These Medications Could Be Causing Your Dry Mouth

Also referred to as xerostomia, the common condition known as dry mouth affects approximately 25% of adults, and the Oral Health Foundation states that the number climbs closer to half as you reach 55 and above. According to a review in Autoimmunity Reviews, dry mouth is a prevalent oral health issue involving dysfunctional salivary glands. Dry mouth causes mouth burning, dry lips, bad breath, infections, and decreased sense of taste. Xerostomia can also result in tooth decay, gum disease, and eating, talking, and swallowing problems (per NHS Inform).

Saliva consists of electrolytes, enzymes, antimicrobial proteins, glycoproteins, immunoglobulins, growth factors, and mucins. Your body produces this substance to slow down the growth of bacteria in your mouth and neutralize the acids it creates when you eat and, along with saliva's ability to aid with removing food from your mouth, reduces tooth decay. Saliva also improves your sense of taste and makes chewing, swallowing, and digesting easier (per the Mayo Clinic). 

Dry mouth may result from other diseases, such as diabetes, neurological problems, and radiation therapy. In addition, certain medications, both prescription and over-the-counter, also cause dry mouth. Here are some examples.

If you have a bout of diarrhea, then the muscles in your gut are contracting too fast, causing food to travel through your system too quickly. As a result, you end up with frequent, watery bowel movements (per Healthline). Diarrhea results from many different health issues, including infection, food intolerance or allergy, parasites, and as a side effect of some antibiotics (via Johns Hopkins Medicine).

The U.S. Food & Drug Administration (FDA) approved loperamide, sold under the name brand Imodium, to treat several different types of diarrhea. Loperamide gets absorbed through your gut (per a review in the Journal of Pharmacy and Pharmacology). It then gets metabolized in your liver and distributed through your circulatory system (per Journal of Pain and Symptom Management).

According to Practical Pain Management, loperamide decreases the activities controlled by your central nervous system, peripheral nervous system, and autonomic nervous system when it reaches your brain. As a result, loperamide slows down the speed at which food moves through your digestive tract giving your bowel additional time to absorb what your body needs (via Healthline). At the same time, this drug also slows down your saliva glands.

According to Reuters Health, nearly 50 million Americans have allergies, and at least a third of them rely on antihistamines, decongestants, or a combination of the two to treat the related nasal congestion, sneezing, and runny nose (via the Mayo Clinic). These symptoms result from the body's production of the chemical histamine, which promotes inflammation and causes allergic reactions (per Reuters Health).

However, the medical professionals at the Cleveland Clinic explain that histamine also plays a role in dilating blood cells, controlling muscle contractions, and assisting with nerve cell communication and bodily fluid movement. Therefore, using antihistamines blocks histamine production not only when related to allergies, but also in all brain cells with receptors for the chemical (via Reuters Health).

Decongestants are often used alone or in conjunction with antihistamines and work to clear your nasal congestion by constricting your blood vessels (per the Mayo Clinic). While this allows air to pass through your nose, it also shrinks blood vessels in other body parts, including your saliva glands (per Robert H. Oliver, MD). Additionally, pseudoephedrine, the most common decongestant sold under the brand name Sudafed, works on your central nervous system, which controls saliva production (via ScienceDirect).

In 2019, Americans filled nearly 61 million prescriptions for albuterol (per Statista). Albuterol is a short-acting bronchodilator used by asthmatics to relieve lung spasms. Albuterol offers immediate relief that lasts up to six hours. There are also long-acting bronchodilators that help prevent spasms and reduce the amount of mucus in your lungs (via Asthma & Allergy Associates, P.C).

According to Charleston Allergy and Asthma doctors, bronchodilators like albuterol work by being inhaled into your lungs to relax and open your airways to make breathing easier. Also called inhalers, these medications not only help those with asthma, but also get prescribed to those with chronic cough, COPD, and bronchitis. Regardless of which medical condition you are using them to treat, bronchodilators contain one of three types of drugs (a corticosteroid, an anticholinergic, or a beta-2 agonist), all of which have dry mouth as a side effect. 

Bronchodilators cause dry mouth in three ways (via BIOTÈNE). First, no matter how hard you try, you cannot inhale all the medication dispensed, and any left in your mouth can dry it out. Second, these drugs have been shown to decrease the amount of saliva you produce by nearly 30%. Finally, some people report developing the oral yeast infection known as thrush as a result of using an inhaler, and thrush reduces saliva production.

ClinCalc reports that in 2020, doctors wrote nearly 90 million prescriptions for diuretics. According to Medical News Today, these drugs treat high blood pressure, congestive heart failure, kidney disease, and other health conditions that cause body tissues to swell. Also referred to as water pills, diuretics increase the amount of water and salt your body disposes of when you urinate to reduce the amount of fluid in your blood vessels. Doing so lowers your blood pressure and reduces the edema associated with several medical conditions (per Healthline).

The most common diuretic is Thiazides, which makes your kidneys extract more water and salt into your urine and relaxes your blood vessels (via Medical News Today). Loop diuretics stimulate your kidneys to produce more urine. To do so, your kidneys need to get more water from the rest of your body, which needs replacing — thus, reducing the amount of liquid in your body. Potassium-sparing diuretics are the only ones that don't cause you to lose potassium when you increase fluid output. Not affecting potassium levels helps those with arrhythmia, but isn't as effective as loop diuretics or Thiazides.

Studies referenced by Healthgrades Marketplace, LLC show that the decrease in your bodily fluid caused by diuretics correlates with a reduction in salivary gland activity.

According to ClinCalc, patients filled just under 40 million muscle relaxant prescriptions in 2020 to relieve muscle pain and spasms (via Medical News Today). Muscle spasms result from multiple sclerosis, motor neuron disease, and cerebral palsy, as well as from persistent head and back injuries, lower back pain, and whiplash (per Egton Medical Information Systems Limited).

Medical News Today reports that there are two different kinds of muscle relaxers. Antispastics improve tightness and spasms through your spinal cord and skeletal muscles. Meanwhile, antispasmodics reduce spasms by stopping neuron transmission from your central nervous system through your brain. Per a review in Physiology International, the most common complaint of users of the antispastic tizanidine report is dry mouth. A study referenced in the journal also shows that baclofen users had the same complaint.

Muscle relaxants work through your central nervous system. Doing so not only relaxes your muscles, but also reduces the production of the neurotransmitter that stimulates saliva production. Without this substance, your salivary glands fail to secrete saliva (per SmartMouth Oral Health Laboratories).

The U.S. Department of Health & Human Services (HHS) reports that nearly 34 million adults in the U.S. smoke, and that smoking kills almost half a million people annually. Additionally, the CDC statistics state that for every person who dies from smoking, more than 30 live with a smoking-related illness. Furthermore, secondhand smoke contributes to over 40 million deaths every year. However, nearly 70% of smokers want to quit, more than half try annually, and 60% of smokers no longer do so (per HHS).

The CDC recommends using one of five types of nicotine replacement therapy (NRT) approved by the U.S. Food and Drug Administration to quit smoking. The most common forms of NRT are patches, gum, and lozenges. All of them replace the nicotine found in cigarettes to decrease the withdrawal symptoms and urges to smoke that often accompany trying to quit.

Nicotine is the chemical found in cigarettes that cause them to be addicting. When you smoke, nicotine unlocks your dopamine receptors, making you feel good. But once the feeling subsides, you need another cigarette to get it back. NRT works by supplying your brain with the addicting chemical nicotine (via Quit Victoria).

However, nicotine is both an immunosuppressant and a vasoconstrictor (per Taylor Dental). Therefore, like cigarettes, NRT minimizes the saliva flow in your mouth, resulting in dry mouth (via Mt. Holly Family Dentistry).

According to the Herman Ostrow School of Dentistry of USC, over 1000 medications cause dry mouth or interfere with saliva production and flow. You may not be able to prevent it, but you can take steps to lessen this particular side effect (via DentalSelect).

The NHS recommends you drink enough water during the day. You can supplement your drinking by sucking on ice cubes or unsweetened drinks. Limit your intake of drinks with bubbles and foods that are overly flavored with spices, salt, or sugar. You may also want to avoid acidic fruits like lemons. Be sure to brush your teeth at least twice a day, use alcohol-free mouthwash, and don't sleep with your dentures in your mouth.

Medical professionals at the Delta Dental Plans Association also recommend eating your food slowly by taking smaller bites and chewing well. Foods should be moist and not hard or sticky. Use sauces and gravies, and avoid chips, crackers, and cookies. Additionally, these dentists recommend keeping water beside your bed so you can sip it at night.