Many of us with fibromyalgia (FM) also know what it is like to live with dry mucous membranes. Despite it being a common complaint among fibromyalgia patients, it’s not something that’s often discussed in articles or online groups and forums, but it’s frustrating, nonetheless.
In this article, I want to review the consequences of chronic dry mouth, in particular. We will consider possible causes, its relationship to fibromyalgia, the effects on our gastrointestinal tract, and ways to manage it.
What is Dry Mouth?
Chronic dry mouth, xerostomia (pronounced zero-stO-mEa), is the result of insufficient saliva secretion. This is important because saliva washes away food debris, buffers digestive acids that can cause tooth decay, reduces the formation of plaque, and begins the digestive process.
In 2002, one study reported that salivary gland dysfunction could be exacerbated by several factors, including medications, autoimmune diseases, cancer of the head or neck, neurological conditions, hormonal fluctuations and more. Additionally, a 2018 study provides insights into the mechanisms by which saliva acts as protector and how it relates to taste, chewing, formation of food blockages in the esophagus, enzymatic digestion and swallowing.
Those of us who live with fibromyalgia symptoms should be on the lookout for conditions that can aggravate chronic dry mouth.
Causes of dry mouth
Let’s take a more in-depth look at the myriad of things can act as causes of dry mouth, such as:
- Mouth breathing
- Poor diet
- Central and peripheral nerve damage that affects salivary glands
- Small fiber neuropathy
- Removal of salivary glands (such as seen in oral cancer)
- Medication side effects
- Medical conditions like Sjögren’s, thyroid disease, diabetes, and Lupus)
Furthermore, chronic dry mouth is also one symptom of Sicca syndrome. Sicca is collection of symptoms characterized by unusually dry eyes, mouth, throat, nose, and other mucous membranes. Sicca symptoms are commonly associated with the autoimmune disease called Sjögren’s. Some people interchange the two, and others see Sicca syndrome and Sjögren’s Syndrome quite differently. My own rheumatologist sees Sicca as Sjögren’s without the presence of tissue specific antibodies.
Herein lays the connection between dry mouth and fibromyalgia. In another 2018 study, researchers concluded about 1/3 of fibromyalgia patients tested positive for Sjögren’s-related biomarkers. Plus, the majority of the testing population had the presence of other autoimmune antibodies, lending further credence to the idea that autoimmunity and fibromyalgia are connected.
The Consequences of Dry Mouth
Chronically thick and stringy saliva, a horse or dry throat, a tongue that is grooved or coated white, or sticky surfaces in the mouth suggests the presence of chronic dry mouth. This can contribute to:
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- Difficulty speaking
- Difficulty chewing, swallowing, and tasting
- Insufficient digestive enzyme production
- Increased risk of bacterial and fungal infections (which can travel out of the mouth into the body’s circulation)
- Burning mouth syndrome
- Bad breath
- Mouth sores
- Dental cavities
- Gum disease
- Malabsorption of nutrients
- Gastrointestinal dysfunction
If left untreated or unmanaged, complications related to dry mouth can affect our overall health.
Things We Can Do to Help Chronic Dry Mouth
One of the first things I learned in nursing school was the importance of oral care. Keeping a patient’s mouth moist with glycerine swabs and treating their lips with oral moisturizers is a significant nursing intervention to maintain oral health as well as the health of the body. Other things we can do include:
- Address lifestyle issues, such as stress, diet, tobacco use.
- Consider contributing factors, such as sleep apnea or other airway obstructions (i.e. deviated septum), teeth grinding, TMJ, etc.
- Practice good oral hygiene as recommended by the American Dental Association. Brush teeth twice a day with fluoride toothpaste, clean between teeth daily, limit sugary beverages and snacks, see a dentist regularly.
- Avoid overuse of caffeine, carbonated beverages, and alcohol, which are dehydrating.
- Avoid sugar.
- Sip on water frequently.
- Rinse mouth frequently.
- Don’t use mouthwash that contains alcohol.
- Use oral lubricants and saliva substitutes.
- Suck on sugar-free hard candy or chew sugar-free gum to stimulate saliva production. (Discuss these options with your dentist.)
- Use a humidifier.
- Talk to your dentist about a mouthwash that increases saliva.
- Talk with your doctor or pharmacist about medication side effects. (i.e., antihistamines or other medication used in fibromyalgia treatments).
- Talk with your doctor about prescription medications that can increase saliva production.
Chronic dry mouth is complicated; it’s far more than having periodic cotton mouth. And, while we may not always know what causes it, there are things we can do to minimize the effects, and in the process, have an effect on our overall health.
This article was first published on ProHealth.com on February 6, 2019 and was updated on September 17, 2019.
Celeste Cooper, RN, is a frequent contributor to ProHealth. She is an advocate, writer and published author, and a person living with chronic pain. Celeste is lead author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and Broken Body, Wounded Spirit, and Balancing the See Saw of Chronic Pain (a four-book series). She spends her time enjoying her family and the rewards she receives from interacting with nature through her writing and photography. You can learn more about Celeste’s writing, advocacy work, helpful tips, and social network connections at CelesteCooper.com.
Applbaum, E., and Lichtbroun, A. (2019). Novel Sjögren’s autoantibodies found in fibromyalgia patients with sicca and/or xerostomia. Autoimmunity Reviews, 18(2):199-202.
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