Dry mouth in older adults: causes and relief for xerostomia

Dry mouth in older adults is not always simply the result of drinking too little water. When it is accompanied by difficulty chewing drier foods, changes in taste and a frequent need to drink water during the night, it may indicate xerostomia. This condition involves a feeling of dryness in the mouth and may occur with or without an actual reduction in saliva production.

“Saliva plays important roles in protecting the teeth and the tissues of the mouth. It lubricates the mouth, makes chewing and swallowing easier, supports speech and helps to maintain balance in the oral environment. When the amount of saliva falls or its function is impaired, the risks of tooth decay, infections, sores and difficulty eating increase,” explains Flávia Vidal, coordinator of the Dentistry course at Faculdade Anhanguera.

Causes of dry mouth in older adults

In older adults, one of the most common causes of xerostomia is the use of medication. Medicines prescribed for high blood pressure, depression, allergies, pain, urinary problems and other conditions can affect the production or composition of saliva. The risk may also rise when a person takes several medicines at the same time.

Dry mouth can also be associated with dehydration, breathing through the mouth, excessive alcohol or caffeine consumption, and conditions such as poorly controlled diabetes and diseases affecting the salivary glands. For this reason, it should not simply be regarded as an unavoidable consequence of ageing.

Relieving dry mouth symptoms

Below, Flávia Vidal outlines some measures that may help ease dry mouth symptoms in older adults.

1. Keep water available throughout the day

Rather than waiting until they feel thirsty, older adults can take small sips of water regularly. Appropriate hydration is one of the recommended ways to reduce the discomfort caused by dry mouth.

2. Encourage saliva production

Where there is still salivary production, chewing sugar-free gum or sucking sugar-free sweets may stimulate saliva flow. This approach should not be used by people with specific chewing restrictions or a choking risk, and the choice must take individual circumstances into account.

3. Cut down on factors that worsen dryness

Alcoholic drinks, tobacco and excessive caffeine can intensify the sensation of dry mouth. It may also help to avoid foods that are very dry, hard, salty or spicy when they cause discomfort.

4. Take extra care with oral hygiene

Less saliva means less of an important natural protection for the teeth. Oral hygiene should therefore be maintained through careful brushing at least twice a day with fluoride toothpaste, as well as daily cleaning between the teeth. The American Dental Association (ADA) also advises paying particular attention to fluoride use in people at greater risk of tooth decay.

See a dentist if the problem persists

Persistent dry mouth should not be managed solely with water or products sold to relieve discomfort. A dentist can examine the oral cavity, investigate reduced saliva flow and identify possible consequences, including tooth decay, inflammation and infections. The assessment should also take medicines and health conditions into account, and joint monitoring with other healthcare professionals may be required.

In some cases, saliva substitutes, gels or specific sprays can offer temporary relief. These products do not necessarily treat the underlying cause of xerostomia and should be selected according to each patient's needs.

Flávia Vidal stresses that follow-up is particularly important for older adults taking several medicines. “Patients should not stop or alter a medicine they suspect is causing dry mouth on their own. The right course of action is to tell the dentist and the doctor overseeing the case, so that the possibility of adjusting treatment can be assessed where necessary,” she says.

By Luana Figueiredo