The
brisk arid climate of winter affects many of us. It happens to be an
aggravating factor of what I call my dry fibro body. Our speech is affected,
our tongue sticks to the roof of our mouth, and we crave water as if we just
walked through the Mohave Desert.
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Despite
it being a common complaint among fibromyalgia patients, it’s not something
that’s often discussed in articles or online groups and forums, but it’s
frustrating, nonetheless.
In
this article, I want to review the consequences of chronic dry mouth, in
particular. We will consider possible causes, its relationship to fibromyalgia,
the effects on our gastrointestinal tract, and ways to manage it.
What Is Dry
Mouth?
Chronic
dry mouth, xerostomia (pronounced zero-stO-mEa), is the result of insufficient
saliva secretion. This is important because saliva washes away food debris,
buffers digestive acids that can cause tooth decay, reduces the formation of
plaque, and begins the digestive process.
In
2002, one
study reported that salivary gland dysfunction could be exacerbated by
several factors, including medications, autoimmune diseases, cancer of the head
or neck, neurological conditions, hormonal fluctuations and more. Additionally,
a 2018
study provides insights into the mechanisms by which saliva acts as
protector and how it relates to taste, chewing, formation of food blockages in
the esophagus, enzymatic digestion and swallowing.
Those
of us who live with fibromyalgia
symptoms should be on the lookout for conditions that can aggravate chronic
dry mouth.
Causes Of Dry
Mouth
Let’s
take a more in-depth look at the myriad of things can act as causes of dry
mouth, such as:
- Mouth
breathing
- Poor
diet
- Dehydration
- Chemotherapy
- Radiation
- Central
and peripheral nerve damage that affects salivary glands
- Small
fiber neuropathy
- Removal
of salivary glands (such as seen in oral cancer)
- Medication
side effects
- Medical
conditions like Sjögren’s, thyroid disease, diabetes, and Lupus)
Furthermore,
chronic dry mouth is also one symptom of Sicca syndrome. Sicca is collection of
symptoms characterized by unusually dry eyes, mouth, throat, nose, and other
mucous membranes. Sicca symptoms are commonly associated with the autoimmune
disease called Sjögren’s. Some people interchange the two, and others see Sicca
syndrome and Sjögren’s Syndrome quite differently. My own rheumatologist sees
Sicca as Sjögren’s without the presence of tissue specific antibodies.
Herein
lays the connection between dry mouth and fibromyalgia. In another 2018 study, researchers
concluded about 1/3 of fibromyalgia patients tested positive for
Sjögren’s-related biomarkers. Plus, the majority of the testing population had
the presence of other autoimmune antibodies, lending further credence to the
idea that autoimmunity and fibromyalgia are connected.
The Consequences
Of Dry Mouth
Chronically
thick and stringy saliva, a horse or dry throat, a tongue that is grooved or
coated white, or sticky surfaces in the mouth suggests the presence of chronic
dry mouth. This can contribute to:
- Difficulty
speaking
- Difficulty
chewing, swallowing, and tasting
- Insufficient
digestive enzyme production
- Increased
risk of bacterial and fungal infections (which can travel out of the mouth into
the body’s circulation)
- Burning
mouth syndrome
- Bad
breath
- Mouth
sores
- Dental
cavities
- Gum
disease
- Malabsorption
of nutrients
- Gastrointestinal
dysfunction
If
left untreated or unmanaged, complications related to dry mouth can affect our
overall health.
Things We Can Do
To Help Chronic Dry Mouth
One
of the first things I learned in nursing school was the importance of oral
care. Keeping a patient’s mouth moist with glycerine swabs and treating their
lips with oral moisturizers is a significant nursing intervention to maintain
oral health as well as the health of the body. Other things we can do include:
- Address
lifestyle issues, such as stress, diet,
tobacco use.
- Consider
contributing factors, such as sleep apnea or other airway obstructions (i.e.
deviated septum), teeth grinding, TMJ, etc.
- Practice
good oral hygiene as recommended by the American
Dental Association. Brush teeth twice a day with fluoride toothpaste, clean
between teeth daily, limit sugary beverages and snacks, see a dentist
regularly.
- Avoid
overuse of caffeine, carbonated beverages, and alcohol, which are dehydrating.
- Avoid
sugar.
- Sip
on water frequently.
- Rinse
mouth frequently.
- Don’t
use mouthwash that contains alcohol.
- Use
oral lubricants and saliva substitutes.
- Suck
on sugar-free hard candy or chew sugar-free gum to stimulate saliva production.
(Discuss these options with your dentist.)
- Use
a humidifier.
- Talk
to your dentist about a mouthwash that increases saliva.
- Talk
with your doctor or pharmacist about medication side effects. (i.e.,
antihistamines or other medication used in fibromyalgia
treatments).
- Talk
with your doctor about prescription medications that can increase saliva
production.
Chronic
dry mouth is complicated; it’s far more than having periodic cotton mouth. And, while we may not always know what causes
it, there are things we can do to minimize the effects, and in the process,
have an effect on our overall health.
Granot, M. & Nagler, R.M. (2005). Association between regional idiopathic neuropathy and salivary involvement as the possible mechanism for oral sensory complaints. Journal of Pain, 6(9):581-7.
Mavragani, C.P., Skopouli F.N.,and Moutsopoulos, H.M. (2009). Increased prevalence of antibodies to thyroid peroxidase in dry eyes and mouth syndrome or sicca asthenia polyalgia syndrome. Journal of Rheumatology, 36(8):1626-30. https://www.ncbi.nlm.nih.gov/pubmed/19605678
Pedersen, A.M. , Bardow A., Beier Jensen, S., Nauntofte, B. (2002). Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Diseases, 8(3):117-29.
Pedersen, A., Sørensen, C.E., Proctor, G.B., Carpenter, G.H. (2018). Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. Oral Diseases, (8):1399-1416. doi: 10.1111/odi.12867. Epub 2018 Jun 7.
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You
can read more of the articles I have written for ProHealth, here. Take
a look around. ProHealth is dedicated to providing helpful information on
fibromyalgia, and more.
In healing,
Think adversity?-See opportunity!
~ • ~ • ~ • ~ • ~ • ~
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