What is Oral Dryness?
Oral dryness is the feeling of decreased salivary flow and lubrication of the mouth. Oral dryness can be either objective (clinical evidence of dryness can be found) or subjective (the patient has a sensation of oral dryness without any evidence of decreased salivary flow).
Common Signs and Symptoms:
- Oral dryness can manifest as loss of saliva covering the lining of the mouth, or decreased salivary flow from the salivary glands.
- Oral dryness can also manifest as thick ropey saliva that is more sticky than usual.
- Sometimes irritation of the oral soft tissues is the first indication of an underlying oral dryness.
- In other cases, the presence of fungal infections such as oral thrush, may be the first indication that the patient is suffering from oral dryness.
- In some cases, the patient feels that the mouth is dry, and this can be accompanied by a burning sensation or altered taste.
- Oral dryness can be caused simply by dehydration due to limited water intake or excessive alcohol, tea or coffee intake.
- It can also result as a side effect of certain medications such as antidepressants.
- Oral dryness can result from a decrease of salivary flow because of inflammatory conditions that affect the salivary glands such as Sjogren syndrome.
- Radiotherapy of the head and neck area as a treatment of cancer can also cause oral dryness due to destruction of the salivary glands.
- The sensation of oral dryness can also result from stress, anxiety and depression, or as part of other neuropathic pain conditions.
The specialists at Perth Oral Medicine & Dental Sleep Centre can differentiate objective from subjective oral dryness through examination, special tests, and history taking. This is important as the different diagnoses require different treatments.
- Examination of the oral tissues to assess lubrication, the quality and quantity of saliva, and the flow of saliva from the salivary glands is a very important part of diagnosing oral dryness.
- Salivary tests (both resting and stimulated) assist in differentiating the underlying causes of oral dryness.
- Testing the pH and buffering capacity of saliva is also important in helping patients manage their oral hygiene habits well to prevent dental decay and other problems.
- Some salivary problems require imaging with CT, MRI or Ultrasound.
- Many cases of oral dryness just require that the patient increase their water intake and decrease intake of alcohol, tea, coffee and cease smoking.
- Other cases require that medications be stopped or changed. This will occur in consultation with the patient’s doctor.
- Some cases of oral dryness require saliva substitution. There are several commercial products available to help with this.
- Other causes of oral dryness cannot be managed in this fashion, and require medications that stimulate saliva. These will be considered based on the needs and general health of the patient.
- Other cases however, require medications that remove the sensation of oral dryness despite there being adequate saliva in the mouth. These medications are prescribed after careful assessment of the patient.
- Oral thrush should be treated as part of the overall management protocol for the patient.
- Most patients suffering from objective oral dryness achieve adequate resolution of their symptoms with use of saliva substitution and saliva-stimulating medications. Often however, these need to be taken for a long time.
- Treatment of conditions that alter the perception of oral dryness can be more challenging. This often requires long term medication, and can benefit from other approaches such as cognitive behaviour therapy or relaxation.
- Oral dryness as a result of radiation therapy is a long term ongoing problem for patients.