Dry Mouth

Complaints of dry mouth bedevil an enormous swath of the general population. Symptoms peak in excess of 50% among those over age 65, while dry mouth affects at least 20% of middle aged adults. Nighttime and mealtime elicit the worst manifestations of dry mouth. Depending on severity, lack of adequate saliva complicates chewing and swallowing, leads to bad breath from bacterial overgrowth, increases the risk of oral candidiasis and causes burning tongue and a metallic taste. Dry mouth predisposes to rampant dental caries especially involving the roots and crowns. Dry mouth or xerostomia represents a symptom that may or may not be accompanied by reduced output from the salivary glands. Under normal circumstances about 1.0-1.5 quarts of saliva are produced every day. Without the stimulation of eating or chewing saliva output averages 1 teaspoon every 12-14 minutes. Dry mouth generally indicates a flow rate of less that 1 teaspoon every hour. A large array of prescription and over-the-counter drugs predispose to dry mouth. Dry mouth appears unusually common during the nighttime hours since the glands either stop manufacturing saliva or generate less than 1 teaspoon an hour. Satisfactory therapy for dry mouth remains to be discovered.