Treatments to alleviate dry mouth and associated problems

Although dry mouth can have many diverse causes and require individualized treatments, most treatment strategies focus on improving oral comfort, alleviating symptoms, and finding ways to reduce further damage to teeth and oral tissues. Patients should always consult with their health care provider before initiating treatments on their own.

Current management recommendations include the following:

• Hydrate—drink water, in frequent, small sips that will help to hydrate and cleanse the mouth. Consume small amounts of water and limit total intake (to an amount that still provides adequate hydration) throughout the day, which may reduce frequent urination (i.e., it is not necessary to consume huge amounts of water for this type of hydration).

• Moisturize—try some of the products promoted for dry mouth, like rinses, gels, sprays or lubricants that are applied inside of the mouth or to the lips. These can be especially soothing when applied at bedtime, when traveling in a dry car or public transportation, or whenever water is not readily available.

• Chew—chewing gum or sucking lozenges helps to stimulate saliva production. The chewing motion by the jaw is therapeutic because it actually helps to activate the glands that will start to release saliva. Gum sweetened with Xylitol is generally recommended because bacteria in the mouth will not respond to Xylitol as it would to simple, refined sugar. (But do not use Xylitol in excess, as it can trigger gastrointestinal problems).

• Humidify—set up a room humidifier while sleeping because salivary function is decreased at night, plus there is a tendency for more mouth breathing at night.

• Oral hygiene—strict adherence to daily oral hygiene is strongly advised in order to remove bacteria/plaque throughout the day (so brush after meals and use floss). Sonic brushes are preferred to clean teeth and tongue. It may be necessary to see the dentist more often for check-ups and cleanings. (Some patients may go as often as every 3 months).

• Fluoride—use of high-concentration fluoride toothpaste (some need a prescription), topical fluoride applications (creams or gels that can be applied at home) and fluoride treatments (applied by the dentist) are recommended treatments because fluoride can repair and strengthen the surface of teeth. Remineralizing solutions, with high concentrations of calcium and phosphate, have been shown to repair mucosal tissues as well as repair/prevent dental caries. Most of these products are available by prescription and the prescribing dentist or oral specialist will examine the patient and determine if these products are actually helping.

• Stimulate—salivary output can be further increased with medications (i.e., pilocarpine or cevimeline). These are available only by prescription and may not be suitable for patients with certain conditions. Relief is usually temporary and dose-related.

• Dietary changes—minimize sugar/sugary foods, especially sticky sweet foods, spicy and salty foods. Avoid acidic and caffeinated beverages, alcohol and tobacco.

• Treat—identify/treat fungal infections. If patients have persistent burning sensation in their mouth, they should be cultured and treated with topical antifungal preparations.