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Water's good.  Sugar-free gum helps.  But, Listerine may dry out your mouth.  Saliva is a health drink for your teeth and mouth. The three pints produced by the salivary glands each day contain antibacterial substances that protect teeth from cavities. Like all body fluids, saliva is a near cousin to blood, so it contains calcium and phosphorus that teeth absorb. It also functions as an overall lubricant for the mouth, preventing food from sticking to your teeth and gums. By neutralizing gastric acid and keeping the flow of food and drink through the mouth and esophagus on the right course, saliva may help check gastroesophageal reflux (GERD), a leading cause of heartburn.

A serious lack of saliva — the medical term is xerostomia (pronounced zer-o-STO-me-ah) — may develop for several reasons. It’s a side effect of many medications. It may result from autoimmune diseases like lupus and Sjögren’s syndrome. Head and neck cancer patients struggle with dry mouth after receiving radiation treatments.

Dry mouth is another reason you should see a dentist regularly. During a routine exam, dentists are supposed to look for little pools of saliva in the bottom of the mouth. The inside of your lower lip contains hundreds of tiny salivary glands, so dryness there is a bad sign.

Why drugs cause dry mouth:

Some medications cause dry mouth because they have anticholinergic side effects — that is, they block the action of acetylcholine, the signaling molecule that nerve cells use to “switch on” muscles and glands, including the salivary glands.

Other anticholinergic side effects are constipation, blurred vision, and retention of urine. Acetylcholine levels tend to decrease with age, so as we get older, we’re more likely to experience these side effects, including dry mouth.

Anticholinergic effects can be desirable. Some drugs used to treat nausea and tremors work by blocking acetylcholine activity.

The treatment depends on the cause and its severity. Doctors and dentists no longer believe that old age by itself causes clinically significant dry mouth. But salivary glands do tend to become less productive with age, so keeping your mouth moist becomes an important part of oral hygiene after age 50 or so. Here are seven tips for dealing with dry mouth:

1. Chew sugar-free gum. Chewing stimulates the salivary glands to produce saliva — presuming, of course, that there is still some working salivary gland tissue to stimulate. The gum should be sugar-free because, just as you’ve been told, sugar promotes cavities.

2. Eat fibrous foods. Here’s another reason for eating an apple a day: Crunchy, fibrous fruits and vegetables like apples, carrots, and celery are mildly abrasive, so they sweep bacteria and plaque off teeth, according to Dr. Ward Massey, an assistant professor at the Harvard School of Dental Medicine and an expert on dry mouth.

3. Watch the alcohol. Moderate amounts of alcohol may benefit the heart, but alcohol does tend to dry out the mouth.

4. Wet your whistle. Water lacks many of saliva’s healthful properties, but regular swigging will keep your mouth nice and moist. Unlike tap water, most bottled water doesn’t contain fluoride, so if you drink bottled water, you may need to be especially conscientious about using a fluoride toothpaste, dry mouth or not. Dr. Massey recalls a dry mouth patient who had an especially bad tooth decay problem because the bottled water she was chugging was highly acidic. Serious cases of dry mouth can benefit from saliva substitutes, which include glycerin and water mixes (Moi-Stir), carboxymethyl cellulose gels (Salivart), and mucopolysaccharide ointments (Mouth Kote).

5. Floss and use mouthwash. Flossing and brushing become even more important if your mouth is dry because saliva protects against tooth decay. Alcohol-based mouthwashes like Listerine are double-edged swords: they kill bacteria, but also dry out the mouth. Nonalcoholic mouthwashes like ACT and Biotene or low-alcohol ones like Plax are better choices.

6. Take medications to stimulate the salivary glands. Ordinarily, these are reserved for more serious cases of dry mouth. Pilocarpine (Salagen) is used more often, but cevimeline (Evoxac) seems to have fewer side effects.

In our practice clients have been having positive results with a newer product called NeutraSal. It is a prescription product that comes in an oral rinse as well as chewing gum form. The chewing gum form seems to be the preferred method of use with best reported results. For more information the link to the NeutraSal website is: http://www.neutrasal.com . 

7. Get special treatments for your teeth and gums. Sometimes there’s no effective way to stimulate or replace saliva. In that case, protecting teeth and gums against the consequences of dry mouth becomes a priority. Teeth can be coated with protective substances. Some dentists fill cavities with materials that contain fluoride, which is then gradually released and absorbed by the tooth. Regular cleanings to remove plaque are especially important if your mouth lacks saliva.