Dry Mouth From Medication: Why Cavities Appear After 60

Short answer: hundreds of medicines can reduce saliva, including many for blood pressure, depression and bladder control.¹ Common allergy medicines such as antihistamines and decongestants can do it too.² Saliva is the mouth's main defense against decay, so less of it raises the risk of cavities, often along the gum line and on exposed roots.²³ Sipping water, chewing sugar-free gum, using prescription-strength fluoride and keeping up with dental visits all help.¹³

A patient who has had healthy teeth for decades suddenly has three new cavities. It is one of the most common surprises we see in patients over 60, and it is usually not about brushing. More often, the cause is a new prescription and the dry mouth that came with it.

Why does dry mouth cause cavities?

Saliva does a lot of quiet work. It washes away food and neutralizes the acids that bacteria produce.² It also carries minerals such as calcium and phosphate that help keep teeth strong and fight decay.¹ When saliva drops, acid lingers on the teeth longer and that protection weakens. The result can be new decay, sometimes in several places at once. In people with dry mouth, the ADA notes that cavities are especially common:³

• Along the gum line
• On root surfaces exposed by gum recession
• On the tips and biting edges of teeth

Which medications cause dry mouth?

The list is long. The National Institute of Dental and Craniofacial Research notes that hundreds of medicines can cause dry mouth.¹ Common types include:³⁴

• Some blood pressure medications, including diuretics
• Antidepressants and anti-anxiety medications
• Antihistamines and decongestants
• Medications for overactive bladder
• Some pain medications and muscle relaxants
• Medications for Parkinson's disease

Taking several medications at once can raise the risk.³ Dry mouth can also come from conditions such as diabetes and Sjögren's disease, and from radiation treatment for cancer.¹

Please do not stop or change any medication on your own. If dry mouth is a problem, talk to your physician. Sometimes a different medication or dose is an option, and sometimes the right answer is simply to protect your teeth more carefully.¹

What are the signs of dry mouth?

Common signs include:³

• A sticky or dry feeling in the mouth
• Trouble chewing, swallowing or tasting food
• Bad breath
• A dry or sore throat
• Cracked lips, a dry tongue or a burning feeling in the mouth
• Dentures that rub or will not stay in place

What helps?

• Sip water throughout the day, and keep a glass by the bed.¹
• Chew sugar-free gum or suck sugar-free candy to stimulate saliva.¹ Cleveland Clinic suggests gum that contains xylitol.⁴
• Choose water or sugar-free drinks over juice, soda and sweetened coffee or tea, and avoid sticky, sugary foods.³
• Limit alcohol and caffeine, both of which dry the mouth further.¹
• Use a humidifier in the bedroom at night.¹
• Try saliva substitutes or dry mouth products from the pharmacy.³
• Ask about prescription-strength fluoride. The ADA lists a daily prescription fluoride gel and in-office fluoride varnish among the ways to help prevent decay in people with dry mouth.³

How often should I see the dentist if I have dry mouth?

The ADA's guidance for people with dry mouth includes dental visits at least twice a year.³ Depending on what we see, we may suggest coming in more often than that, so new decay is caught while it is still small. Small problems are simpler and less expensive to fix. Bring an up-to-date medication list to every visit so we can spot the changes that matter.

Does dry mouth affect dentures?

Yes. Dry mouth can make dentures hard to keep in place and harder to wear.³⁴ A denture that moves can rub and cause sore spots. If that sounds familiar, our post on signs your dentures need attention may help.

Dental care that keeps up with you

Our dental care for seniors page covers how we plan care for patients with medical conditions and medications, and our cleanings and exams page explains what a visit includes. We see many patients from Porters Neck, Southport and Kure Beach. To book, call 910-762-0958 or request an appointment.

Sources

1. National Institute of Dental and Craniofacial Research. Dry Mouth. NIDCR, National Institutes of Health.
2. American Dental Association. Dry Mouth. MouthHealthy.org.
3. American Dental Association. Xerostomia (Dry Mouth). ADA Oral Health Topics, ada.org.
4. Cleveland Clinic. Dry Mouth (Xerostomia). Cleveland Clinic Health Library.

This article is general information for patients. It is not a diagnosis, and it does not replace an exam or advice from your own dentist or physician.