Dry Mouth

What Causes Dry Mouth? How Can it be Treated?

Up Date: July 2012
We are sad to report that our company will no longer be selling the product: NeutraSal. We do want you to know about the product, as we do feel it is a quality pharmaceutical.

The following articel was posted/published first by: WebMD, December 30, 2009.

We all need saliva to moisten and cleanse our mouths and digest food. Saliva also prevents infection by controlling bacteria and fungi in the mouth. When we don't produce enough saliva, our mouth gets dry and uncomfortable. Fortunately, there are many effective treatments for dry mouth.

Featured patient discussions on dry mouth

"Sometimes I try to remember what it is like to have a normal mouth with saliva. That is not my present reality. I have dry mouth due to Sjögren's Syndrome. No matter how much I drink, my mouth always feels sticky and dry. When I wake up in the morning, I can barely swallow. I can no longer lick an envelope or spit (not that I was much of a spitter). The corners of my mouth often crack from dryness and my tongue hurts. I can't eat anything spicy or use any minty oral care products as they hurt my tongue. I use special toothpastes and other products for dry mouth but nothing really helps. I have difficulty talking unless I chew gum so I always carry it with me."

What Causes Dry Mouth?

There are several causes of dry mouth, also called xerostomia. These include:

Side effect of certain medications. Dry mouth is a common side effect of many prescription and nonprescription drugs, including drugs used to treat depression, anxiety, pain, allergies, and colds (antihistamines and decongestants), obesity, acne, epilepsy, hypertension (diuretics), diarrhea, nausea, psychotic disorders, urinary incontinence, asthma (certain bronchodilators), and Parkinson's disease. Dry mouth can also a side effect of muscle relaxants and sedatives.

Side effect of certain diseases and infections. Dry mouth can be a side effect of medical conditions, including Sjögren's syndrome, HIV/AIDS, Alzheimer's disease, diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, Parkinson's disease, stroke, and mumps.

Side effect of certain medical treatments. Damage to the salivary glands, the glands that produce saliva, for example, from radiation to the head and neck and chemotherapy treatments for cancer, can reduce the amount of saliva produced.

Nerve damage. Dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery.

Dehydration. Conditions that lead to dehydration, such as fever, excessive sweating, vomiting, diarrhea, blood loss, and burns can cause dry mouth.

Surgical removal of the salivary glands.

Lifestyle. Smoking or chewing tobacco can affect saliva production and aggravate dry mouth. Continuously breathing with your mouth open can also contribute to the problem.

What Are the Symptoms of Dry Mouth?

Common symptoms of dry mouth include:

A sticky, dry feeling in the mouth

Frequent thirst

Sores in the mouth; sores or split skin at the corners of the mouth; cracked lips

A dry feeling in the throat

A burning or tingling sensation in the mouth and especially on the tongue

A dry, red, raw tongue

Problems speaking or difficulty tasting, chewing, and swallowing

Hoarseness, dry nasal passages, sore throat

Bad breath

Why Is Dry Mouth a Problem?

Besides causing the aggravating symptoms mentioned above, dry mouth also increases a person's risk of gingivitis (gum disease), tooth decay, and mouth infections, such as thrush.
Dry mouth can also make it difficult to wear dentures.

Next: Why is dry mouth a problem?

How Is Dry Mouth Treated?

If you think your dry mouth is caused by certain medication you are taking, talk to your doctor. He or she may adjust the dose you are taking or switch you to a different drug that doesn't cause dry mouth.
In addition, an oral rinse to restore mouth moisture may be prescribed. If that doesn't help a medication that stimulates saliva production, called Salagen, may be prescribed.
Other steps you can take that may help improve saliva flow include:

Sucking on sugar-free candy or chewing sugar-free gum

Drinking plenty of water to help keep your mouth moist

Protecting your teeth by brushing with a fluoride toothpaste, using a fluoride rinse, and visiting your dentist regularly

Breathing through your nose, not your mouth, as much as possible

Using a room vaporizer to add moisture to the bedroom air

Using an over-the-counter artificial saliva substitute.

WebMD Medical Reference

Reviewed by Louise Chang, MD, on December 30, 2009

Last Editorial Review: 12/30/2009

WebMD NeutraSal Product Review Link

http://www.webmd.com/drugs/drug-153868-Neutrasal+MM.aspx?drugid=153868&drugname=Neutrasal+MM

About NeutraSal^®

What is NeutraSal^®?

NeutraSal^® (supersaturated calcium phosphate rinse) is a prescription mouth rinse. NeutraSal^® is indicated to treat the painful symptoms associated with oral mucositis. NeutraSal^® should be started at the beginning of cancer therapy including chemotherapy or radiation therapy.

NeutraSal® is packaged in single use packets of dissolving powder, that when mixed in water, creates an oral rinse supersaturated with calcium and phosphate ions.How does NeutraSal^® work?
NeutraSal^® is an advanced electrolyte solution that mimics natural saliva. NeutraSal^® contains electrolytes such as calcium, phosphate, bicarbonate and chloride. These electrolytes are necessary for a healthy, functioning mouth. NeutraSal^® is designed to replace the normal ionic and pH balance in the oral cavity (mouth). Biologic Action of NeutraSal^®
When NeutraSal^® is taken at the start of chemotherapy, NeutraSal^® maintains the functionality of the oral cavity through healing of the oral mucosa. The ions contained in NeutraSal^® diffuse into the intercellular spaces in the epithelium and permeate the mucosal lesion(s) in mucositis.

Ions within the mouth such as calcium and phosphate play crucial roles in the healing process.

Calcium ions play a crucial role in the inflammatory process, the blood clotting cascade and tissue repair.
Phosphate ions may help repair damaged mucosal surfaces.
Calcium and phosphate ions aid in the prevention of dental caries
Bicarbonate reduces the acidity (pH) of the oral fluids, dilutes the accumulation of mucus, and discourages the colonization of yeast

Indications for Use

NeutraSal^® is also indicated as an adjunct to standard oral care in relieving the discomfort associated with oral mucositis that may be caused by radiation or high dose chemotherapy. Relief of dryness of the oral mucosa in these conditions is associated with the amelioration of pain.
NeutraSal^® may be used for relief of dryness of the oral mucosa when hyposalivation results from the following: surgery, radiotherapy near the salivary glands, chemotherapy, infection or dysfunction of the salivary glands; emotional factors such as fear or anxiety; obstruction of the salivary glands; Sjogren's Syndrome .
NeutraSal^® is also indicated for the dryness of the mouth (hyposalivation, xerostomia).
NeutraSal^® is indicated for dryness of the oral mucosa due to drugs such as antihistamines, atropine, and other anticholinergic agents that suppress salivary secretion.

Clinical Trials

The Role of Saliva in Oral Health: Strategies for Prevention and Management of Xerostomia

Mary Elizabeth Brosky, DMD

Oral complications are the most frequent and debilitating sequelae of radiation treatment for patients with head and neck cancer. Impaired salivary function and consequent xerostomia can persist for years after radiation treatment, significantly increasing the risk of oral and dental disease and negatively affecting patients’ quality of life. Current evidence indicates that many patients undergoing radiation treatment do not receive adequate oral and dental care and follow-up and that patients’ compliance with oral care recommendations is frequently poor. Topical lubricants, coating agents, and saliva substitutes or lozenges may provide transient relief from xerostomia. Cholinergic stimulants such as pilocarpine improve salivary flow but have had mixed results in improving patients’ assessments of symptoms or other quality-of-life measures. Advances in radiotherapy techniques, such as intensity-modulated radiation therapy, have enabled increased delivery of therapeutic doses of radiation to tumors while limiting exposure to normal tissues, thereby reducing the incidence, duration, and severity of xerostomia in some patients with head and neck cancers. Additionally, radioprotective agents such as amifostine have been shown to reduce radiation-induced toxicity to normal tissues within the radiation field. Studies are ongoing to determine the optimal approaches for these techniques and agents to maximize clinical response while improving the overall quality of life for patients with head and neck cancer.
Journal of Supportive Oncology, VOLUME 5, NUMBER 5 ■ MAY 2007

Case Study: Thadden, MD
Results of recent trials indicate that treating nasopharyngeal cancer with a combination of radiation and chemotherapy can increase risk of death from other causes, including severe(grade IV) oral mucositis.
Patient HistoryAn 18-year old male patient was diagnosed with nasopharyngeal carcinoma (stage IV, bilateral midline mass) at a cancer treatment center in Alabama. The patient received cisplatinum with 5-fluorouracil as a continuous infusion and intensity-modulated radiation therapy (IMRT). Click here to read more about the case study.
Case Study: A Siddiqi, MD,San Antonio, TX
The prevalence of severe OM in patients receiving a combination of chemotherapy and radiotherapy is nearly 100%, compared with 60% in those receiving chemotherapy alone. The frequency has increased because of the use of more intensive altered radiation fractionation and concurrent chemotherapy regimens. Patient History

A male patient (Mr. G) was diagnosed with an advanced head and neck tumor, stage III, TxN1 in right bottom of tongue. Click here to read more about the case study.

Efficacy of a Supersaturated Calcium Phosphate Oral Rinse (NeutraSal®) in the Treatment of Xerostomia Secondary to Sjogren's Syndrome

Efficacy of NeutraSal® (Supersaturated Calcium Phosphate Rinse) in the Prevention and Treatment of Chemotherapy and/or Radiotherapy-induced Oral Mucositis