Dry mouth or xerostomia occurs in many diseases and can be a side effect of medications. Inadequate saliva can lead to cracked lips, bad breath, sore throat and sores on the corners of the mouth. Dry mouth becomes a health issue when the normal bacteria in the oral cavity and the potential for tooth decay develops. According to the Mayo Clinic, saliva boosts the ability to taste food and facilitates swallowing as well.
Oral Care
Those with dry mouth should practice consistent oral hygiene with tooth brushing, flossing and rinsing at least three times per day. The American Dental Association advises the use of fluoride toothpaste, a fluoride rinse and brush-on gel at bedtime.
Amifostine
The Food and Drug Administration approved the drug amifostine or Ethyol for protection of the mouth during radiation for cancer. This medication falls under the classification of a chemoprotectant drug and requires intravenous or subcutaneous (under the skin) injection. "Support Care in Cancer" describes the ability of amifostine to accumulate in the salivary glands and protect them from radiation damage. Individuals receiving the drug before radiation therapy report less dry mouth during treatment.
Pilocarpine hydrochloride
Pilocarpine hydrochloride, or Salagen, appeared in 1998 for the treatment of dry mouth associated with Sjogren's syndrome and cancer treatment. An article published in the Journal of the American Medical Association reports that pilocarpine hydrochloride, a cholinergic agonist, reverses dry mouth by stimulating the salivary glands to produce more saliva. Patients take pilocarpine hydrochloride orally, in doses ranging from 5 mg to 30 mg per day.
Cevimeline
The Food and Drug Administration approved cevimeline, or Evoxac, in 2000. The drug treats dry mouth associated with Sjogren's syndrome. According to "Support Care in Cancer," cevimeline enhances saliva production and belongs to the class of drugs called cholinergic agonists. Patients take it in pill form, 30 or 45 mg three times per day.
Over-the Counter Saliva Substitutes
Saliva substitutes contain carboxymethycellulose or hydroxyethyl cellulose. Local pharmacies carry related products under the brand name of Biotene that include toothpaste, mouthwash, spray, gel, gum and liquid formulations. "Support Care in Cancer" reports that patients claim the mouthwash and gel formulations produce more effective relief of dry mouth than other preparations.
Products Not to Use with Dry Mouth
Some products worsen dry mouth and should be avoided by those who suffer from this condition. Caffeine-containing beverages, alcoholic beverages, cigarette smoking, over-the-counter antihistamines and mouthwashes containing alcohol all contribute to dry mouth problems. And according to MedLine Plus, more than 400 medications can cause or worsen dry mouth, including medications for urinary incontinence, pain, allergies and high blood pressure as well as antidepressants.
Acupuncture
"Support Care in Cancer" discusses studies on acupuncture that show promising results for decreasing dry mouth, using the placement of fine needles. Although preliminary results are positive, more research is needed before acupuncture becomes a standard treatment.
References
- MayoClinic.com: Dry Mouth
- MedLine Plus: Dry Mouth
- American Dental Association: Do You Have Dry Mouth?
- "Support Care in Cancer"; A Systematic Review of Salivary Gland Hypofunction and Xerostomia; S. B. Jensen, et al.; 2010
- Journal of the American Medical Association; Treatment of Primary Sjogren Syndrome; Manuel Ramos-Casals, M.D., Ph.D., et al.; 2010
