Natural Dry Mouth Remedies
© 2014 by Kate Parker, RDH, BS-DH, RF
Dry mouth remedies can help you feel normal again
On the surface, dry mouth remedies appear to be for the purpose of making life more comfortable, and that's about it. Yet chronic dry mouth, known medically as xerostomia (zeer-uh-sto-me-uh), is one of the biggest problems we face in dentistry today.
It can definitely be uncomfortable, and even painful, to have a chronically dry mouth. But there's a lot more to it than that! Saliva contains key factors that buffer the pH in the mouth (alkalize the oral environment), restore minerals that strengthen the teeth, restore health to the mouth with antibiotic and antibacterial properties, and carry enzymes that aid in digestion (such as salivary amylase.)
Lack of saliva is responsible for many ills in the dental world, most of them uncomfortable for the person suffering from them. The #1 cause for concern, however, is the increased tendency to rampant tooth decay. Without saliva's protecting factors in the mouth, the teeth are drastically more prone to cavities and the overpopulation of bacteria. Chronic dry mouth also often leads to gum disease and ongoing fungal infections like candida.
- Rampant decay, gum disease, and unchecked fungal infections like candida are almost always found in people with untreated chronic dry mouth
- Dry mouth remedies can greatly reduce the chances of developing cavities, gum disease, and fungal infections caused by chronic dry mouth
Saliva's important roles in the body:
While most of us don't think about saliva probably at all, it's quietly making many aspects of our lives possible. Here are some of the amazing things saliva is responsible for:
- Buffering the teeth and oral cavity
- Remineralization of tooth enamel
- Digestive enzymes
- Antibacterial and antibiotic properties
- Retaining dentures
- Read more about the importance of saliva
Symptoms Of Chronic Dry Mouth
Food and lipstick may stick to the teeth
- Rampant decay or an increase in dental cavities
- Opportunistic infections like oral candidiasis (fungal infection)
- Recurrent infection of the salivary glands, especially the parotid gland (in cheeks)
- Altered taste (metallic taste or can't taste anything)
- Altered sense of smell
- Difficulty swallowing
- Increased tendency to halitosis (bad breath)
- Creamy white coating on tongue, palate, or cheeks (candida infection)
- Burning and tingling sensation of the oral tissues and tongue
- Thick, ropey, viscous, or foamy saliva
- Red, wrinkly, lobulated (bumpy), fissured tongue that appears inflamed
- Tongue denuded of filiform papillae, causing shiny appearance
- Tongue sticks to the palate, lips stick to each other
- Clicking noise when speaking due to tongue sticking to oral tissues and palate
- Difficulty wearing dentures, especially when swallowing, eating, or talking
- Ulcerations and soreness in tissues covered by dentures
- Oral mucositis (inflamed oral tissues) and generalized tissue soreness
- Food and lipstick may stick to the teeth
- Dry, cracked, and sore lips
- Angular cheilitis (cracked corners of mouth), especially with dentures
- Need of dry mouth remedies to speak, swallow, and eat normally
- Some people may experience no symptoms but still have xerostomia
- Some people may experience multiple symptoms but not have xerostomia
What Causes Dry Mouth
Nearly 40% of the US geriatric population has medication-induced chronic dry mouth, many of whom do not use dry mouth remedies
- Physiological: Salivary flow naturally decreases while sleeping. This is why it's so important not to send kids to bed with sugary drinks like milk or juice. Salivary flow also decreases while experiencing the "fight or flight" response and during periods of high anxiety. Aging itself can affect the rate at which salivary glands produce saliva, although aging alone generally doesn't decrease saliva to true xerostomic levels.
- Mouth Breathing: Chronic mouth breathing (all day and all night, not just while sleeping) can cause chronic dry mouth and a greatly increased risk of developing cavities, gum disease, and oral fungal infections. Mouth breathing can be caused by misalignment of the teeth, by physiological factors concerning the jaw, or by nasal obstructions like polyps or a deviated septum.
- Dehydration: If your body isn't getting enough water it will begin conserving moisture that's not critical to survival. Salivary glands decrease their saliva output or stop altogether. Drinking more water should restore the salivary flow to normal levels if no other conditions are causing the chronic dry mouth.
- Medication-Induced: This is by far the most common cause of xerostomia, or chronic dry mouth. Up to 30% (95 million) Americans currently suffer from xerostomia. Of this, nearly 40% of the geriatric population has medication-induced chronic dry mouth. In practice I would argue that these numbers are much much higher, as most people are on medications. It's estimated that at least 500 common medications cause xerostomia. Nearly none of the doctors who prescribe these drugs warn patients about the greatly increased risk of rampant tooth decay associated with medication-induced xerostomia. See a list of common medications here.
- Sjögren's Syndrome: This autoimmune disease damages the salivary and lacrimal glands (which produce saliva and tears, respectively.) People with this disease suffer from chronic dry mouth and eyes, and some people also experience a chronically dry nose, larynx, and genitalia. Primary Sjögren's mainly involves the mouth and eyes. Secondary Sjögren's involves the mouth and eyes in addition to other autoimmune conditions like lupus and rheumatoid arthritis.
- Radiation Therapy: Irradiation of the head and neck (as in cases of cancer) completely destroys the salivary glands, thyroid, and other organs. Most people who have had head and neck radiation therapy will suffer from chronic dry mouth. Their salivary glands either no longer function at all or produce such a reduced amount of saliva as to render it ineffective.
Extreme Xerostomia: Conventional Dry Mouth Remedies
For extreme xerostomia that affects the ability of a person to function, conventional dry mouth remedies are recommended
The need for dry mouth remedies will vary depending on severity and how chronic the condition is.
Extreme cases of xerostomia are usually found in people with Sjögren's syndrome or those who have experienced irradiation of the head and neck. Extreme cases of xerostomia can result when a person is on many medications as well.
For extreme xerostomia that affects the ability of a person to function, conventional dry mouth remedies are recommended. This can be in combination with natural home remedies, but generally conventional methods are needed in order to mitigate the damage of a complete absence of saliva. As noted above, a complete absence of saliva causes rapid changes in the mouth and body that can result in irreversible damage and rampant tooth decay.
Extreme xerostomia may require multiple dry mouth remedies, namely oral lubricants (often called saliva substitutes), moisture-restoring dental products (toothpaste, mouthwash), and saliva-stimulators (lozenges.) These products restore moisture to the mouth and aid in remineralization of the teeth; however, they do not replace digestive enzymes or the antibacterial/antibiotic qualities of saliva.
List Of Conventional Dry Mouth Remedies
This is the product range that the majority of patients use. Biotene is the #1 recommended product by both dentists and dental hygienists for dry mouth. However, about 20% of people prefer other products like Oasis. Mainly this is because they like the taste of Oasis better, although they agree that Biotene is a great saliva substitute and the effects tend to last longer than some others on the market. Drawbacks are that it's a little more pricey than some of the other saliva substitutes on the market, and some people don't care for the taste.
- Oral rinse
- Main ingredients: Glycerin, Xylitol
- Pros: It's #1 recommended and is very effective
- Cons: It's a little pricey and some people don't like the taste
The product range is more limited, but some patients definitely prefer the taste of Oasis compared to Biotene. Biotene is generally considered the best at keeping the mouth moistened, while Oasis is generally turned to when people can't take the taste of Biotene. I have had many patients who love Oasis and take it everywhere they go. That said, the main ingredient is glycerin and not xylitol. Glycerin is a vegetable-based humectant and does not raise the pH or help remineralize the teeth as much as xylitol does. I always recommend xylitol-based products over glycerin-based products, but some people swear by this stuff.
- Oral rinse
- Main ingredients: Glycerin
- Pros: Pleasant refreshing flavor, and somewhat effective
- Cons: Many people don't feel it works as well as other products
Xylitol is an excellent saliva stimulator, aids in remineralization of the teeth, and prevents cavities 6 times more effectively than fluoride. Oracoat Xylimelts are great time-release discs that secure to the cheek and constantly release moisture in the mouth. Many people recommend using two discs at night and two more to get through the day. A drawback though is that many people have commented on the weird taste and texture. This product is kind of all over the map; it works well for some people, and others hate it.
- Time release discs
- Main ingredients: Xylitol
- Pros: Time-released xylitol, lasts for many hours
- Cons: Mixed results, weird taste and texture
The range of products is good, but it's a little bit harder to find than Biotene and Oasis. Feedback from patients has ranged all over the map for this one. Considering the main ingredients are fermentable sugars, chances are this is not an optimum choice for prevention of oral decay (which is the #1 reason for using saliva substitutes in the first place.) Xylitol is a great ingredient, but so little is used that unless you really like the product, it would be better to use a different one that has xylitol as its main ingredient.
- Oral rinse
- Main ingredients: Sorbitol, Maltodextrin, Xylitol
- Pros: There's a good range of products and they contain a little xylitol
- Cons: The main ingredients are fermentable sugars, with variable results
These are relatively new to the market, although I have heard some good feedback about the lozenges. The good news is that it contains xylitol as one of its main ingredients. Xylitol is one of the best things you can do for the health of your mouth (see more about xylitol in the section below.) The one drawback that I've heard about is that the soothing moisture effect doesn't last for long. That said, most people like the effect when it's working.
- Oral rinse
- Main ingredients: Xylitol, Glycerin
- Pros: Inexpensive, contains xylitol as a main ingredient
- Cons: The effect doesn't last for very long
Mild To Moderate Xerostomia: Natural Dry Mouth Remedies
Xylitol is one of the best natural dry mouth remedies
Milder cases of xerostomia are generally the result of medications, mouth breathing, or dehydration. Milder cases will be annoying but will not impact the ability to function like extreme xerostomia does. These cases should be fine with home remedies alone, although there are definite benefits to using conventional dry mouth remedies as well.
While extreme xerostomia dry mouth remedies use actual saliva substitutes to help restore moisture in the mouth, mild home remedies for dry mouth act to stimulate saliva flow instead of replace it.
Stimulation of salivary glands generally involves sucking or chewing on something that's sugar-free and non-acidic. This is because teeth decay in acidic environments, and sugar causes bacteria in the mouth to release acid. Steer clear of these things when looking for a natural way to kick your salivary glands into gear.
List Of Natural Dry Mouth Remedies
Xylitol is a natural non-fermentable sugar proven to be 5-6 times more effective at preventing cavities than fluoride. It helps remineralize and strengthen the teeth, increases salivary flow, and raises the pH in the mouth to neutral or alkaline levels. It is also diabetic friendly and can be used in baking.
And if that wasn't enough, xylitol actually changes the DNA of cariogenic (cavity causing) bacteria in the mouth over time. With regular use, xylitol makes it so that bacteria can no longer physically stick onto tooth surfaces. Instead, they rinse away in the saliva, helping protect the teeth from developing cavities in the first place.
- Main ingredients: Xylitol
- Pros: Xylitol is sweeter than normal sugar, is diabetic friendly, and is 6 times more effective than fluoride at preventing cavities. Over time xylitol changes the DNA of oral bacteria so that they can no longer cling onto the teeth. It also raises oral pH and helps restore minerals to the teeth.
- Cons: To be truly effective at cavity prevention, you need to consume 6-10g daily in any form. However, positive results have been seen with any consumption of xylitol. Another drawback is the cost of xylitol. It's more expensive than normal subsidized sugar. Note: If you have SIBO, do not consume xylitol (use stevia instead.)
Saliva Stimulating Products
The key to stimulating saliva is to suck or chew on something continuously. Obviously this should be sugar free and non-acidic or it can cause even more damage than a mere absence of saliva can. When the mouth is dry it has little defense against acids and sugars and I have seen patients rapidly develop rampant cavities from using sugared lozenges when they had dry mouth.
- Sugar free gums
- Sugar free lozenges
- Sugar free hard candies
- Dental wax pellets
- Pros: Stimulation of saliva helps bathe the teeth in restorative minerals, it's antibacterial, and it promotes a neutral or alkaline oral pH.
- Cons: Beware of using sugared candies or gums to stimulate saliva. These will cause more problems than they'll solve. Also try to find products that are xylitol based; it truly is the best option.
Keep Your Mouth Moist Naturally
- Drink lots of water, sipping on it throughout the day
- Snack on foods with a high water content (like celery)
- Avoid alcohol-based mouthwashes and alcohol; they're drying to the oral tissues
- Avoid smoking cigarettes, cigars, and marijuana as these dry the oral tissues. Opt instead for e-cigarettes or vaporizers
- Sleep with your mouth closed, and avoid mouth breathing
- Use a humidifier when you sleep or if your home has dry air
- Pros: These things are pretty easy to do and are very cost effective.
- Cons: This list probably won't be enough on its own. Chances are you'll need to find a combination of dry mouth remedies that work just right for you.
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