Dry Mouth: a Common Medication Side Effect that Causes Cavities

David W. Branch, DDS

Could the medications you take be causing dry mouth?

More than 80 percent of the most commonly prescribed medications cause dry mouth (also called xerostomia).  Drugs that treat depression, anxiety, high blood pressure, allergies, pain, acid reflux, nausea, inflammation, cancer and many other conditions can make a person’s mouth dry. While dry mouth may be perceived as simply an inconvenience, it can actually be a cause of severe tooth decay and gum disease.

Healthy teeth and gums are essential to maintaining our health and quality of life as we age. The health of our mouths is directly tied to the overall health of our bodies. Gum disease has been linked to many chronic conditions, including diabetes and heart disease. And having healthy teeth promotes proper nutrition. Since approximately one in three seniors has dry mouth, it is important that all seniors be aware of the risks.

What are the symptoms of dry mouth?

Saliva protects our mouths by washing away food particles, killing bacteria, diluting and neutralizing the acids that cause tooth decay, and strengthening teeth with minerals like calcium and fluoride. People with dry mouth lose this protection because they don't have enough saliva. Dry mouth can also make it hard to eat, swallow, taste food, and even speak. Common symptoms of dry mouth include:

• A sticky, dry feeling in the mouth and/or throat
• A burning or tingling sensation in the mouth and especially on the tongue
• A dry, red, raw tongue
• Sores in the mouth; sores or split skin at the corners of the mouth; cracked lips
• Hoarseness, dry nasal passages, sore throat
• Frequent thirst
• Bad breath

What do I do if my mouth feels dry?

If your mouth feels dry, it is important that you talk with your healthcare providers. Your doctor and pharmacist can evaluate your medications to determine what could be causing your dry mouth. Sometimes your doctor can make an adjustment that will help with the dry mouth symptoms (note: always take your medications exactly as your doctor prescribes). Dry mouth can also be a sign of a health condition such as diabetes or high blood pressure, so it's important to have any symptoms evaluated by your doctor.

You should also have regular visits with your dental professional, who can check your teeth for signs of cavities and gum disease and can also prescribe items to give your teeth extra protection, such as a toothpaste with extra fluoride, a fluoride rinse, or a fluoride varnish.

Your doctor, pharmacist, and dentist can all recommend healthy ways for coping with dry mouth that protect your teeth, including:

• Drinking extra water. Sipping fluoridated water throughout the day can help reduce dry mouth and better protect your teeth at the same time.
• Chewing sugarless gums or mints, especially those with xylitol. Xylitol is a natural sweetener found in many gums and mints that protects teeth from decay.
• Using a saliva substitute. These are available in most pharmacies. They help moisten your mouth, reduce bacteria, and make you more comfortable.

People with dry mouth should avoid:

• Candy, cough drops and drinks high in sugar
• Drinks with caffeine or alcohol
• Carbonated and citrus drinks—even diet sodas can damage your teeth
• Mouthwash with alcohol
• Overly salty or spicy foods
• Tobacco products

Proper management of dry mouth in partnership with your healthcare providers will help you continue to live well, enjoy life, and avoid painful and costly oral disease!

For more information on dry mouth, view the Washington Dental Service Foundation's brochure. Free print copies of the brochure are also available in bulk by contacting the Foundation at (206) 729-5570.

Dr. David Branch is a general dentist practicing in downtown Seattle.  Dr. Branch has served as a member of the Board of Trustees of Washington Dental Service Foundation since 2005.