How can I treat chronic dry mouth

Dry mouth

Brief overview

  • Causes of dry mouth: e.g. lack of fluids, breathing through the mouth (e.g. when snoring), nervousness, medication, diseases such as colds, sinus infections, diabetes mellitus or tumors
  • This helps against dry mouth: You can do something yourself by chewing well, drinking enough and observing good dental and oral hygiene. If necessary, the doctor will suggest further measures and therapies depending on the cause.
  • When to the doctor If the dry mouth persists or occurs frequently, if there are additional symptoms such as bad breath, changes in taste, etc., or if the dry mouth occurs when you take a new medication.

Dry mouth: causes and possible diseases

Normally, six large and countless small salivary glands keep our oral cavity moist with around half a liter to 1.5 liters of saliva every day. If this is not (no longer) the case, it manifests itself in a dry mouth.

The lack of saliva is often due to harmless causes. Drugs in particular have a negative side effect on the flow of saliva. But often a serious condition causes the dry mouth like that Sjogren's syndrome - one of the more common autoimmune diseases.

Unpleasant consequences

But regardless of whether the cause is harmless or serious: dry mouth in itself is always unpleasant. Because if the mouth is dry, speaking and especially swallowing become torture. In most cases, the taste is also impaired or the mouth burns. Since saliva also has the task of making the chyme slippery and using enzymes to help break it down, hard edges on the food can cause painful injuries to the palate or the oral mucosa if the mouth is dry - this further increases the agony.

In addition, the teeth lack the protective and cleaning function of saliva, because it contains ions such as sodium, calcium or fluoride. Bacteria and food residues are no longer washed away, the body's own antibodies are reduced, and acids in the food are no longer adequately neutralized. As a result of dry mouth, bad breath, caries-infected teeth and inflammation of the oral mucosa and the teeth supporting structures develop.

General causes and diseases

  • Dehydration: Either not drinking enough or losing too much fluid through exercise, diarrhea or vomiting can reduce the production of saliva - resulting in a dry mouth.
  • dry air: Especially in winter, the dry heating air irritates the mucous membranes of the respiratory tract. The consequences are a dry nose, red eyes and a dry mouth.
  • Age: In old age, not only are body functions slowed down, older people also drink less and often take various medications; both together can also have a negative effect on the flow of saliva.
  • Mouth breathing: Children in particular often breathe habitually through their mouth - torn lips and corners of the mouth as well as dry mucous membranes and bad teeth are often the consequences. However, a constantly blocked nose can also be the cause of mouth breathing.
  • Snoring: Even when snoring, people only breathe through their mouths - hoarseness and a dry mouth in the morning can be signs that you are a “snorer”.
  • Psyche: The sympathetic, part of the nervous system, prepares the body for fight or flight in dangerous situations: the heart beats faster, the airways expand, all non-important organ functions are throttled - including digestion and salivation. Thus, dry mouth is a typical symptom of stress. But a dry mouth is also often a symptom of depression or anxiety disorders.
  • Smoke: Nicotine constricts the blood vessels and thus inhibits the blood flow in the body; In addition, smoke particles stick to the oral mucous membranes and dry them out. All of this together ensures that the mouth becomes dry.
  • Salivary gland tumors: Malignant as well as benign tumors of the salivary glands can limit their functionality. One of the possible signs of this is a dry mouth.
  • Cold, inflamed sinuses: If the nose is tight, the affected person breathes through the mouth - and it becomes dry.
  • Autoimmune Diseases: Sjogren's syndrome (sicca syndrome, dryness syndrome) particularly affects women after the menopause. Chronic inflammation destroys the tear and salivary glands here. Typical symptoms are dry mouth, reddened mucous membranes, burning tongue, dry nose and eyes and swollen salivary glands.
  • Metabolic diseases: Diabetes mellitus, in particular, initially manifests itself through unspecific symptoms such as frequent urination, a strong feeling of thirst and a dry mouth, difficulty concentrating or headaches.
  • Diabetes insipidus: Sounds similar to diabetes mellitus, but it is a different disease. Due to a hormonal disorder, a massive amount of urine is excreted. The resulting severe water loss manifests itself in a dry mouth and a great feeling of thirst.
  • Sialadenosis: This painless bilateral swelling of the salivary glands can also reduce the flow of saliva. The causes for this are diverse and range from eating disorders to alcoholism and hormonal disorders.
  • Sialadenitis: This group of inflammatory salivary gland diseases is associated with dry mouth. Possible causes are, for example, bacteria, viruses, sarcoidosis or the above-mentioned Sjogren's syndrome. Radiation therapy for tumors in the head and neck area can also trigger sialadenitis.
  • Irradiation: Radiation therapy for tumors in the head and neck area often damages the salivary glands. The tissue can become inflamed (sialadenitis) or even remain destroyed over the long term. Sometimes the mouth remains permanently dry, and those affected have taste disturbances or a burning tongue.

Medication and drugs

Many medications and some drugs influence the autonomic nervous system, which is responsible for controlling saliva production. Dry mouth is a particularly common side effect of the following products:

  • Antihypertensive drugs: These drugs reduce blood pressure and are therefore prescribed for high blood pressure (hypertension). They include beta blockers, ACE inhibitors, water drugs (diuretics) and calcium channel blockers.
  • Painkiller: Strong opioid drugs cause dry mouth.
  • Anti-Parkinson drugs: Some dopamine agonists used to treat Parkinson's disease cause dry mouth.
  • Sedatives and sleeping pills: Antispasmodic drugs (antispasmodics), some sleeping pills (hypnotics), and tranquilizers (sedatives) can also cause the mouth to become (and remain) dry.
  • Antihistamines: These are active ingredients used to treat allergies. They can also cause dry mouth as a side effect.
  • Anticholinergics: These drugs inhibit the effect of acetylcholine - this is the main messenger substance of the parasympathetic nervous system ("antagonist" of the sympathetic nervous system). They are used, for example, for asthma and irritable bladder - with dry mouth as a possible side effect.
  • Cytostatics: These are drugs that are administered as part of chemotherapy for cancer. They can inhibit the growth and reproduction of fast-growing cells (such as cancer cells). The unpleasant side effect is often severe dry mouth.
  • Antiepiletics: These are drugs that are used in epilepsy. They can also trigger dry mouth.
  • Antiemetics: Medications for nausea and vomiting often cause dry mouth.
  • Psychotropic drugs: Some medicines for depression (antidepressants) and for anxiety (neuroleptics) also often cause dry mouth.
  • illegal drugs: The active ingredient of cannabis, tetrahydrocannabinol (THC), as well as other illegal drugs such as heroin, cocaine or ecstasy (MDMA) impair the function of the salivary glands. This can dry out the mouth.

Diseases with this symptom

Find out here about the diseases that can cause the symptom:

Dry mouth: you can do it yourself

  • chew well: Swallowing is already difficult when your mouth is dry - which makes it all the more important to chew thoroughly. This also promotes the flow of saliva.
  • drink a lot: Make sure you drink enough - especially if you lose more fluids due to exercise or diarrhea. Water and sugar-free fruit teas are particularly good for rinsing your mouth out and keeping it moist.
  • Stimulate salivation: Chewing gum and acidic drops bring saliva production into full swing. It is best to use sugar-free chewing gum or drops, as the teeth are vulnerable to many bacteria due to the lack of saliva. Chewing gums with xylitol as a sugar substitute are suitable here; it has a proven antibacterial effect.
  • good oral hygiene: In order to additionally protect the teeth from tooth decay and periodontal disease, you should pay attention to careful oral hygiene. This includes brushing your teeth twice a day with a fluoridated toothpaste. In addition, you can apply a fluoride gel to your teeth once a week. Also go to the dentist for regular checkups!
  • Stop smoking: Smoking especially dries out your mouth. The only thing that helps here is to get used to the unhealthy vice.

Dry mouth: what does the doctor do?

Since the causes of dry mouth are so diverse, the doctor first tries to narrow down the possibilities. This is often already possible based on information from the patient interview Medical history survey (Anamnese). For example, your lifestyle and eating habits and whether you are currently under particular stress are important. In addition, the doctor asks, among other things, about any previous illnesses and the use of medication.

In the subsequent physical exam The focus is first on the mouth and the salivary glands. Often from the reddened, torn corners of the mouth it can be seen from the outside that the patient is suffering from dry mouth. In menopausal women, the doctor will also examine the eyes and nose to check that the mucous membranes are well moisturized.

In order to objectively determine whether the glands are really producing too little saliva, the doctor can do the Saliva flow rate determine: In this test, chewing on a paraffin block is intended to stimulate saliva production. You have to spit out the saliva that has formed at certain intervals over a period of five minutes. This amount of saliva is then measured. This is how you can judge whether you are producing enough or too little saliva. The doctor also determines the pH of your saliva - it is often lower if you have a dry mouth.

Some patients find it easier to take the test to determine the salivary flow rate if they are not watched while chewing and spitting.

Depending on the suspected cause of the dry mouth, the doctor will also Blood and urine tests cause. He can also use the salivary glands Ultrasonic Examine (sonography) for changes.

In unclear cases, additional examinations by an ear, nose and throat specialist (ENT specialist), neurologist, rheumatologist, dentist, psychiatrist or other specialist may be necessary.

Important investigations

These examinations help to find out the causes of the symptoms:

Dry mouth: when do you need to see a doctor?

In certain situations, a dry mouth simply cannot be avoided - especially if you are under stress or have not drunk much during the day. But the unpleasant dry mouth can also be caused by diseases of the salivary glands or systemic disorders. You should always consult a doctor if you notice any suspicious changes yourself. Examples are:

  • The dry mouth does not only exist for a short time, but over a longer period of time or occurs again and again.
  • They have problems chewing, speaking or swallowing and often need to take a sip of water.
  • Not only is the mouth dry, but so are the nose and eyes. There may also be a burning sensation in the mouth.
  • The salivary glands are palpably swollen - with or without pain.
  • The dry mouth has set in since I took a new drug.
  • You suffer from extraordinary psychological stress.
  • You have additional symptoms such as blurred vision, nausea and vomiting - this may be poisoning, which is why you should see a doctor as soon as possible!
  • Dry mouth is accompanied by changes in taste, gum problems, dental caries or bad breath, body aches, frequent urination, feeling very thirsty, headache and / or a general feeling of illness.

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