Head and Neck

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Dry Mouth (Xerostomia)

Dryness of the mouth is due to low salivary (spit) gland production.  It can cause trouble swallowing, changes in taste, mouth pain and irritation, and dental problems.

Causes: tumors of the salivary glands, radiation to the head and neck, medications (anti-nausea, anti-histamines, anti-anxiety medications), surgery to the salivary glands, and dehydration.

Prevention

  • Stay hydrated by taking regular sips of water, drinking sugar-free liquids, and avoidance of oral irritants (eg, coffee, alcohol, and nicotine).
  • Avoid oral drying substances (eg, coffee, alcohol, tobacco and cannabis smoke).
  • Avoid medications with the side effect of oral dryness such as over-the-counter cold/sleep remedies and allergy medications.
  • Avoid mouth breathing.
  • Avoid low-humidity environments, such as air-conditioned stores, centrally heated houses, and airplanes. Humidifiers are encouraged to maintain adequate humidity, particularly at night.
  • Avoid drinking acidic beverages or sipping on acidic beverages between meals such as Cola drinks, coffee, tea (herbal and black), energy drinks, and flavored waters.

Treatment

  • Replacement: Various solutions can be used to replace saliva, ranging from water to forms of artificial saliva. We suggest frequent sips of water. Sufficient water is needed to maintain adequate hydration. However, water used for moistening does not have to be swallowed; it can be rinsed around the mouth and then spit out. Some patients prefer sucking on ice. Artificial saliva can be purchased over-the-counter (eg, Biotene, Caphosol, Aquaoral, SalivaMAX, Oasis, SalivaSure). Use as directed.
  • Stimulation: Increase salivary flow by sucking on sugar-free candies/lozenges and using sugar-free chewing gum. Add drops of lemon juice in a glass of water. Eat dried fruit slices, such as peaches or nectarines, which stimulate salivary flow.  Ask your doctor about prescription medications to increase salivary production.

 Management

  • Stay hydrated! Drink about eight 8 ounce glasses of water daily.
  • Soft, moist, and bland foods are better tolerated if you suffer from dry mouth.
  • Keep lips moist.
  • Good oral hygiene: brush your teeth at least twice a day and fluoride mouthwash (eg, ACT) is encouraged. Avoid alcohol based mouthwash (eg, Listerine).

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