Dry mouth – Xerostomia

The worth of water will be realised only when the well goes dry. Likewise, the worth of saliva can be really noted only when one suffers with dryness of mouth. Dry mouth is medically termed as ‘Xerostomia’. It commonly occurs with salivary gland problems. It can also occur temporarily due to various factors starting from environmental factors, social factors and with other general diseases. It usually comes as a symptom rather than a disease. Nowadays, people take soft drinks, coffee, tea, etc., in plenty, to combat thirst / dry mouth and accounting them for fluid balance of the body. The real thing is all these will really need more water to eliminate or to wash them away (?).

Incidences - Dry mouth commonly occurs in elderly people. It usually follows dehydration and disease – i.e. exhausted state. Its incidences and intensity vary according to humidity, management and treatments. It is also common in people who are tensed and worry a lot.

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Causes – The most common reasons for dry mouth are

• Environmental factors – continuously exposed to very hot & dry winds or having direct blow from air-conditioners.

• Occupational - strenuous work or working more near furnaces or in hot atmosphere

• Deficiency of vitamins and minerals

• Habits – smoking, breathing through the mouth/ improper closure of mouth (after losing teeth in elderly persons) / snoring, drinking soft drinks often, taking preservative-added foods, taking less water, etc.

• Diseases –

  • Infection – cold, cough

  • Facial paralysis – here dryness may occur due to lesions occurring in nerves supplying the salivary glands or by affectation of facial muscles which lead to failure to close the mouth fully

  • Auto immune disorders – AIDS, SLE, diabetes, Sjogren’s syndrome, etc.

• Salivary gland disorders –

  • Infection and inflammation of salivary glands

  • Duct blocks due to stricture or stones

  • Less production of saliva due to glandular diseases

  • Lesion in nerve supplying salivary gland

  • Tumours of salivary glands

• Drug induced – dry mouth may also occur as adverse effects of pain killers, diuretics, anti-depressants, anti-histamines, birth control pills, sedative drugs

• Treatments – steroidal therapy, chemotherapy, radiation therapy

Symptoms – Dryness of mouth itself comes as a symptom rather than a disease. The low abnormal quantity of saliva may reflect in the quality of the saliva too and can cause a variety of problems. The common accompanying symptoms are

• Oral discomfort and altered taste

• Thick, ropy, sticky saliva

• Burning or tickling or numb sensation in tongue or mouth

• Poor oral hygiene

• Cracked, dry or scaling lips

• Coating of tongue

• Halitosis – bad breath

• Difficulty in swallowing since mastication process cannot make food into bolus

• Difficulty in fluency of speech

• Recurring throat infection and gum problems

• Dry cough

• Constipation

Diagnosis – is very important to fix the complaint to cure. It needs to be analysed in every way, i.e., from intake of water, suffering complaints, treatments, medications, etc. Need for investigations may vary depending upon the symptom presentation of the disease. In general, the following tests are necessary.

• Palpation of salivary glands

• Routine blood tests to rule out infection, diabetes, high cholesterol

• Culture and sensitivity tests

• X-ray / CT / MRI scan to rule out stones or stricture in salivary gland ducts.

Complication – Any disease left untreated will bring complications as reward or bonus. Dryness of mouth is also no exception. In due course, dry mouth can cause

• Fungal infections / thrush

• Discomfort in mouth

• Altered taste which can end in disgust for food and weight loss

• Depression and restlessness

Prevention and management – Dry mouth should be cared for in the initial stages itself to avoid complications. Also, one should maintain good oral hygiene with proper cleaning, brushing, flossing, etc. to avoid unnecessary added infections. The easy managements are

Dos

• Take adequate amount of water / fluids

• Take good amount of nutritious food

• Take care of nose block or snoring to avoid mouth breathing

• Take care of every disease in the start-up itself with good amount of fluid supplements to avoid dehydration and exhausted state

• Drink water before, during and after meals

• Wash away the mouth / gurgle the mouth after food intake and maintain cleanliness

• Mastication process improves saliva secretion so masticate well while eating or you can chew gum on other occasions

• Use room humidifier in very hot and dry climates

Avoid

• Dry foods (take food with good amount of gravy)

• Exposure to smoke, wind, dust, etc

• Smoking, tobacco chewing, coffee, tea, soft drinks, etc.

• Very hot and spicy food

• Preservative-added foods / drinks / fast foods

• Breathing through the mouth

General treatment – In general, treatment will be successful only when actual cause is removed and condition is treated accordingly i.e., treating salivary gland infection / fever / sinusitis / lung infection / chronic bronchitis, etc. Vitamins and mineral supplements will also be provided along with the treatment to maintain good health. In case of salivary gland stone or obstruction or stricture, treatment will be aimed with surgical option. But on some occasions, treatment / medicines itself causes dry mouth, where treatment need to be stopped. In cases where the causes cannot be traced out, treatment and management will be difficult.

Homeopathic approach – Nowadays, Homeopathy has gained importance in the tide of health fortunes and has made the world to turn towards it for cure. Homeopathy has marvellous medicines to improve the quantity and quality of saliva. With the most apt drug, Homeopathy can control infection, enhance immune power and stream line the normal required saliva secretion.

Regarding treatment of dry mouth, symptom presentations may differ from person to person depending upon the disease, cause, intensity, etc. Homeopathy gives importance to these individual symptoms / patient’s feelings than for the disease symptoms. So, prescription also differs in Homeopathy from person to person. For example – for

• Dry mouth without thirst – Apis, Puls, Nux mos,

• Dry mouth with excessive thirst – Bryonia

• Dry mouth with thirst for little quantity – Ars alb

• Ropy saliva – Iris vers, Kali Bich, Picric acid,

• Offensive saliva – Baptisia, Baryta Mur, Merc sol, Nitric acid,

• Salty saliva – Cyclamen

• Sour saliva - Ignatia

• Tasteless saliva – Veratrum alb

• Sweetish saliva – Chamomilla

With proper medicines, Homeopathy can remove the disease completely and act locally on glands, or neurologically to stimulate the gland for quantitative and qualitative normal saliva secretions. Homeopathy can also expel / bring out salivary stone without any surgical intervention.

Homeopathic medicines commonly used for dry mouth are Acid nit, Acid flour, Acid phos, Alumina, Apis mel, Ars alb, Aurum met, Arum triphyllum, Baryta mur, Bryonia, Calc carb, Carbo animalis, Carbo veg, Graphites, Hepar sulph, Hyoscyamus, Lachesis, Merc sol, Nat mur, Nux mos, Opium, Petroleum, Phosphorus, Psorinum, Pulsastilla, Rhus tox, Silicea, Staphysagria, Sulphur, Thuja, Tuberculinum, Uranium nit, Veratrum alb, etc. These medicines should be taken on the advice and diagnosis of a Qualified Homoeopath.