Dry mouth, at night: causes and elimination in the elderly

In this article, we will look at the causes and elimination of such an unpleasant symptom as dry mouth (medical term: xerostomia) in the elderly.

What is xerostomia

Xerostomia is a symptom of dry mouth. This condition develops due to insufficient production of saliva in order to moisturize the oral cavity.

Normally, any adult can experience such sensations, not to mention the elderly (stress, lack of water). However, if an elderly person constantly, especially at night, at rest is worried about dry mouth, then this indicates possible health problems.

Xerostomia is a common complaint among the elderly (about 30%).

The level of salivary secretion of saliva by the salivary glands decreases significantly with age, which, in turn, can cause the development of xerostomia. Such dysfunction in old age is mainly due to the influence of various systemic diseases, the action of drugs, side effects of radiation therapy in the field head and neck.

Top Causes of Dry Mouth in Older People

Dry mouth symptom is a common symptom diabetes mellitus 1 and 2 types. This occurs due to the side effects of the drugs taken and an increased level of sugar in the blood.

The development of diabetic neuropathy can also cause dry mouth, this is due to disorders of the nervous system, due to diabetes lesions of small blood vessels.

However, diabetes is not the only cause of dry mouth. In medicine, there are a number of diseases and conditions in which the salivary glands reduce the production of their secretions.

Let's take a closer look at the other major causes of dry mouth:

• side effects of drugs. In total, almost four hundred drugs have been identified that suppress the secretion of saliva, including such groups drugs like antihistamines, analgesics, decongestants, antihypertensives, diuretics, antidepressants;
• disturbances in the work of sensitive receptors located in the oral cavity;
• violations of the trophism of the oral mucosa;
• the influence of toxins, both from outside and formed as a result of the vital activity of his own body;
• violations of the electrolyte balance of the body and its water metabolism;
• the oral mucosa is mechanically dried out by the surrounding air, while the tongue sticks to the palate;
• hormonal disruptions have a negative effect on the work of the glands that produce saliva.

The presence of diseases that disrupt the proper functioning or anatomical integrity of the salivary glands:

• diabetes Types 1 and 2 (the main cause of dry mouth);
• renal failure;
• Sjogren's syndrome;
• lymphogranulomatosis (Hodgkin's disease);
• Parkinson's disease;
• Alzheimer's disease;
• essential tremor (Meniere's disease);
• intestinal obstruction;
• acute and transient disorders of cerebral circulation;
• inflammation of the trigeminal nerve;
• cholecystitis;
• appendicitis.

Dry mouth at night while sleeping can also be due to:

• mouth breathing (people in the elderly often sleep with their mouths open);
• evening overeating;
• a number of the above diseases.

In addition, night is a time of rest for many structural elements of the human body, including the secretion of the salivary glands.

A special case of Sjogren's syndrome.

Dry mouth - can also occur in cases of Sjogren's syndrome in the elderly, it is an autoimmune disease. That is, the body's protective function mistakenly attacks the cells of the salivary and lacrimal glands. The disease can also affect the mucous membranes of the nose, larynx, bronchi and vagina.

Clinical manifestations of xerostomias

A dry mouth is caused by a decrease in the amount of saliva in the mouth. Signs of xerostomia include:

• rough, dry tongue;
• burning of the tongue;
• lack of moisture in the mouth;
• frequent pain in the mucous membrane;
• chapped lips;
• inflammation in the mouth;
• infections in the mouth;
• difficulty swallowing

What does the feeling of bitterness in the mouth with xerostomia at night say?

Such a symptom, combined with dryness of the oral mucosa, can develop in two main scenarios:

• disruption of the functioning of the biliary system;
• disorders of excretion and evacuation of hydrochloric acid and gastric digestive juice.

In both cases, the normal excretion of aggressive secretions of the digestive tract is disrupted. As a result, stagnation occurs, leading to the gradual absorption into the blood of the products formed during their breakdown, which is reflected in the composition of saliva.

Most often, this condition is caused by the following pathologies:

• cholecystitis, both acute and chronic.
• biliary dyskinesia, subject to stagnation of bile.
• chronic forms of toxic and viral hepatitis.
• stomach ulcer;
• gastritis;
• chronic pathologies of the pancreas, leading to problems with bile discharge.

Bitter constituents of digestive juices can be deposited directly in the mucous membrane of the mouth.

What does the plaque in the tongue say with xerostomia

Language is not for nothing called a mirror of the state of the abdominal organs, because by the presence and characteristics plaque on it, you can get a lot of information about the functional state of the entire gastrointestinal path. Dry mouth almost always accompanies such changes.

This combination of symptoms allows one to suspect the presence of the following pathologies:

• gastritis;
• gastroduodenitis;
• gastroesophageal reflux disease GERD);
• reflux esophagitis;
• peptic ulcer and 12 duodenal ulcer;
• nonspecific ulcerative colitis;
• enterocolitis.

If, however, a sharp pain is added to the symptoms listed above, then this indicates the onset of an acute condition:

• appendicitis, both simple and complicated;
• cholecystitis;
• chronic pancreatitis;
• pancreatic necrosis of the pancreas;
• acute intestinal obstruction;
• cholecystopancreatitis.

All these diseases are urgent conditions, their treatment should be started immediately, and most often the help will consist in surgical intervention.

What does dizziness say with xerostomia in the elderly?

Complex of dry oral mucosa with dizziness in old age should alert a person doubly, because he always warns of serious health problems.

In particular, we are talking about problems with the automatic regulation of the supply of blood to the brain, arising for two main reasons:

1. the presence of primary brain damage, manifested by dryness of the oral mucosa and dizziness;
2. the presence of other diseases leading to intoxication or dehydration, reducing the volume of circulating blood, as a result of which the blood supply of the brain falls, the innervation of all organs, including salivary ones, is upset glands.

Naturally, in both cases, dizziness remains the leading symptom, the cause of which is the same - a violation of the blood supply to the brain tissues.

Frequent urination with xerostomia

In the case of the simultaneous appearance of symptoms such as dryness of the mucous membrane and increased urination, the following pathologies can be assumed:

• chronic inflammatory kidney disease leading to long-term water imbalance in the body;
• diabetes mellitus.

Diagnostics

When diagnosing, a number of the following examinations are carried out:

• sialometry;
• biopsy of the salivary glands.

For patients in whom dry mouth is unclear, sialometry can be done by placing devices to collect saliva behind the openings of the main ducts, and then stimulate saliva production with citric acid or when chewing paraffin.

Basically, the saliva flow from the duct of one parotid gland is 0.4–1.5 ml / min. Monitoring the rate of saliva flow can also help determine the response to treatment.

The cause of xerostomia is often obvious, but if the causes and provoking factors are not clear to specialists, further assessment should be carried out with a biopsy of the small salivary glands (to detect the syndrome Sjogren, diseases Benier-Beck-Schaumann, amyloid dystrophy, tuberculosis or neoplastic diseases). The lower lip is a convenient site for biopsies of the salivary glands.

How to treat dry mouth in old age

The first thing to do to eliminate the unpleasant sensation is increase the amount of fluid consumed. It should be drunk often (during the day), in small sips.

It is best to drink water, lightly acidified with lemon juice, or weak and unsweetened tea. You can also use small pieces of ice on your tongue.

There is only one way to completely cope with the dryness of the mucous membranes - by eliminating the cause of the provoking state of dryness.

In the event that the cause of this unpleasant symptom is a side effect of the medicinal product, you should contact your doctor with a request to find an equivalent replacement for this medicines.

If the function of the salivary glands is not completely lost, then a specialist can stimulate it by prescribing medications that enhance their secretion. In the case when it is impossible to completely cope with the cause of dryness, or it can be done, but for a sufficiently long period of time, it is necessary to temporarily maintain the required humidity level in the mouth. This problem can be solved in several ways:

• use a special moisturizer, the so-called "saliva substitute";
• Reduce intake of caffeinated drinks, tea, coffee, and carbonated drinks, as they only increase the feeling of dry mouth;
• leave bad habits, such as smoking and drinking alcohol, as they dry out the oral mucosa;
• install an indoor humidifier;
• you should often suck on sugar-free candy, but have a taste of cinnamon, mint, citrus, and chew gum, this will help the production of saliva in the mouth.

You should also exclude salty and spicy foods from your diet, since they can provoke the appearance of painful sensations in elderly people suffering from dryness of the oral mucosa.

Dry mouth due to diabetes can be treated by lowering blood sugar. You can reduce your blood sugar levels by following these methods:

• consume foods and drinks that are low in sugar;
• consume foods high in fiber;
• take omega-3 fatty acids;
• Take your medications as directed by your doctor.
• monitor your glucose regularly.

Don't forget the main thing: drink plenty of water, 1.5-2 liters of liquid per day, not immediately, it is advisable to drink in small sips a little during the day.

Which doctor should i contact for dry mouth

If you complain of a dry mouth symptom, you can contact your dentist or general practitioner (therapist). After establishing the provoking factors for the sensation of dryness, you may be redirected to an endocrinologist, gastroenterologist or rheumatologist.

Complications of dry mouth

Xerostomia can lead to oral health problems. Saliva breaks down carbohydrates and contains cells that fight pathogenic microorganisms that cause infections.

If left untreated, dry mouth can lead to the following complications over time:

• gingivitis or inflamed, irritated gums due to the presence of bacteria;
• periodontitis or inflammation around the dental tissue;
• thrush or oral candidiasis due to fungal growth oral candida.

A dry mouth can also lead to sleep problems and affect taste buds.

Forecast and recommendations

Xerostomia in the elderly is usually treated after therapy for the underlying disease. Take your medications as instructed by your healthcare provider and avoid sugary foods and drinks. If dry mouth continues to be a problem for you, talk to your doctor. This can be a side effect of some medications.

Dry mouth is becoming an increasingly common condition in old age, and is probably due to the intake of various drugs commonly used by the elderly, as well as by itself aging.