Xerostomia

Xerostomia is the medical term used to describe a condition in which a person has severely dry or dehydrated salivary glands, resulting in insufficient saliva production. Saliva plays an important role in maintaining oral health and comfort in the mouth.

Xerostomia can cause a variety of symptoms and problems, including:

1. Dry Mouth: The main symptom of xerostomia is a feeling of dryness or even dryness in the mouth.
2. Swallowing difficulty: Lack of draining saliva can make swallowing more difficult.
3. Difficulty speaking: Dry mouth can affect the clarity and fluency of speech.
4. Constant thirst: In response to dry mouth, a person may experience constant thirst.
5. Bad breath (halitosis): Lack of saliva can promote the growth of bacteria in the mouth, which can lead to bad breath.
6. Dental Cavities and Gum Disease: Saliva helps protect teeth and gums from bacteria and acids, so the risk of developing dental cavities and gum disease increases with xerostomia.
7. Pain or irritation in the mouth: Dryness can cause irritation of the oral mucosa and discomfort.

Xerostomia can be caused by a variety of things, including certain medical conditions (e.g., diabetes, Sjögren's disease, Parkinson's disease), medications (certain drugs such as antidepressants, anti-spasticity medications, anti-seizure medications), radiation therapy to the head and neck, autoimmune diseases, and other factors.

Treatment for xerostomia depends on the cause and may include the use of special medications, oral moisturizers, changes in medication therapy, nutritional support, and other methods. If you have symptoms of xerostomia, it is important to see your doctor or dentist to determine the cause and develop a treatment plan. [1]

Causes of the xerostomia

Some of the major causes of xerostomia include:

1. Medications: Many medications, including antidepressants, antihistamines, anti-allergic drugs, antihypertensive drugs, antispasmodics, and others, can cause decreased saliva production.
2. Medical procedures and treatments: Radiation and chemotherapy for cancer treatment can affect salivation and cause xerostomia.
3. Systemic diseases: Some systemic diseases such as Sgogren's syndrome, diabetes, thyroid disease, autoimmune diseases, and HIV infection may be associated with xerostomia.
4. Age: As we age, saliva production may decrease, which can lead to dry mouth.
5. Tobacco and alcohol use: Smoking and alcohol use can cause a decrease in saliva production.
6. Stress and anxiety: Constant stress and anxiety can affect salivary gland function and cause xerostomia.
7. Notdrinking enough: Notdrinking enough water can reduce body fluid levels and worsen salivation levels.
8. Hormonal changes: Some hormonal changes, such as menopause in women, may be associated with xerostomia.
9. Other Factors: Dry mouth can also be caused by extensive head and neck surgery, as well as other factors. [2]

Symptoms of the xerostomia

Some of the main symptoms of xerostomia may include the following:

1. Dry mouth: One of the main symptoms is the sensation of dry mouth. Patients may feel that their mouth has become dry and stale.
2. Difficulty swallowing: Reduced saliva may cause difficulty swallowing food and liquids.
3. Feelingof discomfort: Xerostomia can cause discomfort in the mouth, as well as a feeling of splinters or sand.
4. Itchingand burning: Some patients may experience itching and burning in the mouth.
5. Exposure to infections: Saliva plays an important role in protecting the mouth from bacteria and infections. Reduced saliva can make the mouth more susceptible to infections and inflammation, such as tooth decay and gingivitis.
6. Bad breath: Decreased saliva can also contribute to bad breath (halitosis).
7. Chewing and speech problems: Due to difficulty in chewing and swallowing food, as well as dry mouth mucosa, patients may have trouble chewing and pronouncing words.
8. Dry lips and throat: Xerostomia can also cause dry lips and throat.
9. Change in taste: Some people may notice a change in the flavor of food because saliva plays a role in taste perception. [3]

Diagnostics of the xerostomia

Diagnosing xerostomia (dry mouth) may involve a number of steps to determine the cause and nature of the condition. The doctor performs a physical examination, asks questions about the patient's symptoms and medical history, and performs specialized tests. Here are some of the methods used to diagnose xerostomia:

1. Physicalexamination: The doctor examines the patient's mouth, assessing the condition of the mucous membranes, teeth and gums. He or she may also look for signs of inflammation or infection.
2. MedicalHistory: The doctor asks questions about the nature of the dry mouth, the duration of symptoms, and factors that might contribute to it, such as medications, medical conditions, or environmental exposures.
3. Medication Exclusion: If a patient is taking medications known to cause dry mouth (e.g., antiseptics, antihistamines, blood pressure medications, etc.), the physician may review the prescription and discuss possible changes with the patient.
4. General blood tests: Some medical conditions, such as diabetes or anemia, may be associated with xerostomia. Blood tests can help detect such conditions.
5. Salivary tests: Special tests may be performed to measure saliva levels and composition to assess salivary gland function and detect changes in saliva that may be associated with xerostomia.
6. MRI (magnetic resonance imaging) or ultrasound (ultrasound): In some cases, educational studies may be performed to evaluate the salivary glands and structures in the head and neck region.
7. Special saliva tests: Your doctor may perform various tests on saliva to evaluate its physical and chemical characteristics, including pH, viscosity, and secretion. [4]

Treatment of the xerostomia

Treatment for xerostomia (dry mouth) can include a variety of approaches and medications to improve oral moisturization. Here are some of them:

1. Saliva Substitutes: These are formulated specifically to moisturize the mouth and restore the natural balance of saliva. Some of the popular saliva substitutes include:
   • Carboxymethylcellulose-based products (e.g. Oral Balance, Biotene).
   • Glycerin-based products (e.g., XyliMelts).
2. Salivary gland stimulation medications: These medications can help increase saliva production. Examples include:
   • Pilocarpine-based medications (Salagen).
   • Cevimeline-based medicines (Evoxac).
3. Ointments and gels for lips and oral mucosa: Ointments, gels or balms can help soothe and moisturize dry lips and oral mucosa.
4. Hyaluronic acid preparations: Hyaluronic acid promotes moisture retention and can be used to soften and moisturize the oral mucosa.
5. Anti-inflammatory medications: If dry mouth is associated with inflammation, your doctor may prescribe anti-inflammatory medications.
6. Masticatory massages and exercises: A specialist can teach the patient how to perform exercises and massages to stimulate the salivary glands.
7. Drinking: Drinking water and fluids consistently can help reduce dry mouth.
8. Avoiding irritants: Avoid alcohol, tobacco and spicy, acidic, salty or hot foods that can irritate the oral mucosa. [5]

Xerostomia sprays

Mouthwash sprays can be useful for treating xerostomia (dry mouth). They help moisturize the mucous membranes of the mouth and relieve symptoms of dryness. Here are some examples of mouth moisturizing sprays that can be used:

1. Biotene Moisturizing Mouth Spray: This spray contains enzymes that help replenish the lack of saliva and provide long-lasting mouth hydration.
2. Oasis Moisturizing Mouth Spray: This spray contains urea and sodium hyaluronate to help moisturize the oral mucosa.
3. TheraBreath Dry Mouth Oral Rinse: This spray contains natural moisturizers and hydrating ingredients to help eliminate dryness and give you fresh breath.
4. XyliMelts: These are not a spray, but wafers that are placed on the upper gum and slowly dissolve, releasing xylitol and helping to moisturize the mouth.
5. Salivix Mouth Spray: This spray contains saliva simulants that help stimulate the natural secretion of saliva.

It is recommended to consult a dentist or doctor before using any oral moisturizing spray, especially if dry mouth is caused by medical reasons or medications. It is also important to follow the directions for use on the product packaging. [6]

Xerostomia pastes

Xerostomia (dry mouth) can be treated with special toothpastes or gels that are formulated to alleviate discomfort and maintain moisture levels in the mouth. These products may contain ingredients such as glycerin, carboxymethylcellulose, xylitol, and others that help moisturize the mucous membranes and improve comfort. Here are some of the pastes and gels that may be helpful for xerostomia:

1. Biotene Oralbalance Moisturizing Gel: This gel is formulated specifically for dry mouth and contains enzymes that help restore the normal balance of microflora in the mouth.
2. Sensodyne Pronamel Gentle Whitening Toothpaste: This toothpaste contains glycerin and other moisturizing ingredients that help reduce dry mouth.
3. TheraBreath Dry Mouth Toothpaste: This paste is specially formulated to combat xerostomia and contains ingredients that help moisturize and protect the mouth.
4. Oasis Moisturizing Mouthwash: While this is not a toothpaste but a moisturizing liquid solution, it can be used in conjunction with a moisturizing toothpaste to provide additional hydration.
5. XyliMelts: These are chewable disks that contain xylitol and dissolve slowly, which can help moisturize the mucous membranes in the mouth.
6. Colgate Hydris Dry Mouth Toothpaste: This toothpaste is specially formulated for dry mouth and helps retain moisture.

Xerostomia gels

There are many gels and balms on the market designed to soften and moisturize the mouth for xerostomia (dry mouth). Some may be available over-the-counter, but it is always advisable to consult your doctor or dentist before using such products to make sure they are suitable for you and will not cause allergic reactions. Here are some examples of gels and balms for xerostomia:

1. Biotene OralBalance Gel: This gel contains enzymes that help replicate the natural action of saliva. It also contains glycerin and carboxymethylcellulose to moisturize the mouth.
2. Xerostom Dry Mouth Gel: This gel is specially formulated to help relieve dry mouth. It contains hyaluronic acid and propolis to help moisturize and soften the mucous membranes.
3. Orajel Dry Mouth Moisturizing Gel: This gel contains carboxymethylcellulose and other ingredients to moisturize the mouth and relieve dryness.
4. Caphosol: This solution is for the mouth and throat and contains phosphate and calcium to fill in mineral deficiencies and maintain oral health.
5. Squigle Enamel Saver Toothpaste: Although this is a toothpaste, it can be helpful for xerostomia. It does not contain sodium lauryl sulfate and other irritating ingredients, making it gentler on mucous membranes.

It is important to remember that the effects and effectiveness of gels and balms may vary depending on the individual and the cause of xerostomia. [7]

Folk remedies

Xerostomia (dry mouth) can be temporarily relieved with some folk remedies. However, it is worth remembering that folk remedies are not a substitute for professional medical treatment and do not address the underlying cause of xerostomia. Here are some folk remedies that can help moisturize the mouth and relieve dryness:

1. Chemera: An infusion of dried succession can help moisturize the mucous membranes of the mouth. To prepare, brew 1 teaspoon of dried succession in a glass of boiling water, leave for 15-20 minutes, strain and use as a mouthwash.
2. Lime water: Mouthwash with lime water can help moisturize your mouth. Add a small amount of lime water to a glass of water and use to rinse your mouth.
3. Honey: Honey has moisturizing properties. You can place a small amount of honey under your tongue and let it dissolve gradually. However, keep in mind that honey contains sugar and can increase the risk of tooth decay, so make sure you take care of your teeth.
4. Aloe vera: Aloe vera leaf gel can be used to moisturize the oral mucosa. Simply apply a small amount of gel on the tongue and allow it to spread in the mouth.
5. Chewingflax seeds: Chewing flax seeds can help stimulate saliva production.
6. Melissaand melissa tea: Melissa (citron mint) can help moisturize the mouth. Prepare melissa tea and drink it several times a day.
7. Nuts and seeds: Nuts and seeds, such as almonds and sunflowers, can help stimulate salivation when consumed.
8. Propolis: Propolis, which has anti-inflammatory properties, can be chewed like candy.

Apart from these folk remedies, it is important to follow good oral hygiene, drink water regularly and avoid irritating foods. [8]

Prevention

Preventing xerostomia (dry mouth) involves a number of activities that will help maintain normal saliva secretion and reduce the risk of developing this condition. Here are some recommendations for preventing xerostomia:

1. Hydration: Drink enough fluids throughout the day. Water is the body's main source of hydration. Avoid excessive consumption of alcoholic and strong drinks, as they can contribute to drying of the oral mucosa.
2. Avoid high-sugar foods: Too much sugar can exacerbate dry mouth and contribute to tooth decay. Limit your intake of sugary foods and sugar derivatives.
3. Take good care of yourmouth: Proper oral care includes regular brushing, flossing, and rinsing with antiseptic mouthwash. This will help prevent infections and inflammation that can make xerostomia worse.
4. Avoid tobacco and nicotine: Smoking and tobacco use can worsen the condition of the oral mucosa and contribute to dryness. If you have this unhealthy habit, try quitting it.
5. Moderate coffee consumption: Coffee can cause dry mouth in some people. If you have a sensitivity to coffee, try moderately limiting your coffee intake.
6. Avoid unhygienic conditions: Dry mouth may be caused by infections or other pathologic conditions. Avoid contact with contaminated or infected objects and surfaces.
7. Medication management: If you are taking medications that may cause dry mouth as a side effect, discuss this with your doctor. It may be possible to change medications or adjust the dosage.
8. Regular dental visits: Visit your dentist regularly for preventive checkups and teeth cleanings. The doctor can detect problems early and suggest effective treatment and prevention methods.
9. Use of special products: In some cases, your dentist may recommend special oral care products such as moisturizing gels or mouthwash sprays.
10. Follow individualized recommendations: If you have health conditions that may increase your risk of xerostomia (such as radiation therapy or chemotherapy), follow your doctor's or dentist's individualized recommendations.