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Dry Mouth

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Definition and Symptoms

To describe what the patient reports with the expression “dry mouth”, doctors prefer to use the terms xerostomia o dry mouth .

Whatever you want to call it, dry mouth is an unpleasant condition caused by a lack of saliva. This deficit can alter the perception of the normal flavor of foods, make speech difficult and predispose to dental caries. Saliva, in fact, is able to buffer the acidity of the mouth and contains some substances with antimicrobial action.

Dry mouth can also make swallowing difficult, while the digestive processes do not suffer any particular negative consequences (the lack of intervention of salivary amylase is largely compensated by pancreatic amylase). In addition to dryness of the oral mucous membranes, the patient may complain of a sore throat, chapped lips, constant thirst, difficulty speaking, bad breath, gum disease and fungal infections of the mouth (see oral candidiasis or thrush).

Cause

Diet

Having a dry mouth from time to time is a completely normal phenomenon, often the result of slight dehydration caused by too much sweat, poor fluid intake or excessive ingestion of alcohol or salty foods. Remember that under normal conditions the salivary glands produce and secrete approximately one liter / one and a half liters of saliva per day.

Medicines

In addition to food-related causes, dry mouth can have iatrogenic origins, i.e. linked to the intake of certain medicines.

The list of offending drugs is quite long and includes in particular pharmaceutical products used for the treatment of depression, anxiety, Parkinson's disease, obesity (sibutramine, phendimetrazine, amphetamine derivatives), urinary incontinence and cancer (chemotherapy), but also narcotics, antihistamines – decongestants, antihypertensives (diuretics), antidiarrheals and muscle relaxants.

Smoking and Narcotics

Tobacco (smoked or chewed), exercise while breathing through your mouth, and talking or singing for too long can aggravate the feeling of dry mouth.

In other cases, dryness can be caused by the abuse of drugs, such as marijuana, cocaine, ephedrine and amphetamines, or alcohol (which has a dehydrating effect on the body).

Diseases and Disorders

A nasal obstruction (septal deviations, allergic rhinitis, nasal polyposis, etc.), which forces the patient to breathe through his mouth, can make him parched like the conditions listed above.

Among the diseases responsible for dry mouth Sjogrens syndrome stands out, followed by common diabetes and insipidus, mumps (mumps), cystic fibrosis and psychological disorders (depression and anxiety); the sensation of dry mouth can also be felt by patients suffering from Parkinson's disease or who have suffered a heart attack.

When dry mouth is accompanied by excessive sweating and marked thinness it can be a sign of a thyroid disease called hyperthyroidism.

Dry mouth can also be caused by damage to the salivary glands, for example due to trauma to the head, surgery or localized radiotherapy to the neck and head (in this case the damage may be irreversible).

For further information: Dry Mouth: Causes and Symptoms »

Diagnosis

To diagnose xerostomia, the doctor or dentist carefully examines the patient's clinical history and the symptoms he or she complains of; a careful inspection of the oral cavity and palpation of the neck and cheeks – possibly associated with blood tests or imaging techniques (diagnostic imaging) – may possibly help to identify the origins of the problem. At home, dry mouth can be “diagnosed” by ingesting crackers or dry rice: if you have difficulty chewing or swallowing the test is considered “positive”.

Treatment

The treatment of xerostomia is personalized in relation to the underlying causes. For example, your doctor may decide to discontinue certain medicines and replace them with others. Oral rinsing with special mouthwashes, application of artificial humectants in spray (Xerotin, Secriva), capable of mimicking the effect of saliva (especially useful before meals) and the adoption of other palliative measures considered secretory-stimulating (chewing gum or dragees, strictly sugar-free), represent a generalized intervention strategy. The patient, for his part, must maintain adequate oral hygiene and correct any so-called bad habits, abolishing smoking, trying to breathe through the nose rather than the mouth, increasing the intake of liquids and humidifying the environments in which he stays.

When the salivary glands are healthy, the treatment of dry mouth can make use of specific sialagogue drugs, such as anetholtrithione (Sulfarlem) and pilocarpine (Salagen), which increase the flow of saliva.

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