Dryness of the mouth is a symptom that correlates poorly with the amount of saliva that is produced in your mouth. When there is an inadequate production of saliva, an individual may notice difficulty talking or swallowing dry food. Additionally, the individual may have unusual sensitivity to acidic or spicy foods and notice burning of their mouth. There may be an increased rate of dental decay. The most common cause of dry mouth is as a side effect of certain medications, including anti-depressants, anti-motility drugs (used for spastic colon or irritable bladder), and diuretics. Sjögren’s syndrome, certain other diseases, and irradiation of the neck or face can damage the salivary glands, leading to decreased saliva production.
An inadequate production of saliva can be assessed by an oral examination. The amount of saliva that is produced over a 5 to 15 minute period can also be measured with simple tests. These are either done with stimulation (such as chewing or having lemon juice placed on the tongue) or without stimulation. The collection can be done with spitting into a cup or with the use of special suction devices that collect the saliva from specific areas of the mouth. The function of the salivary glands can also be assessed with a nuclear medicine study, called parotid scintigraphy.
Dry mouth symptoms can often be managed by frequently sipping small amounts of water (just enough to moisten the mouth), chewing sugarless gum, and sucking on sugar-free candies or lozenges. There are medications (cevimeline and pilocarpine) that can stimulate salivary flow. Artificial saliva sprays and gels can be helpful, especially at bedtime. Careful attention to dental hygiene is essential in an individual with diminished saliva production. This includes flossing twice daily, brushing teeth after each meal, and receiving regular fluoride treatments, either at home or from a dentist. A detailed description of measures that can be taken to prevent dental decay are provided in the handout, “Preventing Dental Decay”.