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What is Sjögren’s?

Dry Mouth

Dry Mouth

What is Dry Mouth?

Saliva secretion may be normal or decreased in Sjögren’s patients. However, the feeling of a dry mouth, particularly in the areas of the throat or lips is a frequent complaint. The perception or sensation that the mouth is dry is known as “xerostomia”. If this is accompanied by a measurable decrease in the amount of saliva produced, the term “hyposalivation” or “salivary gland hypofunction” is used. With a dry mouth, not only is the quantity of saliva reduced but so is the quality. Saliva is produced primarily by three pairs of major salivary glands and perhaps as well as by a recently discovered fourth pair, in addition to hundreds of minor salivary glands located on the lips, palate, tongue, and cheeks. Saliva has both watery and mucous components in addition to numerous other substances such as proteins, lipids, minerals, antibodies, and complex mixtures which aid in its various functions. Saliva is far more complex than one would think and is involved in: 

  • preserving and maintaining oral health and function; 
  • aiding in digestion; 
  • contributing to taste perception; 
  • facilitating communication; 
  • protecting oral tissues from desiccation, microbial penetration, or ulceration; 
  • stimulating soft tissue repair; 
  • providing comfort while wearing dentures by means of its lubricating ability; 
  • protecting dental surfaces; 
  • neutralizing acids; 
  • acting as a buffer; 
  • diluting acids; and 
  • promoting remineralization of hard tooth structures. 

Prolonged dry mouth may result in difficulty speaking, tasting, chewing, swallowing, and digesting food. Decreased salivary flow and changes in salivary composition increase the risk of developing dental decay since the buffering and remineralizing capacities are reduced. 

How do I manage my Dry Mouth?

Dry mouth is not the same as thirst. While drinking water can satisfy a thirst, it does not relieve dry mouth over an extended period and can make the mouth feel drier since the little amount of saliva produced is swallowed. Nevertheless, it is important to remain hydrated. Some techniques that can be used to stimulate saliva release include: 

  • massaging of the glands in the cheeks or under the tongue; 
  • chewing gum (preferably xylitol-containing); 
  • sucking on a hard object (cherry pit, smooth button, pebble, or xylitol-containing lozenge); 
  • applying dry mouth relieving products such as gels, sprays, adherent discs, or rinses; 
  • oil-pulling with oils such as virgin coconut oil; or 
  • taking prescribed medications (pilocarpine, cevimeline, bethanechol) 

These may all help to relieve dry mouth if only on a temporary basis. No one product or technique works for everyone. They are all individualistic.

How do I take care of my Teeth?

Good oral health is essential. Brushing the teeth/mouth with a gentle, softly-bristled toothbrush upon waking, after meals and before bed are key techniques as well as daily flossing, use of either a fluoride-containing or remineralizing toothpaste, use of fluoride rinses, and regular 3- to 6-month visits to  hygienist/dentist teams particularly those who specialize in dry mouth. Use of anti-bacterial products or techniques, such as application of silver diamine fluoride (SDF) by your dentist can reduce the oral decay-causing bacterial load, which will then allow the fluoride or other remineralizing agents to promote mineralization and increase resistance of tooth enamel to acid attack. Since a dry mouth tends to be more acidic, rinsing with baking soda in water (1/2 tsp or 5 mL in a gallon/litre of water, respectively) can raise the pH and increase the alkalinity. A dry mouth is also more prone to candida (yeast) growth. Oil-pulling with virgin coconut oil or safflower oil has been shown to effectively reduce this.