To describe what the patient refers to as “dry mouth,” doctors prefer to use xerostomia or dry mouth. In this article, we will give you a complete guide about dry mouth at night. This deficit can alter the normal taste of food, make speech difficult and predispose to dental caries. In fact, saliva can buffer the acidity of the mouth and contains some antimicrobial substances.
The dry mouth can also make swallowing difficult. Simultaneously, the digestive processes do not suffer particular negative consequences (the lack of salivary amylase intervention is amply compensated by the pancreatic one). In addition to the oral mucous membranes dryness, the patient may complain of sore throat, chapped lips, continuous thirst, difficulty speaking, bad breath, gum disease, and fungal infections of the mouth (see oral candidiasis or thrush ).
Dry mouth at night: Causes
Having a dry mouth at night from time to time is a completely normal phenomenon, often the result of slight dehydration caused by too much sweat, insufficient fluid intake, or excessive ingestion of alcohol or salty foods. Remember that the salivary glands produce and secrete about one litre / one and a half litres of saliva per day under normal conditions.
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In addition to food, dry mouth can have iatrogenic origins, i.e., linked to certain medicines’ intake. The list of offending drugs is quite long. It includes in particular pharmaceutical products used for the treatment of depression, anxiety, Parkinson’s disease, obesity ( sibutramine, phendimetrazine, amphetamine derivatives), urinary incontinence, and cancer ( chemotherapy ), but also narcotics, antihistamines – decongestants, antihypertensives (diuretics), antidiarrheals and muscle relaxants.
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Smoking and Narcotic
The tobacco (smoked or chewed), l ‘ exercise carried out breathing through his mouth and speaking or singing for too long, can aggravate the feeling of dry mouth at night. In other cases, dryness can be caused by drug abuse, such as marijuana, cocaine, ephedrine, amphetamines, or alcohol (which has a dehydrating effect on the body).
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Diseases and Disorders
A nasal obstruction ( septal deviations, allergic rhinitis, nasal polyposis, etc.), which forces the patient to breathe through the mouth, can make it parched like the conditions listed above. The disease-causing dry mouth stands the Sjogren’s syndrome, followed by the Municipality diabetes and what insipid, the mumps ( mumps ), from cystic fibrosis and psychological disorders ( depression and anxiety).
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When dry mouth is accompanied by excessive sweating and pronounced thinness, it can indicate a thyroid disease called hyperthyroidism. Dry mouth can also be caused by injury to the salivary glands, such as head trauma, surgery, or localized radiotherapy to the neck and head (in which case the injury may be irreversible).
For the diagnosis of xerostomia, the doctor or dentist carefully examines the patient’s medical history and symptoms; a careful inspection of the oral cavity and palpation of the neck and cheeks – possibly associated with blood tests or imaging techniques (diagnostic imaging) – may help him identify the origins of the problem. At home, dry mouth at night can be “diagnosed” by ingesting crackers or dry rice: if you have difficulty chewing or swallowing, the test is considered “positive.”
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The treatment of xerostomia is personalized about the causes of origin. For example, the doctor may decide to discontinue certain medicines and replace them with others. Oral rinses with special mouthwashes, application of artificial humectants in spray (Xerotin, Secriva), capable of mimicking the effect of saliva (beneficial before meals), and the adoption of other palliative measures considered secretory-stimulants (chewing gum or sugared almonds, strictly sugar-free ), represent a generalized intervention strategy.
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For his part, the patient must maintain adequate oral hygiene and correct any so-called bad habits, abolishing smoking, trying to breathe with the nose instead of the mouth, increasing the intake of liquids, and humidifying the rooms in which it stays. When the salivary glands are healthy, dry mouth treatment can use special sialagogue drugs, such as anetholtrithione (Sulfarlem) and pilocarpine (Salagen) increase the flow of saliva.
Dry mouth at night and day
Having a dry mouth is a rather common problem that, if at first glance it may seem little more than a nuisance, in reality, it can go so far as to prevent you from tasting what you eat and can negatively affect the health of the teeth.
The medical term for dry mouth is xerostomia.
Dry mouth is the feeling that there is not enough saliva in the mouth, and we all suffer from it from time to time, for example, when
- we are nervous.
- In a bad mood.
- Or very stressed.
However, having a dry mouth can be particularly annoying and cause health problems, sometimes even severe ones.
The disorder occurs when the salivary glands do not produce enough saliva, often due to dehydration, but also in the case of:
- stress and anxiety.
- Taking certain medications.
- Congested nose.
- Sjogren’s syndrome.
If saliva production is reduced or interrupted, dry mouth at night can cause problems because saliva counteracts the formation of cavities: saliva, in fact, limits the proliferation of bacteria and washes away food particles, but it also serves to improve the sense of taste and to facilitate swallowing. Finally, the enzymes contained in saliva are essential for digestion.
Treatment of xerostomia depends on the cause of the problem, but dry mouth is often a side effect of medications; in these cases, there is a complete regression of symptoms by modifying the dosage or changing medication.
Dry mouth at night: Causes
Xerostomia has several causes, including:
Medicines. More than 400 drugs can have xerostomia as a side effect. Among the drugs most likely to cause dry mouth are:
- The antidepressants and anxiolytics.
- The antihistamines.
- Antihypertensives, including diuretics.
- The antidiarrheals.
- Muscle relaxants.
- Urinary incontinence medications.
- Drugs for Parkinson’s disease.
Congested nose. Breathing through your mouth while you sleep can cause a decrease in oral lubrication. Also, snoring may contribute to the problem.
Chemotherapy. I chemotherapy may alter the composition and the amount of saliva produced, causing dry mouth.
Radiotherapy. The radiotherapy to the head and neck may cause damage to the salivary glands, causing a substantial decrease in saliva production.
Injuries to the nerves. An injury or surgery that causes nerve damage to the head and neck is also capable of causing xerostomia.
Other pathologies. Dry mouth can be caused by certain conditions (or therapies), such as Sjögren’s syndrome, HIV, and diabetes.
Aging is not per se a direct cause of dry mouth, but older people tend to be more prone to it.
- They are more likely to take drugs that can cause xerostomia problems.
- They are at greater risk of suffering from health problems that can cause dry mouth (type 2 diabetes).
- The smoke can also worsen symptoms.
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Dry mouth at night and/or in the morning
In addition to the causes already seen, if the problem is perceived above all during the night or in the morning, upon awakening, one of the possible reasons is the possible presence of nasal obstruction, a condition that forces the patient to breathe only through the mouth; it is obviously a disorder that can be occasional, for example, related to a cold or a seasonal allergy, or chronic, as in the case of nasal polyposis, allergy to dust, hypertrophic adenoids, deviated nasal septum, chronic sinusitis, In these very often the symptom is accompanied by snoring.
Among other possible causes, we also remember
- the use of bites or orthodontic appliances.
- Use of a CPAP mask for the treatment of obstructive sleep apnea.
- The presence of arid air can contribute to this situation by making the problem worse.
The specific symptoms related to nocturnal oral dryness are:
- frequent awakenings in search of water.
- Waking up in the morning with dry lips, tongue, and mouth.
- Sore throat.
- Bad breath.
In these cases, in addition to resolving the root cause of the disorder when possible, the use of a humidifier is certainly useful.
Typical symptoms of dry mouth are:
- the feeling of a dry and sticky mouth.
- Problems with chewing, swallowing, tasting.
- Insensitivity to food tastes.
- Difficulty speaking.
- Burning sensation in the mouth.
- The feeling of dryness in the throat.
- Cracked lips.
- Dry and rough tongue.
- Ulcers in the mouth.
- Predisposition to the development of infections in the mouth and lips.
- Bad breath.
- Increase in plaque and caries.
- Saliva is responsible for more than just keeping your mouth moist. It also helps.
- Protection of the teeth from the attack of bacteria.
- Protection of the oral cavity from the development of thrush.
- Chewing and swallowing process.
When to call the doctor
When the symptoms of dry mouth persist over time, it is essential to report it to the doctor to investigate the causes to understand if the disorder is due to pathology.
To understand if you suffer from xerostomia, the doctor or dentist will examine your mouth and formulate an accurate medical history (state of health, drugs are taken, medical history).
In some cases, it may be necessary to diagnose the cause of the problem
- blood tests,
- salivary gland imaging exams,
- measurement of the amount of saliva produced.
Treatment and therapy
Treatment of the disorder is closely related to the cause, and, for this reason, an accurate diagnosis is essential:
- If a drug causes the disorder, the dosage or therapy will be changed whenever possible, looking for an approach that does not cause the reduction of saliva production.
- If you have diabetes, you will likely need better glycemic control through insulin and/or oral medications.
- So if the salivary glands are still able to produce saliva, it may be advised to resort to pilocarpine or cevimeline (not on the market in Italy), stimulating saliva production.
- It may be useful to use a saliva substitute (usually a gel, which can be purchased at the pharmacy).
- It is essential to maintain good oral hygiene, reduce the risk of dental problems, and schedule periodic check-ups at the dentist.
Lifestyle and practical remedies
If your doctor fails to diagnose or fix the cause of the disorder, or when a reduction in symptoms is not possible, the following tips can help relieve the discomfort caused by xerostomia and keep your teeth healthy.
- Drinking water or sugar-free drinks with meals will facilitate chewing and swallowing while also increasing taste perception.
- Avoid spicy or salty foods that can hurt your mouth if you already have a dry mouth.
- Chewing gum or sugarless candy can help stimulate saliva production.
- Reduce your caffeine intake, which can make your mouth very dry. Therefore, avoid drinks that contain it, such as coffee, tea, and some types of carbonated drinks.
- Reduce alcohol intake, which causes irritation and dehydration.
- Stop smoking.
- Frequently drink a few sips of water or hold an ice cube in your mouth to hydrate your mouth. Drinking a lot during the day will reduce the risk of dehydration.
- Try saliva substitutes for sale without a prescription.
- Avoid over-the-counter medications that can make the problem worse, such as antihistamines (drugs used to control allergies ) and decongestants (drugs used for colds and allergies).
- Breathe with your nose instead of your mouth.
- At night, use the humidifier in the room where you rest.
If you suffer from a dry mouth, you will need to pay particular attention to your teeth’ health. For example, it is recommended to:
- Avoid sugary or acidic foods, as they promote tooth decay.
- Gently brush your teeth at least twice a day (it would be preferable after each meal).
- Floss every day,
- Use fluoride-based toothpaste with help from the dentist.
- Use a fluoride-based mouthwash or fluoride-based gel before bed, but they must be alcohol-free to keep your mouth from drying out.
Acupuncture is an alternative medicine involving tiny needles in different body points, depending on the disorder’s area. However, there is currently no certain evidence of its effectiveness. When practised by competent health personnel, there are generally no contraindications to try. Any other alternative approaches to relieve the discomfort caused by dry mouth are always evaluated first with the doctor.
What to do in case of a dry mouth?
To give a handy answer, it is necessary to understand why a dry mouth problem occurs because only based on the cause can you act in a targeted way. From a very general point of view you can try to:
- frequently drink, keeping water available even at night,
- melt ice cubes in your mouth
- chewing sugar-free gum
- avoid alcohol and caffeine
- avoid acidic foods (such as citrus fruits and tomatoes), salty, spicy, too sweet
- not smoking.
What does dry mouth depend on?
The possible causes are numerous, but the most common are:
- dehydration (when not drinking enough).
- Medications (including prevalent ones, such as antihistamines and diuretics).
- Breathing through the mouth at night (possible reasons are particularly numerous).
The cause is less commonly found in an underlying disease, such as diabetes or Stogner’s syndrome.