Dry Mouth

[nohorn]

I am in my early 70's. Suddenly each night my mouth becomes very dry, because my mouth hangs open when I sleep. I have to drink waters several times a night which wakes me up.

This does not happen in the daytime. Everything I have tried does not help. (Biotene products, etc.) Any suggestions where I can increase my saliva production?

[theprof]

I think I may be able to give you some advice nohorn but first of all, if you'll bear with me, I'd like to check if your lifestyle may be contributing to the problem.

First of all, do you suffer from high blood pressure? If so, are you taking diuretics? These can contribute towards a dry mouth in a big way and if you are taking them, it may be worth having a chat with your GP to see if a different type may suit you better.

The next thing I'd suggest you do is to avoid tea and coffee as both of these can cause a type of diuresis that shows itself in the form of a dry mouth. Try cutting them out in the late afternoon and/or evening to see if it makes a difference.

Are you taking any anticholinergic drugs? These are renowned to cause the symptoms you describe. A typical example is ipratropium bromide used to treat COPD and similar conditions. Opioid analgesics and cardiac drugs such as Clonidine can also do it. Also avoid any mouthwashes containing alcohol.

If this xerostomia occurred in the daytime as well, I'd suggest you need to avoid mouth breathing at all costs. I do appreciate that this is impossible while your asleep. All the same, the salivary glands do atrophy as we get older and it's not unusual for people to have to drink water during the night, so what you're describing is not that unusual.

(continued)

[theprof]

Forget Biotene products. The therapy is based upon dubious biochemical concepts, which as a biochemist I can tell you are without any real, provable foundation. The theory hold water but that's about it.

There is a substance called Pilocarpine which could help you. The problem is that normally it's only used as a treatment alongside chemotherapy for head/neck cancer in patients. Doctors and dentists are a bit reluctant to prescribe it for other patients mainly because it has quite a few unwanted side-effects which could be unpleasant. These include wheezing, slowing of the heart rate, sweating, dizzinesss and increased urination. These side effects are caused because Pilocarpine acts on many different systems in the body. It shouldn't be prescribed for those with asthma, COPD or people with peptic ulcers.

All the same, if this is really intolerable, I'd suggest you pop along to your GP and discuss the merits of Pilocarpine with him or her.

Another thing you could try is to suck lemon drops or lemon sherbets late in the evening. These should stimulate saliva production as they are sour. I used them myself some years ago when I had similar symptoms after having all four wisdom teeth extracted in hospital.

[theprof]

Incidentally my temporary xerostomia was due not only to the wisdom teeth extraction but also because of bilateral parotitis which I've suffered from since catching mumps in my thirties.

[Clanad]

I could only add that a friend experienced the same symptoms. A physician here in the U.S. suggested he try a fitted mouthpiece that's usually worn at night by those that suffer from snoring. His drymouth condition ended abruptly the first night. Seems the unconcious effort to keep the device in his mouth results in keeping his mouth closed.
These devices, somewhat like a mouth guard worn by athletes, can be expensive if prescribed by a doctor... however, they are very reasonable when purchased over the counter and appear to be the same in construcyion... Can't hurt, no?

[theprof]

Clanad, you're absolutely right. I'd be the first to agree that the device you describe might well help nohorn enormously.

As you say, it can't hurt.

Your input is much appreciated.

[nohorn]

Thank you "the prof" and "clanad" for the thoughtful answers. It does give me some insight on what to do.
nohorn