My Opioid Meds Are Making My Mouth So Dry

Why chronic opioid therapy causes dry mouth and how to combat it.

One of the most annoying and potentially costly side effects of taking opioids is dry mouth (clinically known as xerostomia). Individuals who have this condition can be at risk for a variety of dental problems. Saliva, which helps prevent against tooth decay and gum disease and washes away food and neutralizing acids made by bacteria in the mouth, is diminished in someone with dry mouth. Bacteria can multiply and cause dental problems that start with gingivitis, and may end up leading to periodontitis, which calls for tooth removal in untreated cases.

“Dry mouth is a fairly common complaint for those who use opioids on a daily basis,” says Melissa Callahan, CRNP, corporate director of nursing for Retreat Behavioral Health in Palm Beach County, Florida, and Lancaster County, Pennsylvania. Even intermittent opioid use may lead to some complaints of dry mouth, she added.

Why chronic opioid therapy causes dry mouth and how to combat it. (Source: 123RF)

Why Opioids Make Your Mouth Dry

Opioid use decreases the activities of the central nervous system, the peripheral nervous system, and the autonomic nervous system, Callahan explains. “Saliva is produced and secreted by the salivary glands of the body and these glands are controlled by the autonomic nervous system,” she says.  “So opioid use will decrease the production of saliva and cause dry mouth.”

“In some cases,” Callahan adds, “switching from one opioid to another may be the best solution.” But if you have already tried a different medication and are still experiencing this side effect, consider the dry-mouth remedies below. (Read also about constipation, another common opioid side effect.)

How to Combat a Dry Mouth

Stay Hydrated

Stay hydrated, advises Houman Danesh, MD, director of integrative pain management at Mount Sinai Medical Center in New York City. Drink plenty of fluids, primarily water but occasionally a beverage that contains electrolytes and is low in sugar. “If you just drink water, after a certain point, you just pee it out,” he says. “When you drink something with electrolytes, like a sugar-free Gatorade, you hopefully will stay well-hydrated.”

Remember that fruit contains sugar as well as water. So if you want to sub in some fruit for part of the water as part of your daily fluid intake, stick to lower-sugar fruits like apples rather than higher-in-sugar fruits like watermelon, he advises.

Callahan notes that lemon juice, in particular, has been “widely documented to help cleanse the mouth and eliminate the bad breath that has been associated with dry mouth.” Coconut water, cucumbers, and pineapple can also be beneficial, she says. If you are not into fruit, chewing on ginger or snacking on celery sticks can both help to stimulate the saliva glands and add moisture naturally, she adds.

Use Moisturizing Mouthwashes

Avoid using mouthwashes that have alcohol and peroxide, Dr. Danesh says, because they will further dry out your mouth. Instead, try moisturizing mouthwashes and prescription-strength mouth rinses. Artificial saliva and moisturizers (such as over-the-counter melting tabs) to lubricate your mouth can also provide some relief, Callahan says. Sleeping in a humidified room can be helpful as well, she says, as can sucking on sugar-free candy or chewing sugar-free gum to promote saliva production.

Items to Avoid

Don’t smoke or chew tobacco, and avoid sugary or acidic foods and candies, Callahan suggests. Finally, keep in mind that spicy foods and acidic foods can irritate the inside of the mouth and worsen a dry mouth.

Be sure to talk to your doctor if your dry mouth is impacting how or what you can eat.

Updated on: 02/15/19
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