DEAR DOCTOR K >> My mouth and throat are always very dry. As a result, I am constantly sipping water. It's annoying and uncomfortable. Is this normal? Is there anything I can do?
DEAR READER >> Dry mouth is not as common as dry eyes (something I have), but it's not uncommon. The medical term for dry mouth is xerostomia (pronounced ZE-ro-STOME-ee-uh), but I'll avoid doctor-speak and call it dry mouth.
Usually, dry mouth is mild enough to be an annoyance, as it is with you. However, severe cases can cause complications. Dry mouth can rob you of your sense of taste and can make chewing slow and swallowing difficult. Also, since saliva is important for dental health, dry mouth can contribute to tooth decay and periodontal disease.
The first step in dealing with dry mouth is to be sure you're well-hydrated, as you are. At night, do you breathe dry air through your mouth because your nose is congested? If so, nasal decongestants may help restore nose breathing. Also, a bedroom humidifier can add moisture to the air you breathe.
Quite a number of medications can cause dry mouth as a side effect. That's particularly true of medicines that have what's called "anticholinergic" effects, which cut the production of saliva. Commonly used medicines with such effects include antihistamines, tricyclic antidepressants, antispasmodics, and certain drugs used for Parkinson's disease, overactive bladder and chronic bronchitis. Take an inventory of your medications. If you round up a few suspects, discuss them with your doctor.
Some medical conditions can cause a dry mouth. Your doctor should check for an oral yeast infection (thrush) and for problems that affect the salivary glands themselves, such as Sjogren's syndrome.
Even if you can't correct the underlying cause of your dry mouth, you can do things to make your mouth less dry. Chew sugarless gum or suck on sugarless candy to stimulate the flow of saliva. Avoid dry or very spicy foods. Drink plenty of water, but steer clear of alcoholic and caffeinated beverages, as they tend to reduce saliva. And don't forget regular dental care: Untreated disease of the gums can cause dry mouth.
Finally, try using artificial saliva products. These are available over-the-counter as sprays, swabs and solutions. Though not identical to natural saliva, artificial saliva can help moisten the tissues in your mouth and throat.
I mentioned once before in this column a memorable patient with a dry mouth. She was an 84-year-old woman whose daughter reported that she had started sucking on apricot pits all the time, something she had never done before. I figured out that it was because her mouth was very dry, and sucking on apricot pits helped produce saliva.
But why was her mouth so dry? It wasn't for the usual reasons that I've just mentioned. It was because she had developed diabetes. Her sugar level was so high, and she was so dehydrated, that I immediately hospitalized her. She almost died, but recovered and lived to be 99 years 4 months old.