Dry Mouth and Arthritis

Lots of things can contribute to a chronically dry mouth, but medications are the main culprit. More than 500 prescription and over-the-counter (OTC) drugs affect how your salivary glands work. If your mouth feels like it’s permanently stuffed with cotton, start by checking the side effects of your medications or ask your doctor about them.

• Antihistamines
• Antidepressants
• Antipsychotics
• Blood pressure pills
• Diuretics
• Pain relievers
• Sedatives  

Drugs and aging are the most common causes of dry mouth. But if you have rheumatoid arthritis (RA) or lupus you’re also at increased risk of Sjogren’s syndrome, an autoimmune disorder whose main symptoms are dry mouth and eyes.

For years, Sjogren’s was considered a nuisance condition that didn’t cause serious problems. It’s now known that it can also affect your joints, kidneys, lungs, skin and cause ongoing fatigue. Like other autoimmune diseases, Sjogren’s occurs when inflammation is directed against the body’s own tissues – in this case, the glands that produce moisture in your mouth and eyes.

There are two types of Sjogren’s syndrome – primary and secondary. Primary is when you have Sjögren’s symptoms but you don’t have another major rheumatic or autoimmune disease. The secondary form is diagnosed when someone who already has another autoimmune disease, such as RA or lupus, develops Sjogren’s symptoms. Dry mouth symptoms tend to be worse in primary Sjogren’s.

Dry mouth is uncomfortable and can present daily challenges, including the inability to taste or enjoy food. More important, it affects your oral health and digestion. Saliva contains antibacterial compounds that prevent tooth decay, gum disease and bad breath. It also makes chewing and swallowing easier and contains the enzyme amylase, which helps break down starches.

“Operating a mouth with no spit is like driving a car without motor oil,” explains Anna Diaz-Arnold, DDS, a professor in the Department of Family Dentistry at the University of Iowa.

The goal of treatment is to keep your mouth as moist as possible. Most therapies are simple things you can do yourself, others will require a prescription. 

• Take small sips of water throughout the day.
• Chew sugar-free gum. This will help keep as much saliva flowing as possible.
• Invest in a room humidifier. A moist environment can help your skin, mouth and eyes.
• Try saliva substitutes. These come as sprays, gels and lozenges and are sold online and in most pharmacies. Some contain xylitol, which can help protect against cavities but may also cause stomach upset. You might want to stick with products made from carboxymethylcellulose or hydroxyethylcellulose. Your dentist can probably suggest a good brand.
• Avoid sugary foods and candies. Lower your risk of cavities by avoiding these.
• Limit caffeine. It can make dry mouth worse.
• Try prescription medicines. Two medications are approved to stimulate saliva production in people with Sjogren’s: cevimeline HCL (Evoxac) and pilocarpine (Salagen). These medications are usually only tried if nothing else has worked. Both have side effects and interact with a host of other drugs, so talk to your doctor about the risks and benefits.
• Get frequent dental care. You may need more-frequent cleanings and dental examinations. Your dentist may also suggest anti-cavity toothpaste and other products to help keep your mouth healthy.