The 10 most important tips for dry mouth

Saliva: the all-rounder in the oral cavity

Humans have three large salivary glands, each located on both sides of the mouth. In addition, a large number of small salivary glands are embedded in the oral mucosa. All of them secrete between approx. 700 ml and 1000 ml of saliva into the oral cavity every day. The saliva moistens the tooth surfaces and the mucous membranes with an adherent thin film.

The composition of saliva is complex; the main components are water, organic components such as mucins, proteins, immunoglobulins and inorganic components such as calcium and phosphate.

The flow of saliva fluctuates greatly throughout the day; chewing movements and taste sensations, even the idea of delicious food, stimulate the flow of saliva, while it is greatly reduced at night.

You can't eat without saliva

Saliva fulfils a number of important functions in the oral cavity. Chewing or swallowing is hardly possible without the moisturising of the mucous membranes through saliva and its rinsing function. Saliva has an antibacterial effect and the enzymes it contains begin to digest food.

The mineral balance of the teeth is maintained and acids are buffered (neutralised). Saliva also plays an important role in the perception of flavour.

Dry mouth can significantly reduce the quality of life and

increase the risk of many oral diseases

The stimulated saliva flow rate, e.g. when chewing chewing gum, is approx. 1 ml of saliva per minute. Less than 0.3 ml of stimulated saliva flow (hyposalivation) per minute is referred to as dry mouth (xerostomia). People affected by this often suffer greatly. The tongue sticks to the palate, speaking is difficult, swallowing can become a pain, there is unpleasant bad breath as well as burning mouth and tongue. The spread of bacterial infections in the mouth is favoured and the risk of oral fungal infections increases. The lack of cleaning and remineralisation of the teeth leads to the rapid progression of tooth decay and inflammation of the gums, periodontium and oral mucosa. The sense of taste is also very limited, even to the point of discomfort such as the salty perception of sweet food (dysgeusia).

Temporary dry mouth can have a variety of causes

In the short term, dry mouth can occur as a result of a lack of fluids, mouth breathing, snoring, dry ambient air (e.g. in winter), in connection with flu-like infections or hoarseness. Stress, excitement, nervousness, but also depression and stimulants, especially smoking and alcohol abuse, can lead to dry mouth.

Hormonal changes (pregnancy, menopause, hormone preparations) also often correlate with a transitional dry mouth. Older people are often affected, but up to 10% of young adults also appear to suffer from dry mouth to a greater or lesser extent.

Dry mouth as a disease

Persistent dry mouth is often the result of radiotherapy or chemotherapy, a concomitant symptom of a disease of the salivary glands, a consequence of salivary gland tumours or diabetes.

In Sjögren's syndrome, an autoimmune disease, a chronic inflammatory reaction leads to the destruction of the salivary and lacrimal glands. Post-menopausal women in particular can be affected.

Many medications can lead to dry mouth as an undesirable side effect

Last but not least, dry mouth often occurs as a result of side effects of medication:

Antihypertensives (blood pressure-lowering drugs), beta-blockers, antidepressants, psychotropic drugs, antihistamines (anti-allergic drugs), antiepileptic drugs, drugs for Parkinson's disease, muscle relaxants, painkillers from the opiate group, tranquillisers and sleeping pills, diuretics (diuretic drugs), but also antiemetics (anti-nausea drugs, travel sickness) can lead to (greatly) reduced salivation.

Home remedy for dry mouth

The obligatory glass of water on the lectern is said to alleviate the dry mouth of the often excited speaker, facilitate the flow of speech and prevent hoarseness. It also helps to drink enough throughout the day, preferably water or unsweetened tea. In general, food should be chewed thoroughly. Stimulants such as excessive consumption of coffee or alcohol should be avoided and smoking should be reduced or even stopped. Salty, spicy and strongly flavoured foods should also be avoided.

Particularly in winter, care should be taken to ensure that rooms, especially bedrooms, are sufficiently humidified and regularly ventilated.

Regularly chewing sugar-free chewing gum (e.g. ApaCare Gum) or lozenges (e.g. Xerodent) stimulates the flow of saliva.

Professional help for dry mouth

The special suppleness of the oral mucosa and its ability to store water and lubricate food is achieved primarily through naturally formed hyaluronic acid in the connective tissue. This natural substance promotes wound healing and inhibits inflammation

. Regular use of high-molecular hyaluronic acid preparations 3-5 times a day, especially mouth rinsing solutions containing hyaluronic acid (ApaCare OraLactin mouth rinsing solution) or sprays (GengiGel spray), can significantly improve this ability, especially in cases of dry mouth. The reduced amount of saliva is bound to the surface of the mucous membrane more effectively and sustainably.

Dental and oral care for dry mouth

Healthy teeth require a balanced mineral balance. After every meal, the formation of lactic acid by plaque bacteria (biofilm) leads to demineralisation of the tooth surface. Calcium and phosphate ions in particular are dissolved out. The buffer systems in saliva slow down this natural process. The minerals from the saliva are then incorporated back into the tooth surface (remineralisation). With sufficient saliva, demineralisation and remineralisation are in balance. Fluorides also require sufficient saliva in order to build up the protective calcium fluoride layer on the tooth surface, for example when brushing with a fluoridated toothpaste. Here too, the calcium comes from saliva. Without saliva, the protective function of the fluoride is considerably reduced. Especially in the case of dry mouth, it is therefore necessary to supply dental minerals such as calcium phosphate and hydroxyapatite with dental care products. The best way to do this is with a toothpaste that contains hydroxyapatite as well as fluoride (e.g. ApaCare Remineralising Toothpaste).

Prevention of tooth decay and periodontitisEnamel minerals

such as hydroxyapatite from ApaCare toothpaste are deposited on the tooth surface as an additional protective layer during tooth brushing, which reinforces or partially replaces the function of saliva on the tooth surface. If dry mouth persists for a longer period of time, so-called tooth repair pastes should be used in addition to brushing with fluoridated toothpaste containing hydroxyapatite (e.g. ApaCare Repair tooth repair paste). These are highly enriched with tooth minerals such as hydroxyapatite and are applied with a toothbrush or finger after brushing.

In severe cases of dry mouth or after consuming highly acidic meals or drinks, it is advisable to use these repair pastes (ApaCare Repair tooth repair paste), for example with dental splints (e.g. ApaCare Repair dental splint) several times a day or even overnight to achieve sufficient remineralisation of the tooth surface regardless of the low saliva flow.

When should a doctor be consulted?

Do not hesitate to consult your general practitioner, ear, nose and throat specialist or dentist if the dry mouth persists over a longer period of time, if you have increasing problems with fluency of speech or even difficulty swallowing

. There are also important indications of general medical causes if not only the mouth is dry, but also the nose or eyes on a regular basis, if taste is impaired or if the salivary glands become palpable or swollen.

What else can be done

After a detailed medical history (questioning the patient about their state of health, medication, general illnesses, course of symptoms, etc.) and a thorough examination of the patient with a particular focus on the oral cavity and salivary glands, the stimulated salivary flow rate is usually determined. If the suspicion is confirmed, further examinations such as laboratory diagnostics, blood tests, sonography (ultrasound examination) of the salivary glands, endoscopic examinations of the salivary ducts, X-rays, magnetic resonance imaging, scintigraphy, if necessary with contrast medium, can be carried out to narrow down the cause. In rare cases, a sample is taken from the salivary gland (biopsy). In addition, an interdisciplinary diagnosis or therapy may be necessary, involving hormone specialists, endocrinologists, rheumatologists or psychologists.

Saliva substitutes are often the last resort in very severe cases of dry mouth in order to form a film on the mucous membranes of the mouth and throat and thus facilitate speaking, eating and swallowing

Living with dry mouth

Saliva substitutes consist of sodium carboxymethylcellulose (Na-CMC), carboxyethylcellulose (CEC), hydroxyethylcellulose (HEC), animal mucin, linseed oil, sorbitol or polyethylene oxide (PEO), among others. Enzymes and substances to adjust the pH value and viscosity are also added to many saliva substitutes. To prevent caries in dentate patients, pH-neutral saliva substitutes that contain fluoride and are supersaturated with calcium and phosphate should be recommended wherever possible. Butter and wetting the mucous membranes with edible oils are also helpful. Despite all these substances, no substitute preparation has yet been found that can replace human saliva. Unfortunately, many forms of dry mouth still cannot really be treated in a cause-specific manner and the affected patient has to live with dry mouth.

As the relief of symptoms with the above-mentioned therapeutic approaches is perceived differently from person to person, it is recommended that the affected person tries out different measures to find the best one for them individually