Did you know that millions of patients experience dry mouth on an episodic or chronic basis? Or that dry mouth isn’t a disease itself, but a symptom of an underlying issue?
 
Here are 5 other things you probably don’t know about dry mouth, according to the Bad Breath Bible by Harold Katz, MD, founder of the California Breath Clinics and developer of the line of oral care products.
 
1. The majority of commonly prescribed medications list dry mouth as a possible side effect.
Prescription medications that may cause dry mouth include antidepressants, antihistamines, antihypertensives, and anticonvulsants (Table 1). However, many OTC medications can also frequently cause dry mouth, including OTC antihistamines, pain relievers, and antidiarrhetics.
 
TABLE 1: MEDICATION CLASSES THAT CAUSE DRY MOUTH
Antirexiant Antidiarrhetic Antipsychotic
Antiacne Antihistamine Bronchodilator
Antianxiety Antihypertensive Decongestant
Anticholinergic/
Antispasmodic
Anti-inflammatory Analgesic Diuretic
Anticonvulsant Antinauseant/Antiemetic Muscle Relaxant
Antidepressant Antiparkinsonian Narcotic Analgesic
Sedative    
Source:
 
2. Alcohol causes the worst form of dry mouth.
That’s because alcohol is a drying agent that substantially reduces the flow of saliva and oxygen content in the mouth, which both prevent dry mouth.
 
Notably, alcohol is the most common drying agent found in food and beverages. It’s also found in many popular mouthwashes, which may contain up to 27% alcohol and will actually exacerbate dry mouth.
 
Other things to avoid in order to prevent dry mouth include toothpaste that contains sodium lauryl sulfate, which is proven to cause mouth dryness, and tobacco use, as long-term smoking reduces salivary flow and increases oral and dental disorders associated with dry mouth.
3. Dry mouth in the morning could mean breathing problems.
Waking up with dry mouth is linked to the inability to breathe normally while asleep. When an excessive amount of air is inhaled and exhaled through the mouth overnight, it can reduce saliva flow, which in turn causes dry mouth and bad breath.
 
4. Dry mouth can cause tooth decay and gingivitis.
Because saliva minimizes the bacteria that cause cavities and other oral infections, a decrease in saliva flow related to dry mouth can increase the risk of tooth decay and gingivitis, which causes the gums to become red, swollen, and prone to bleeding easily.
 
If left untreated, gingivitis can progress to periodontitis, a serious inflammatory disease affecting the gum tissues, which many patients with dry mouth will unfortunately develop. In advanced cases, periodontal disease may affect bone growth and lead to serious jaw malformations.
 
5. Artificial saliva products can prevent and treat dry mouth.
A host of artificial saliva products are available to prevent and treat dry mouth, and they come in formulations such as rinses, sprays, toothpastes, gels, lozenges, and gum (Table 2). These products are formulated to mimic the chemical and physical properties of natural saliva, but they don’t contain the protective measures of natural saliva.
 
Artificial saliva products typically contain carboxymethylcellulose and glycerin for viscosity, as well as calcium and phosphate ions. Some products contain fluoride and/or a flavoring agent/sweetener. Pharmacists should remind their patients that these products are classified as replacement products and not cures for dry mouth.
 
TABLE 2: PARTIAL LIST OF OTC PRODUCTS FOR DRY MOUTH
ACT Total Care Dry Mouth Lozenges
Biotene Dry Mouth Toothpaste
Biotene Oral Balance Dry Mouth Moisturizing Gel
Biotene Mouth Spray for Dry Mouth
Biotene PBF Oral Rinse
Biotene Oral Rinse
MedActive Oral Relief Gel for Dry Mouth
MediActive Oral Relief Lozenges for Dry Mouth
Orajel Dry Mouth Moisturizing Gel
Oasis Moisturizing Mouthwash for Dry Mouth
Oasis Moisturizing Mouth Spray for Dry Mouth
Salese Dry Mouth Relief Moisturizing Lozenges
Salivart Oral Moisturizer Spray
SalivaSure Lozenges
SmartMouth Dry Mouth Relief Mints
Stoppers 4 Dry Mouth Spray
XyliMelts Discs for Dry Mouth