How important is saliva?

Keith is an active 88-year-old former college basketball player and retired physical education teacher. "When I started getting up 3-4 times a night to go to the bathroom, my urologist started me on this medicine."

He showed me a sample bottle of Vesicare® (Solifenacin), a drug marketed for overactive bladder. "I was on the 5mg tablets at first, but I didn't notice any difference, so the Doc upped it to 10mg tablets." "Are those working any better?" "I noticed some difference for the first couple of days, but now I can’t tell any difference." "Any problems or side effects from it?" "What do you mean?"

"Keith, does your mouth feel dry since you started taking it?"

"Now that you mention it, yes. I want to drink more water, but I have to go to the bathroom more often whenever I do that. I’ve tried sucking on lemon drops, and that helps some."

It's estimated that over 30% of people older than 65 years have some degree of dry mouth. While healthy people can make up to 1.5 liters of saliva every 24 hours, people suffering from dry mouth, called xerostomia, make much less. 

Your salivary glands are responsible for secreting saliva. They can be damaged by radiation to the head and neck for cancer treatment or impaired by autoimmune diseases like Sjogren's, rheumatoid arthritis, or lupus. And like Keith experienced, some medicines can decrease tear production, saliva secretion, or both.  Saliva is vital for a healthy mouth. June is Oral Health Month, a collaboration between the American Dental Association and the Colgate company. Their goal is encouraging people to maintain healthy habits that protect their teeth, like brushing, flossing, and seeing a dentist regularly for cleaning and fixing cavities.

Moisture from your saliva helps you chew food and swallow it without choking and helps you enjoy your food more by spreading it over your taste buds.

Saliva also protects the lining of your mouth and teeth from injury and infection, helps prevent food particles from sticking to your teeth, and contains essential antibacterial compounds that prevent tooth decay and gum disease.

Dry mouth symptoms like Keith experienced are not just a nuisance. Without enough saliva, the lining of your mouth will become more easily damaged as your usually moist tissue dries out. Food will stick to your teeth and tongue without saliva's moisture, dramatically increasing plaque formation, tooth decay, and gum inflammation.

When your gums get too dry, they tend to shrink and become more sensitive. This can significantly affect the fit and comfort of dentures. The dryness in your mouth often makes you want to drink more fluids. When Keith drank more water to relieve his dry mouth, he urinated more frequently, which cancelled out his goal of needing fewer trips to the bathroom when taking his Vesicare.

Mouth dryness can sneak up on you and create serious dental problems before you realize it. Keith’s habit of sucking on lemon drops adds to his risk of having more cavities and inflamed gums because he has less saliva to help rinse the sugar out of his mouth.

Here are 6 Tips on Dealing with Dry Mouth:

1.Ask your doctor or pharmacist.

One common reason for dry mouth is that it is a side effect of a medicine. Ask your doctor or pharmacist if any of your medications could be causing your dry mouth. Keith ended up switching drugs, which really improved his frequent urination symptoms.

2. Avoid chewing or smoking tobacco.

The nicotine in tobacco can interfere with saliva production.

3.Avoid chewing gum or hard candy sweetened with sugar.

Sugar encourages bacteria in your mouth to produce more acid, which attacks your teeth and gums. Switching to a sugar-free gum or mint containing xylitol will decrease your risk of caries.

4.Take extra good care of your teeth.

Brush and floss twice a day with a very soft toothbrush to reduce damage to your mouth. See your dentist regularly for cleanings and follow-ups.

5.Try an over-the-counter saliva substitute.

Saliva substitutes come as sprays, gels, and even small discs that you stick inside your mouth where baseball players put chewing tobacco. Over 80% of my pharmacist colleagues recommend Biotene® dry mouth relief spray and Biotene® Oral Balance clear gel.

6.Ask your dentist or doctor for a prescription-only saliva stimulant.

If non-prescription products don’t help, ask your doctor or dentist for pilocarpine drops. These are eye drops you put in your mouth just before eating to directly stimulate your salivary glands.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog,  ©2022 Louise Achey




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