Practices good dental hygiene by cleaning teeth regularly and visit your dentist for a check-up to reduce dental decay
Symptoms of Dry Mouth
- Course feeling inside of mouth
- Dry tongue that sticks to the top of your mouth
- Bad breath
- Difficulty swallowing, particularly dry foods
- Mouth ulcers and fungal infections
- Tooth decay
- Dry or cracked lips
- Saliva that seems thick and stringy
- Bad fitting dentures
Treatment of dry mouth syndrome
Treatment depends on the cause, but may include:
- changes to medicines – if you are taking a medicine that causes dry mouth as a side effect, the doctor may be able to alter the dose or prescribe an alternative medicine
- saliva substitutes – your doctor or dentist can prescribe an artificial saliva substitute based on your medical condition. Use strictly as directed
- dry mouth products – these contain lubricants that may help with the symptoms of dry mouth. They include toothpaste, mouthwash, gums and topical gels. Discuss with your dentist or pharmacist which one would be best for you
- antibiotics and anti-fungal drugs – may be prescribed if there is an infection
- surgery – in the case of salivary gland blockages, such as stones, surgery may be needed
Any condition, such as Sjogren’s syndrome or diabetes, needs to be managed by your health care provider.
Natural Therapies
Some herbs can be useful for dry mouth syndrome.
Gentian gentiana lutea is a bitter herb which improves digestive function, stimulating gastric and salivary production. It is approved by Commission e for its use in digestive disorders. [1]
Flaxseeds/linseeds – the action of flaxseeds as a demulcent, emollient as well as being a popular fibre for the bowel make it useful in dry mouth syndrom. The mucopolysaccharides fraction of the seed has been found useful when used as a rinse for oral dryness due to Sjogren’s syndrome. A suggestion would be to crush and/or soak the seeds before rinsing the mouth. [2]
Ginger- is well known and studied for its anti-nausea activity and being useful for arthritis, but it also is able to stimulate the production of saliva.
Animal studies have found fresh ginger taken orally had a stimulating action on gastric secretions. German scientist found chewing 9 grams of crystallized ginger stimulated salivary production greatly [3].
Peppermint oil - Try smelling the essential oil of menth x piperita - peppermint. Studies revealed saliva is stimulated through the olfactory nerve, the nerve in the nose that is related to smelling by peppmint.
Other suggestions:
- Think about your food – whats for lunch? - make it attractive and inviting
- Eat foods with inviting aromas
- Practise mindful - eating and chew your food well before swallowing
- Choose watery foods to increase fluids and chewy foods to promote saliva
- Chew sugar-free gum between meals to promote the flow of saliva
- Drink a glass of water, rather than sipping so as not to rinse away saliva
What to Avoid
- Dry foods that may injure the mouth
- Acidic foods and foods containing simple sugars to avoid damaging teeth
- Cigarettes, alcohol, caffeinated drinks
References
- https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dry-mouth-syndrome
- Whitney, Eleanor Noss; Cataldo, Corinne Balog; Rolfes, Sharon Rady; 2002, Understanding Normal and Clinical Nutrition 6th Edition, Wadsworth/Thompsons Learning, Australia
- Caries prevention for patients with dry mouth. https://www.ncbi.nlm.nih.gov/pubmed/21774875
- https://www.mayoclinic.org/diseases-conditions/sjogrens-syndrome/symptoms-causes/syc-20353216
- Submandibular Sialadenitis/Sialadenosis Treatment & Management https://emedicine.medscape.com/article/882358-treatment
- [1,2] Fisher, Carole; 2009, Materia Medica Of Western Herbs, Vitex Medica, New Zealand.
- The efficacy of Pelargonium sidoides in the treatment of upper respiratory tract infections in children with transient hypogammaglobulinemia of infancy. https://www.ncbi.nlm.nih.gov/pubmed/22809962
- Antiviral potential of medicinal plants against HIV, HSV, influenza, hepatitis, and coxsackievirus: A systematic review. https://www.ncbi.nlm.nih.gov/pubmed/29356205
- https://medlineplus.gov/ency/article/001041.htm
- Saliva Substitutes (By mouth) https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0012072/
- [3] Mills, Simon and Bone, Kerry, 2009, Principles And Practices Of Phytotherapy, Churchill Livingstone
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