All about xerostomia

People who undergo cancer treatment more prone to oral complications and side effects because the radiation and chemotherapy hinders the growth of new and fast growing cells, says DR RISHI AJAY KHANNA

Xerostomia or dry mouth can result from treatments that are used to fight cancer. For those undergoing radiation therapy or chemotherapy for cancer, symptoms of dry mouth are common.

During cancer treatment, saliva production actually increases because of irritation caused by radiation or chemotherapy. During treatment, the saliva tends to get thicker and is often described by patients as difficult to control. Once the treatment concludes, the excessive saliva goes away and the mouth becomes dry. This can be a temporary side effect or lead to a permanent loss of saliva production. Xerostomia is also a common complaint among older adults. However, Xerostomia is not related to age but to the medications that cause Xerostomia as a side effect.

Symptoms

Xerostomia occurs when the salivary glands of the body fail to produce adequate amounts of saliva to keep the mouth moist. Saliva has several important functions including mechanical cleansing action, antimicrobial activity, and removal of food debris from oral cavities, control of pH, oral cavity lubrication, and remineralisation and maintaining the integrity of the oral mucosa.

• Thick, stringy saliva
• Burning sensation or pain in the mouth or on the tongue
• Cracks at the corner of the mouth or lips
• A dry tongue
• Difficulty in chewing or  swallowing

• Difficulty in talking
• Taste disorders
• Tooth decay

• Skin Rash
• Dry skin and eyes
• Oral candidiasis
• Parotid gland enlargement

Cause

People who undergo cancer treatment are more prone to oral complications and side effects for various reasons. A common reason is that radiation therapy and chemotherapy hinders the growth of new and fast growing cells. Both normal and cancer cells in the lining of the mouth are fast-growing, and treatment may impede their growth.

In addition to that, radiation therapy and chemotherapy may alter the balance of healthy, normal bacteria present in the mouth. Such therapies may also damage the salivary glands and in turn, reduce the production of saliva.

Treatment

Patients experiencing dry mouth while receiving cancer treatment should follow some simple steps that may help alleviate this side effect. If dry mouth is affecting your ability to eat and swallow, be sure to:

• Stay away from foods that are hot, acidic or spicy
• Eat foods that are wet, soft

Chew the food well if one is having trouble swallowing foods and only take small bites

• Season or marinate the food if it tastes bland
• Cut down on the consumption of sugar to avoid tooth decay
• Combine liquid and solid foods to make it easier to swallow

Here are some other guidelines to follow to prevent oral complications and alleviate dry mouth:

• Drink lots of fluids (3-4 litres each day), especially if the mouth feels dry
• Abstain from alcohol and tobacco
• Use a soft toothbrush to brush your teeth and gums 2 to 3 times a day for two to three minutes every time
• Use a humidifier in the bedroom while sleeping

• Use a moisturiser daily on the lips

Before using any medication, it is important to consult a physician. The physician will likely review any medications one is taking to see if any may be causing dry mouth. The physician may change one or more of the prescriptions, or even recommend changing the dosage.

The doctor may also prescribe artificial saliva or medications like E-Saliva Plus to increase saliva production in the mouth.

For dry mouth resulting from the treatment of cancer, keeping up with the oral hygiene routine is essential, including regular dental visits. Dry mouth can be a challenging side effect to deal with on a daily basis. It is best to get in touch with a physician to help manage this side effect.

The writer is Dr Rishi Ajay Khanna(MS ENT), CHL Hospital, Indore, Medical Consultant at ENTOD Pharmaceuticals