Dry Mouth – Everything You Ever Wanted to Know About It, and More!
Desk of Items
Term “Xerostomia” originates from the Greek phrases xeros (dried out) and stoma (mouth area) which means dry mouth. Dry mouth is one of the most common and most bothersome symptom for which patients need help from dental professional. For the majority of individuals who contact their dentist about this problem, the successful treatment is carried out.
Causes of dryness can be many and varied. Dryness of the mouth is one of the first symptoms of diabetes and immune disorders. One such is Sjogren’s syndrome. This symptom also occurs as a result of damage to the salivary glands in patients who have undergone radiation therapy to the head and neck. It represents a very difficult situation. Also, many medications can cause x erostomia .
Nowadays, more than 500 drugs have a side effect of mouth dryness. Among them the most numerous are medications to control high blood pressure, diuretics, antihistamines and drugs for the treatment of numerous mental disorders.
However, there are a lot of people experiencing this disease who usually do not seek medical assistance because they don’t cons > erostomia , however they do not connect it with cigarette smoking.
Whatever the trigger and duration of mouth area dryness, an individual with this issue should contact his dentist as soon as possible. Treatment should begin to avoid many complications that develop in the mouth when there is not enough saliva.
The role of the salivary glands
Salivary glands secrete during the day around one liter of saliva. The total amount varies with regards to the period, hydration, water intake, health and wellness and state of mind of the individual. Saliva is essential to maintain regular functions from the mouth like flavor, nibbling, swallowing and talk.
It includes a safety role because it protects, moisturizes and coats the mucous membranes of the mouth and teeth. It facilitates speech, helps design a morsel of food and swallowing, contributes to the taste of the food. Its minerals, proteins and antimicrobial ingredients protect against cavities. They keep carefully the structure of teeth enamel and react against infections.
What goes on when the quantity of saliva can be reduced in the mouth area?
To show that a one who suffers from by erostomia really does not have enough saliva, the amount of saliva must be measured. It has been shown, namely, that people who sometimes complain of this disease have normal salivation. Such apparent or paradoxical xerostomia may be caused as a change in the grade of saliva once the quantity of saliva isn’t reduced. In cases like this more mucous than serous saliva can be excreted, which creates a feeling of stickiness and dryness.
When the saliva is certainly secreted significantly less than 300 ml each day (0.2 ml / min), it really is an indicator of dysfunction from the salivary glands. Decreased secretion of saliva is named – Hyposalivation.
Mouth area dryness could be acute, short-term and transient or it may last for a long time or even a lifetime. It depends on the cause and manner of treatment.
Short-term dryness of the mouth usually continues only as long as the cause is present. It usually appears in stressful situations or in situations of tension, fear and depression. It can appear after a brief intake of particular drugs, in says with fever and dehydration of the organism. Also, mouth breathing and insufficient stimulation of activity of the salivary glands (eg. eating soft foods), cigarette smoking and alcohol can lead to x erostomia .
Long-term dryness of the mouth or complete loss of saliva are consequences of the completely impaired function from the salivary glands. This is caused by selection of systemic illnesses: diabetes, autoimmune connective cells illnesses (Sjogren’s syndrome specifically), liver organ cirrhosis, illnesses from the central and peripheral anxious system. It could be caused by several medications, rays of the top and throat, chemotherapy, and particular infectious illnesses (HIV, Hepatitis C).
Due to numerous causes a lot of people have problems with mouth dryness, specially the seniors who are usually more susceptible to illness. In addition they typically are acquiring more sorts of medications.
Reduced secretion of saliva and by erostomia may also take place in adults, children and kids who take specific medications that may decrease the secretion of saliva.
Complications of x erostomia
People with xerostomia are at increased risk for the development of numerous dental diseases: caries, gingivitis, periodontal disease (“periodontitis”) and infections of the mucous membrane. Most common type of illness of mucous membrane is definitely fungal illness. Therefore, x erostomia requires increased oral hygiene and the treatment to prevent the development of mentioned oral diseases.
Reduced amount of saliva results in the boost of bacteria on teeth. That is what causes tooth decay. Colonization of bacteria on the teeth and the dental mucous membranes contributes to the development of gingivitis. And from then on periodontitis. It may look that taste reduction is not a problem in sufferers with xerostomia.
The improved feeling of dryness in the mouth area and problems with nibbling and swallowing result in the intake of softer and sweeter meals. That is ideal for the introduction of caries. Frequently patients grab greater usage of glucose and sweetened drinks to motivate salivation and maintain their mouth damp. But that simply speeds up the introduction of caries and irritation of dental mucous membranes.
Increased number of fungal colonies from your genus Candida within the dental mucous membranes of healthful persons is normally connected with poor mouth hygiene. Afterwards that contributes the need for restorations and its continuous use.
When the mouth is dry, it favors settling fungi on mucous membranes. It is an essential factor in the development of fungal infections. The risk of infection is increased in people who wear dentures, smokers and patients with diabetes.
The risk is also high in patients with Sjogren’s syndrome and patients with connective tissue diseases treated with corticosteroids or other immunosuppressive agents. Such agents contribute to the development of candidiasis because these medications reduce the natural resistance of the oral mucous membrane.
When there is not enough saliva wearing dentures is very difficult. The oral mucous membrane beneath the denture is usually sensitive and prone to injury and inflammation.
In addition to dryness, patients also complain of mucosal burning, pain, or change or lack of taste. There’s an elevated demand for normal water throughout meals. Also you can find problems with nibbling and swallowing. Person frequently avoids eating dried out food. Sufferers with Sjogren’s symptoms, where connective oral tissues is certainly affected, also complain in the dryness from the eye, and salivary glands (specifically parotid gland) become visibly improved.
As xerostomia advances, inflammatory adjustments and damages within the mucosa from the mouth area take place. The mucous membrane from the lip area is slimmer, it breaks and peels off. Buccal mucosa is actually wrinkled, tongue is usually red and easy, and the patients complain of solid feeling of mucosal burning up. The mucous membrane from the lip area stick to one’s teeth with people who use dentures the mouth mucous membranes can easily be damaged.
All these complications of xerostomia emerge and evolve quickly. That significantly affects the quality of dental and general health. Therefore, dry mouth should not be regarded as a trivial problem. It’s treatment should begin as soon as possible. Because of the severeness of xerostomia complications, treatment is usually prolonged and more expensive. Doctors constantly explore therapeutic options. They seek new, more effective and more comprehensive medications with at the least side effects. Medicines aim to decrease the dryness from the mouth and stop the introduction of possible problems.
The treating by erostomia
The treating xerostomia is completed with regards to the trigger and the amount of harm to the salivary glands. Used, it is centered on palliative therapy this means to alleviate symptoms and stop oral problems.
The practice of wearing and occasional wetting mouth with water in bottles throughout the day, which has recognition, can also prov > erostomia .
When xerostomia occurs as a result of medications, it is recommended to replace the medication or reduce the dosage in agreement using the skilled doctor. That is useful if an upgraded drug has a similar mode of action.
There are several ways available for treating:
A preventive approach
To all people with this disease who have natural teeth, preparations of fluoride and saturated solution of calcium and phosphate should be transcribed. Fluoride includes into the teeth enamel and restores elements of the teeth. A solution that contains calcium and phosphate ions (artificial saliva) halts the progression of tooth decay. It makes the teeth more resistant.
T his treatment is certainly completed in sufferers with xerostomia when it’s extremely hard to stimulate the secretion of saliva. This means which the saliva should be compensated. That is achieved by acquiring enough fluids during the day and keeping the mouth moist. This is achieved by using solutions of artificial saliva.
Saliva substitutes or artificial saliva are liquids or gels containing hydroxymethylcellulose, hydroxypropylcellulose, carboxymethylcellulose, polyglycerylmethacrylate, mucin or xanthan gum. They may have a calming effect on the dental mucosa. The main disadvantages are their brief duration of actions, and they usually do not defend neither from developing caries nor from mucosal an infection.
Industrial mouthwashes that have alcohol further dry oral mucosa. They must be avoided by sufferers with xerostomia.
The artificial saliva, supersaturated alternative of calcium mineral and phosphate, was primarily developed for the treatment of patients on radiation and chemotherapy. Also for prevention of dental mucositis, and later on for the treatment of dry mouth area.
Within this alternative calcium mineral and phosphate ions display the beneficial results in stopping the development of caries. By their diffusion between intercellular spaces in the lining cell epithelium healing is stimulated. Calcium ions also perform a crucial part in the inflammatory process in the blood coagulation cascade and tissue repair. On the other hand phosphate ions are a key factor in the renewal of the mucous membrane by maintaining it’s pH balance and in prevention of infection.
Local stimulation of saliva secretion
Doctors recommend to people who have, to some extent, preserved function from the salivary glands, therefore the secretion of saliva could be set off by the stimulus of nibbling or rinsing the mouth area with sour solutions. Also, effective is really a biostimulation of salivary glands with laser beam therapy and acupuncture. Electrical excitement shows modest results. Consuming candies to stimulate saliva secretion, due to the sugar content which favors the development of caries, should be avoided.
Systematic stimulation of salivation
This includes taking medicines for systemic use. From twenty four drugs only four are tested and applied in practice. They are parasympathomimetics: bromhexine, anetoletrition, pilocarpine-hydrochloride and cevimeline. As these medications have got known contraindications, and through the application several unpleasant unwanted effects can be created, they can not really be studied by all sufferers with dry mouth area.
In the event that you have problems with this disease, speak to your dentist!
Medications for local make use of and artificial saliva still provide hope to patients in treatment of xerostomia. It really is expected from the products to at the same time moisturize and secure the mouth mucous membranes and the teeth. The truth is that we now have few arrangements for topical program available, which completely adhere to these requirements. Therefore today, in the treating this disease, benefit is directed at solutions offering dampness and stimulate the secretion of saliva, and due to this content of calcium mineral and phosphate ions they also take action on the restoration of tooth enamel, have anti fungal activity and protect the mucous membranes of the mouth in patients undergoing treatment with radiation and chemotherapy.
If you suffer from dry mouth of known or unknown causes, contact your dentist or GP!
This disease is not a normal state of the oral cavity and should be treated!