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Dry mouth is often associated with aging, but it doesn't have to be. DON'T LIVE WITH PRESCRIPTION MEDICATION IS the leading cause of xerostomia—or chronic dry mouth—marked by significantly reduced amounts of saliva in the mouth. Dry mouth affects 30 percent of people older than 65 and up to 40 percent of people older than 80, but seniors can take steps to prevent or alleviate it. "There are over 500 prescription medications that cause xerostomia," says Emil Baccash, M.D., attending physician in internal and geriatric medicine at NewYork-Presbyterian Brooklyn Methodist Hospital. "It is more likely to occur in patients who take more than four daily medications, and a high percentage of older people are in this category." Medications that may cause xerostomia include diuretics like metolazone or ethacrynate as well as calcium channel blockers, such as amlodipine or nicardipine, which are used to lower blood pressure. Other causes of xerostomia include chronic health conditions like diabetes or Alzheimer's disease. Some cancer treatments, such as chemotherapy drugs and radiation for cancers of the head and neck, can thicken saliva or damage salivary glands, both of which contribute to dry mouth. Smoking tobacco and drinking alcoholic or sugary or caffeinated beverages—such as soda, juice, tea or coffee—can also contribute to the condition. SYMPTOMS AND HEALTH CONCERNS Signs of xerostomia may include mouth discomfort, thirst, bad breath, hoarseness and cracked lips. Dry mouth can cause difficulty tasting, chewing and swallowing, as well as oral health issues. "When the mouth lacks essential moisture, a fissured tongue—shallow or deep grooves on the surface of the tongue—and oral mucositis—painful ulcers or sores in the mouth—are possible," says James Sconzo, D.M.D., chief of the Division of Dental Medicine at NYP Brooklyn Methodist. "One of the more damaging effects of dry mouth is that it contributes to greater amounts of bacteria-trapping plaque that stick to the teeth and gums because there's little or no saliva to help rinse the plaque away." Plaque and bacteria on the teeth ultimately cause cavities. In addition, plaque calcifies into tartar, which irritates the gums, making them swell and become tender while producing a tissue-damaging immune system response. Inflammation of the gums, also known as gingivitis, is the first phase of periodontitis, or periodontal disease. "If left untreated, periodontal disease eventually causes the gums to recede so much that teeth become loose or susceptible to root cavities under the gumline, and they may need to be removed," says Dr. Sconzo. "Deep dental cleanings, bone grafts and gum surgery can help stabilize teeth if periodontal disease becomes advanced. When teeth are lost, partial or full dentures may be needed." People who wear dentures also need to be informed about xerostomia symptoms because dry mouth can prevent dentures from fitting properly and they then become painful to wear. Dry mouth can also put denture wearers at a greater risk of developing oropharyngeal candidiasis. This fungal infection, commonly referred to as oral thrush, is caused by the development of yeast, which shows as white patches on the tongue or other areas of the mouth. DRY MOUTH PREVENTION AND SOLUTIONS "If people suspect that their medications may be contributing to dry mouth, they should speak with their prescribing doctor about lowering their dose or switching medications," says Dr. Baccash. "This may help clear up the symptoms." If medication cannot be changed or when health conditions are the cause of dry mouth, using saliva substitutes, chewing sugar-free gum and drinking water throughout the day can alleviate symptoms. Dry Mouth FA L L 2 017/ / W W W.N Y P.O RG / BRO OKLY N 24 A G I N G G R A C E F U L LY