Healthy Geezer: Bad breath can indicate dry mouth


Q I seem to have bad breath a lot. I’ve also noticed that my mouth is a bit dry most of the time. Could these two things be related?

A Definitely. Bad breath is often a symptom of dry mouth, a lack of saliva. The medical term for this condition is “xerostomia.”

Other symptoms of this problem are: saliva that seems thick, sores or split skin at the corners of your mouth, difficulty speaking and swallowing, a change in your sense of taste, increased plaque, tooth decay and gum disease.

Everyone experiences dry mouth occasionally. We get it when we are under stress. But if you have dry mouth all or most of the time, you need medical help.

Most xerostomia is related to the medications taken by older adults rather than to the effects of aging. More than 400 medicines can affect the salivary glands. These include drugs for urinary incontinence, allergies, high blood pressure, depression, diarrhea and Parkinson’s disease. Also, some over-the-counter medications often cause dry mouth.

Dry mouth can also be caused by cancer treatments such as chemotherapy and radiation, nerve damage in the head or neck, the autoimmune disease Sjögren’s syndrome, endocrine disorders, Alzheimer’s disease, stroke, anxiety disorders and depression.

Sjögren’s syndrome can occur either by itself or with another autoimmune disease such as rheumatoid arthritis or lupus. Salivary and tear glands are the major targets of the syndrome. The result of the syndrome is a decrease in production of saliva and tears.

The disorder can occur at any age, but the average person with the disorder at the Sjögren’s Syndrome Clinic of the National Institute of Dental and Cranio­facial Research is in his or her late 50s. Women with the disorder outnumber men 9 to 1.

In addition, tobacco, alcohol (in beverages and mouthwash), drinks with caffeine, snoring and breathing with your mouth open can aggravate dry mouth.

If you think you have dry mouth, go to your doctor or dentist. Your doctor may adjust your medication that is suspected of causing the problem. Or, your doctor may prescribe a medication to stimulate saliva production.

There are other ways to improve saliva flow. Try sugar-free hard candy or chewing gum. Avoid lemon-flavored hard candy, because it makes saliva acidic, increasing the possibility of tooth decay. You can also sip water regularly, try over-the-counter saliva substitutes, avoid breathing through your mouth, and use a humidifier in your bedroom.

If you have dry mouth, you have to pay greater attention to your teeth. Brush your teeth with an extra-soft toothbrush after every meal and at bedtime. If brushing hurts, soften the bristles in warm water. Floss your teeth gently every day. Always use toothpaste with fluoride in it. If you have a sweet snack, brush right away.

If you have a question, please write to fred@healthygeezer.com. All Rights Reserved © 2009 by Fred Cicetti.

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