Dry mouth, also called xerostomia, is the condition of not having enough saliva to keep the mouth wet.  Without enough saliva, chewing, eating, swallowing and even talking can be difficult.  Dry mouth also increases the risk for tooth decay because saliva helps keep harmful germs that cause tooth decay and other oral infections in check. Saliva also contains minerals (calcium and phosphate) that can help reverse early decay.  If you have dentures, dry mouth can make them uncomfortable and they may not fit as well.  Without enough saliva, dentures can also rub against the gums and cause sore spots.  It’s important to know that dry mouth is not part of the aging process itself.  However, many older adults take medications that can dry out the mouth. We take a look at what medications cause dry mouth for the older population and how it effects their oral health.

What causes dry mouth and why is it an issue?

Sometimes, a dry mouth is simply the result of not drinking enough water during the day or re-hydrating after strenuous exercise. Temporary dry mouth can also come from stress or nerves, like the kind you may experience before speaking in front of a large group of people. More often, however, dry mouth is a side effect of medication. Dry mouth also raises your risk of gingivitis (gum disease), tooth decay, and mouth infections, such as thrush. Saliva in our mouths helps to wash away food debris and reduce plaque. As such, dry mouth can lead to severe tooth decay and gum disease if left untreated. In fact, 30 percent of all tooth decay in older adults is caused by dry mouth, according to the Oral Cancer Foundation

What are the most common medications that cause dry mouth?

It is estimated that there are over 1,800prescription and nonprescription medications that cause dry mouth, including drugs used to treat depression, anxiety, pain, allergies, and colds (antihistamines and decongestants), obesity, acne, epilepsy, hypertension (diuretics), diarrhea, nausea, psychotic disorders, urinary incontinence, asthma (certain bronchodilators), and Parkinson’s disease. Dry mouth can also be a side effect of muscle relaxants and sedatives. Here are some of the most common medications that have dry mouth as a side effect:

  • Atropine and scopolamine: Atropine and scopolamine can most commonly be used to treat spasms of the gastrointestinal tract, the bladder and the biliary tract. This is helpful for

controlling conditions such as colitis, spastic bladder, diverticulitis, colic in infants, renal and biliary colic, peptic ulcers, motion sickness, nausea and irritable bowel syndrome (IBS).

  • Antidepressants: Antidepressants are drugs used for the treatment of major depressive disorders, as well as other conditions including dysthymia, anxiety disorders, obsessive compulsive disorders (OCD), eating disorders, chronic pain, neuropathic pain and, in some cases, dysmenorrhea, snoring, migraines, attention-deficit hyperactivity disorder (ADHD) substance abuse and sleep disorders.
  • Antihypertensives: Antihypertensives are a class of drugs that are most commonly used to reduce the blood pressure of high blood pressure patients.
  • Antihistamines: Antihistamines are used to treat a plethora of conditions including allergies, eczema, to relieve itching from illnesses such as chicken pox, hives, and for some forms of motion sickness.
  • Anti-reflux drugs: Anti-reflux drugs – particularly proton pump inhibitors (PPIs) – are most commonly used to treat peptic ulcer disease as a way to reduce irritation of the stomach lining, allowing the ulcer to heal.
  • Opioid Drugs: Opioid drugs are most commonly used to treat moderate to severe pain.
  • Cannabinoids: Cannabinoids are most commonly used to treat neuropathic pain and spasticity, Multiple Sclerosis, advanced cancer pain and nausea/vomiting, as an appetite stimulant, as neuroprotective agent to protect the brain from damage following cardiac surgery, to regain memory and other high-level functions following Traumatic Brain Injuries, as an anti-inflammatory to help relieve pain from arthritis, for bladder control and hypertension.
  • Cytotoxic drugs: Cytotoxic drugs are most commonly used in the treatment of several forms of arthritis and other conditions, including: systematic lupus erythematosus, steroid-resistant polymyositis or dermatomyositis, Wegener’s granulomatosis, and some forms of vasculitis. They also have the ability to treat malignancies by directly killing tumor cells.
  • Retinoids: While retinoids are best known for their uses in dermatology (acne, psoriasis, and photoaging), they may also be used in the treatment of acute promyelocytic leukemia.
  • Bupropion: Bupropion is most commonly used in the treatment of depression or season affective disorder (SAD). However, it may also be used to treat attention deficit hyperactivity disorder (ADHD), in combination with bipolar medication, or to help people quit smoking by decreasing cravings and withdrawals effects.
  • Diuretics: Diuretics may be used to treat a number of heart-related conditions, including high blood pressure, heart failure, diabetes, edema, some types of kidney and liver problems, and glaucoma.
  • Benzodiazepines: Benzodiazepines are most commonly used to treat epilepsy, panic disorders (anxiety), or to help control certain manic symptoms in bipolar disorder such as mania, insomnia, and seizures.

How is dry mouth treated?

If you think your dry mouth is caused by certain medication you’re taking, talk to your doctor. The doctor may adjust the dose you’re taking or switch you to a different drug that doesn’t cause dry mouth.

The doctor may also prescribe an oral rinse to restore mouth moisture. If that doesn’t help, he or she may prescribe a medication that boosts saliva production called Salagen.

You can also try these other steps, which may help improve saliva flow:

  • Suck on sugar-free candy or chew sugar-free gum.
  • Drink plenty of water to help keep your mouth moist.
  • Brush with a fluoride toothpaste, use a fluoride rinse, and visit your dentist regularly.
  • Breathe through your nose, not your mouth, as much as possible.
  • Use a room vaporizer to add moisture to the bedroom air.
  • Use an over-the-counter artificial saliva substitute.

 

If you have any questions about medication and dry mouth, call Winning Smiles to schedule an appointment with your dentist – 716-332-2444.