Identify and neutralize: symptoms and treatment of xerostomia

A dry throat, like a sore mouth, is a very common symptom that everyone has encountered at least once. In a healthy person, as a rule, unpleasant sensations appear suddenly, and it is problematic to immediately understand the reasons for a dry throat.

Dry throat is a condition that is caused by a wide variety of reasons: from harmless external or physiological factors to serious diseases of human organs and systems. Only a doctor can accurately determine the cause of which disease is dry throat. Self-diagnosis and improper treatment can only cause harm and aggravate the course of the disease. A big mistake many patients who self-medicate is trying to eliminate dry throat using folk remedies and medications chosen at random, rather than dealing with the causes of the unpleasant symptom.

An important conclusion from all of the above: effective treatment of dry throat is possible only after identifying the root cause of discomfort in the throat. An accurate determination of the pathological factor will allow not only to prescribe effective treatment, but also to avoid a number of serious complications.

The causes of dry throat can be divided into three groups: physiological, pathological diseases of the respiratory system and diseases of other human organs and systems. Let's look at each group separately.

Does COVID-19 affect the health of teeth and gums?

With Covid, skin symptoms may appear. Unfortunately, doctors often ignore examining the oral cavity of patients with suspected coronavirus infection for safety reasons.5

According to The New York Times, after suffering from coronavirus, a person may experience problems with teeth and gums. The newspaper cites several cases where people who recovered from COVID-19 experienced tooth loss.7

These observations support the need for dental monitoring of patients during illness and after COVID-19.

How to prevent the disease

So, what will help avoid an “outbreak” of fungal infection?

• Careful oral care.
• Solving dental problems and treating common diseases.
• Compliance with the rules of personal hygiene, hygiene of infant feeding and care1.
• Mandatory treatment of the disease during pregnancy and after childbirth1.
• Prophylactic use of antifungal agents, for example, during treatment with antibiotics and immunosuppressive drugs (radiation or chemotherapy)1.

Important: frequent outbreaks and severe cases of candidiasis are a reason to consult a doctor and undergo a full examination. Taking into account the fact that mycoses develop against a background of reduced immunity, they can act as a marker of serious diseases2. According to the World Health Organization, recurrent candidiasis should be a reason for testing for HIV.

Up to contents

Dry mouth due to COVID-19

Studies have found that during COVID-19, 70% of patients experience salivary gland dysfunction, which can lead to dry mouth and burning sensation.17 Dryness can occur after taking medications or under the influence of systemic diseases, such as diabetes. .17

How to get rid of dry mouth?

• An integrated approach is needed: first of all, cure the underlying disease (COVID-19)
• Strengthen immunity
• Drink more water
• Do not rinse your mouth with water, but make mouth baths with water: put water in your mouth and hold
• Chewing sugar-free gum (such as with xylitol): This process causes the muscles to press on the salivary glands and release saliva
• Do not smoke, do not drink alcohol
• Do not use toothpastes with SLS

Diagnosis of oral mycosis

Most often the diagnosis is obvious. However, in difficult situations, for example, in the presence of complications or individual intolerance to certain drugs, to confirm it, microscopic and cultural analysis of scrapings from the surface of the mucous membrane is used to determine the sensitivity of the microflora to antifungal drugs. Moreover, the mere presence of Candida threads in scrapings from the oral cavity is not always enough to make a diagnosis - fungi can be present in the mouth, but not cause any diseases. In such a situation, quantitative assessment is important, that is, counting the pathogen cells, and increasing their number when re-analyzed after 2-3 days.

Up to contents

Gum diseases due to COVID-19

100% of the examined patients who have recovered from COVID-19 have periodontal disease , poor hygiene, and the presence of supragingival and subgingival tartar.2

Periodontium is the tissue that holds the tooth in the jaw. If these tissues disappear, the tooth begins to move and falls out.

In 80% of cases, the leading role in the occurrence of periodontal pathology belongs to dental plaque and tartar.14 Therefore, during illness, you need to pay special attention to oral hygiene : brushing your teeth and tongue destroys a huge number of microbes that attack the body, and since during this period the body weakened, it is more difficult for him to fight viruses.

When you feel unwell, plaque accumulates faster and tartar forms due to the proliferation of microorganisms. This can lead to gum inflammation and bleeding, which is also a common complaint among COVID-19 survivors.17

According to Dr. Brian Franz, President of the American Academy of Periodontology, patient flow to the dentist has never been as high as it is now during the COVID-19 pandemic, which further supports the impact of COVID-19 on periodontal health.4

How to avoid gum disease?

• Be sure to brush your teeth 2 times a day
• Use all hygiene products (toothbrush, dental floss, dental brush, tongue scraper)
• After recovery, change all personal hygiene products
• After recovery, do professional oral hygiene
• Sanitize the entire oral cavity: cure all teeth

Cheilitis with COVID-19

Cheilitis is an inflammatory disease of the lips, the skin around the lips and the mucous membrane of the lip.

Main symptoms of cheilitis10:

• dryness and tightness of lips
• crusts on lips
• itching, burning
• redness
• soreness
• cracks

Less common:

• bubbles
• blood crusts
• exudate (liquid secretion)

The severity of symptoms and their presence depends on the type of cheilitis. Treatment of cheilitis is always complex and also depends on the form of cheilitis.

General treatment of cheilitis

• Normalization of nutrition, adherence to a diet that does not contain allergens, exclusion of spicy, irritating foods
• Taking vitamins, especially group B and PP (nicotinic acid)
• Antibacterial, antifungal and antiviral drugs for infectious cheilitis (Important! These drugs are taken only as prescribed by a doctor!)
• Antiallergic drugs
• Sedatives (Prescribed by your doctor!)

Local treatment of cheilitis

• Painkillers if necessary
• Antiseptics
• Proteolytic enzymes for cleaning erosions
• After inflammation and pain have subsided, healing ointments
• Corticosteroid ointments (Important! They are rarely prescribed and only by a doctor, as they have many side effects.)
• Physiotherapy
• Surgery

For actinic cheilitis, it is necessary to reduce sun exposure and be sure to use creams and lipsticks with SPF.

An important stage is oral hygiene; it is necessary to remove tartar, plaque and cure caries, otherwise there is a high probability of relapses.

It is necessary to treat not only the affected area, but also the entire oral cavity antiseptically, in order to avoid infection of the affected areas of the lip and reduce the risk of relapses.

To treat infectious cheilitis, you can use Tantum® Verde .

Stomatitis with COVID-19

Stomatitis is an inflammation of the mucous membrane of the cheeks and lips, palate, tongue, floor of the mouth and gums.

Catarrhal stomatitis

At the onset of the disease, catarrhal stomatitis develops.16 It is characterized by a burning sensation, mild swelling, and redness of the mucous membrane.
Due to decreased immunity, herpetic stomatitis may develop at the end of the disease. The prevalence of herpes simplex virus in the population ranges from 65% to 90%.15

Herpetic stomatitis

Herpetic stomatitis is manifested by itching, burning, the appearance of blisters that burst and form erosions (superficial defects of the mucous membrane), and may also be accompanied by an increase in temperature, enlarged lymph nodes, and weakness (especially in children).

Candidal stomatitis

Candidal stomatitis may also develop. The main symptom of fungal stomatitis is a burning sensation and the presence of a white, cheesy coating, when removed, a swollen, red mucous membrane appears. The general condition of adults with candidal stomatitis often does not worsen.

Prevention of stomatitis

• strengthening the immune system, giving up bad habits, hardening, playing sports
• eating a diet with sufficient nutrients and vitamins, especially vitamin C
• regular visits to the dentist
• adequate brushing of teeth at home, as well as removal of dental plaque in the dentist’s office once every 6 months
• identifying the allergen and avoiding contact with it
• undergoing medical examination for timely detection of diseases
• treatment of systemic diseases
• taking antibiotics (only as prescribed by a doctor, together with a course of probiotics to avoid dysbacteriosis)

To maintain immunity, we recommend taking Tantum® Propolis . Propolis has an immunostimulating effect and promotes healing, and vitamin C, which is part of it, is responsible for cell regeneration, participating in collagen synthesis. Propolis also has antiviral and antifungal effects. Therefore, vitamin therapy with Tantum® Propolis is an effective means of preventing stomatitis.

It is worth concluding that it is very important to monitor oral hygiene not only during health, but also during illness. It is also recommended to engage in the prevention of dental diseases to avoid possible problems with teeth and gums.

Who's at risk

First of all, these are people who have the following unfavorable factors:

1. Weakened immunity.

Defects in immune defense are the main factor predisposing to the occurrence of mycoses (fungal infections)1,2,4. The increase in their incidence in all countries of the world is due, first of all, to various types of conditions accompanied by weakened immunity1,[3]. It is not for nothing that “thrush” is called “the disease of the sick”1. Among its reasons:

• severe general diseases, for example, infectious2,3;
• cancer accompanied by sudden weight loss, lack of vitamins and microelements, requiring radiation and chemotherapy2,3;
• congenital and acquired forms of immunodeficiency, including AIDS2,3;
• endocrine disorders, for example, diabetes mellitus2,3.

1. Dental diseases.

• Inflammatory , such as caries and its complications, gingivitis, periodontitis, periodontal disease and others2. The huge number of bacteria present during inflammation weakens the immune system and contributes to the proliferation of fungal microflora2. A diseased tooth with a carious cavity “infested” with microbes or a periodontal pocket filled with pus may well provoke the development of “thrush”3,[4].
• Non-inflammatory , which change the structure of the oral mucosa, for example, folded tongue and leukoplakia4. It is easier for fungi to attach to a damaged surface than to a healthy one.

1. Constant dry mouth.

• Insufficient saliva (xerostomia), associated with a variety of problems, contributes to the development of oral mycosis4. Saliva contains many enzymes and antibodies that protect the mucous membrane from the action of microbes4. If there is little saliva, it dries out, its protection is weakened, which creates favorable conditions for the development of other infections.

1. Defects in oral hygiene.

• Insufficient care . Problems more often arise in those who rarely brush their teeth and ignore the care of their tongue, interdental spaces and dentures4.
• Injuries . Sometimes the cause of an “outbreak” of oral mycosis is a too hard toothbrush or rough manipulation of dental floss and toothpicks. Injured gums are easy prey for fungi2.3,4.

1. Incorrect use of removable dentures.

• Poorly customized removable dentures can rub the gums3,4, making them accessible to germs.
• No night break in using prostheses4. The gum located under the prosthesis is poorly enriched with blood, it lacks oxygen, it is not washed with saliva - this predisposes to the development of infection4.
• Improper care of dentures. Artificial teeth need care just as much as your own. Deprived of attention, they become covered with a thin film of various microbes, which then “attack” the gums.

1. Age.

• Most often, doctors find “ thrush” in the mouth of infants and the elderly4. The reason for this is the imperfections of the immune system, which create favorable conditions for the proliferation of pathogenic microflora1,4,[5]. In addition, in childhood, dietary habits affect, and in old age – constant dry mouth and lack of teeth, forcing you to wear dentures1,5.

1. Medicines

• Antibiotics. They kill not only pathogenic microbes, but also beneficial ones, thereby disturbing the balance of microflora and creating conditions for mycoses to flourish1,2.
• Drugs that inhibit cell proliferation (cytostatics). They interfere with the renewal of surface mucosal cells and disrupt local and general defense mechanisms against infections1,2.
• Immunosuppressive medications, which are prescribed when immune responses need to be suppressed, such as during transplantation1,2.
• Inhaled corticosteroids, which are used in the treatment of bronchial asthma and, due to their side effects, increase the susceptibility of the mucous membrane to infections2,[6].

1. Unbalanced diet

• Lack of iron, vitamins C and B12, and folic acid1 in the diet, which leads to decreased immunity.
• Excess carbohydrates1,2. Excessive consumption of sweets, flour products, sweet fruits, starchy vegetables and other foods containing large amounts of simple carbohydrates contributes to the appearance of thrush in adults and children1,2.

Up to contents