The Tribune

By DR ANDRE CLARKE

SALIVA is very important to us and impacts the mouth’s health greatly. It is made in salivary glands; some large (major) and some small (minor). Some salivary glands make thick saliva and others watery saliva, and all the saliva comes together to make an ideal consistency.

Why do we need saliva? Saliva not only keeps the mouth wet, but helps digest food, protects teeth from decay and prevents mouth infection by controlling bacteria and fungi in the mouth. Saliva also makes it possible to taste, chew and swallow food. Additionally, an all too important function of saliva which must not be forgotten is its function in lubrication of the mouth and upper mouth airways.

To recap, the three paramount functions of saliva are: the digestion of food, the maintenance of tooth structure and the fighting off of mouth infections.

Saliva has enzymes (very small proteins that help with chemical reactions in the body) which aid in the digestion of food before it gets to the stomach for further digestion.

When the food is chewed and mixed with saliva, digestion starts.

The second function of saliva is to keep the teeth strong. Teeth are in a constantly shifting state. They shift between a liquid state and a solid state. The solid state usually predominates and that is when teeth are strong and hard. If the liquid state predominates instead, the teeth become weak and break apart easily. The minerals and nutrients in saliva are readily available to pass easily into the teeth and ensure that the surfaces of the teeth are strong and hard.

The third major role of saliva is fighting off infections with its complement of immune system proteins. Now, it is not hard to appreciate the importance of saliva.

The reduction of saliva or perceived reduction of saliva (dry mouth) can affect us all at any point. The scientific term for dry mouth is xerostomia. It is a very subjective complaint and may be the result of a real problem or the result of an imaginary (psychogenic) problem.

It is possible to have seasonal dry mouth and in such a case, it is usually associated with hay fever and the resultant antihistamine medication usage. A dry mouth can also be experienced by persons experiencing a fever and/or influenza. There are more serious and sinister reasons for a dry mouth, and they include the shrinkage of the salivary glands and the damage to blood vessels of the salivary glands (e.g. in the course of head and neck irradiation treatment).

All salivary glands are in the head and neck region and the major salivary glands, are in the front of the ears, under the angles of the lower jawbone and under the tongue. Apart from these major salivary glands, there are a number of minor salivary glands throughout the mouth cavity. It is therefore needless to say, that there is an excellent armament of salivary glands ready to stave off dry mouth.

It is worth noting that there usually needs to be a 50 per cent reduction in the production of saliva for an individual to notice mouth dryness. In many cases of dry mouth, however, this 50 per cent reduction in saliva production does not occur, instead there is a change in the consistency (a thickening) of the saliva thereby causing mouth dryness. This reduction in the volume of saliva, in combination with the thickening of saliva, lends to a very patient subjective nature of the dry mouth phenomenon.

There are many known distinctions which are mostly academic, but the patient’s woes are usually the same. The patient often complains of a sticky, dry feeling in the mouth; trouble chewing, swallowing, tasting and/or speaking; a burning feeling in the mouth; a dry feeling in the throat; cracked lips; a dry, rough tongue; mouth sores and maybe an infection in the mouth. Fortunately, the dental healthcare and medical healthcare provider can work together to determine the cause of the dry mouth and pursue a course of management that best suits the patient.

Common causes are drugs (e.g. medications (decongestants, antihypertensives, antidepressants and antipsychotics), alcohol, caffeine and tobacco); mouth breathing, anxiety, menstruation, menopause, head and neck irradiation; chemotherapy and systemic diseases, for example Parkinson’s disease, diabetes mellitus and Sjogren’s syndrome – an autoimmune (self-attacking) disease affecting the eyes and mouth.

After the cause is determined, the first step in treatment is to rectify the underlying cause or to adjust management of the cause with accommodation for any possible dry mouth side effects. Next, the practitioner insists that the patient avoids factors that may increase mouth dryness (dry foods, smoking, drinking and dry hot environments). Then, keeping the mouth as moist as possible, as often as possible, for example by using lip lubricants (water or lanolin based and not petroleum based) is suggested. If the symptom of dry mouth does not abate, the practitioner can and often does suggest saliva substitutes and gives medication to stimulate salivation.

Do not let dry mouth get you down. Visit your dental healthcare and/or medical healthcare provider and tell them your story. They have your best interest at heart and together you can fight that dusty and sandy mouth feeling. Quench your thirst!

• This article is for informational purposes only. It is not intended and may not be treated as a substitute for professional medical/dental advice, diagnosis or treatment. Always seek the advice of a physician or dental professional with any questions you may have regarding a medical/dental condition. Never disregard professional medical/dental advice or delay in seeking it because of a purely informational publication.