Dry Mouth Linked to Prescription and OTC Drugs

A new study reports that a majority of dentists say patients complaining about dry mouth are taking multiple medications.

Researchers affiliated with the U.S. Academy of General Dentistry (AGD; Chicago, IL, USA) reported the findings of a nationwide member survey involving nearly 500 general dentists who responded to a questionnaire. The study reported that 89% of the dentists believe prescription medications are the primary contributor to dry mouth; aging, dehydration, and salivary gland disease were also cited as major contributors. The survey also revealed that approximately two-thirds of the dentists considered dry mouth to be a very serious condition, due to the promotion of tooth decay; 68% said constant thirst is the most common symptom communicated by patients; and 44% said patients have difficulty eating, swallowing, or speaking. According to the survey, more than 92% reported that patients attempt to increase salivary production by drinking water; less than 58% said patients try taking over-the-counter saliva substitutes, chewing sugar free gum, or sucking on hard candy; and more than 60% of those surveyed consider diagnosing a patient with xerostomia after he or she exhibits or reports symptoms of dry mouth.

As indicated by the AGD survey, the most common symptoms reported by patients include constant thirst and difficulty eating, swallowing, or speaking. Foamy or stringy saliva, irritation of the tongue, burning of the tissues inside the mouth, painful ulcerations, and dentin hypersensitivity (extreme sensitivity in one or more teeth) are also dry mouth symptoms. Over time, xerostomia sufferers may experience extensive tooth decay, tooth loss, or gingivitis due to the lack of saliva. The results of the survey were presented at the AGD 57th annual meeting and exhibit, held during July 2009 in Baltimore (MD, USA).

"The number of xerostomia cases has increased greatly over time because people are taking more and more medications,” said Cindy Kleiman, R.D.H, who presented the survey results. "General dentists are seeing this trend in their offices, which is why they are trying to learn all they can about this condition. The more they know, the better they will be at diagnosing and treating patients.”

Xerostomia, sometimes colloquially called pasties or cottonmouth, can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva in remineralizing the enamel is no longer present, and the mucosa and periodontal tissue of the mouth become more vulnerable to infection. Over 500 medications can cause xerostomia, including antidepressants, painkillers, diuretics, antihistamines, and tranquilizers.

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U.S. Academy of General Dentistry