Xerostomia, Dry Mouth, and Lupus

Many people with lupus experience abnormally dry mouths, and this symptom is more than just uncomfortable – it can make other symptoms worse or hint at deeper issues.

Dry mouth is the feeling of stickiness or dryness that is common for people with lupus. Approximately 79-80% (48) of the 93 patients in a lupus study conducted in Brazil had low levels of salivation and dry mouths.  That’s a huge percentage, yet few people think about this symptom.

Dry mouth occurs when there isn’t enough saliva being produced in the mouth, and it causes many problems. Saliva is acidic and has enzymes that prevent infection. Without it, microbes colonize the mouth that would otherwise be destroyed, leading to tooth decay and cavities as well as yeast infections of the mouth. 

Systemic lupus erythematosus is an autoimmune disease where the body attacks itself. Systemic lupus erythematosus is an autoimmune disease that can affect any organ in the body. Because of this, it can cause dry mouth. Because the immune system of a person with lupus is also not operating at peak effectiveness, infections are not easily fought off, so these problems only become worse until the dry mouth is taken care of. This makes preventing infection hugely important, including the maintenance of saliva and other natural first-line defenses of the immune system. Dry mouth can also cause issues with eating, digestion, chewing, and swallowing. 

Sometimes, the mouth is not the only part that is dry. If the eyes are dry, then there can be damage to the eye due to lack of lubrication and the protective tear layer. If mucous production in the throat, and other parts of the body are affected by lupus, it can allow infections to occur there, too. If this happens in the lungs, it can lead to very dangerous pneumonia. A lack of sweat and oil production can cause skin damage and exacerbate cutaneous symptoms of lupus. Dry mouth can be a hint that these other issues are around the corner. 

Sjogrens Syndrome, Lupus and Dry Mouth

Sjogren’s Syndrome is an autoimmune disorder that primarily affects secretion glands, including tear and saliva glands as well as mucous producing glands throughout the body. It often occurs alongside other autoimmune diseases. It mainly targets the glands that make tears, mucous, and saliva. These glands fail to produce enough fluids, leaving the body without its normal lubrication and protection layers.

Symptoms include: 

• Joint pain and stiffness
• Skin rashes and dry skin
• Vaginal dryness
• Persistent dry cough
• Drawn out fatigue

People with lupus can experience similar symptoms without specifically having Sjogren’s Syndrome. whether it is Sjogren’s syndrome or another manifestation of lupus is not important – either way, the mouth is not producing enough saliva and is dry, and this leads to other problems.

Dental Health and Dry Mouth

Tooth decay is more frequent and, often, more severe for people with lupus. 9-45% of people with lupus have some form of oral symptoms, including missing teeth, dry mouth, and oral ulcers. It goes deeper than just the teeth – tooth decay can lead to higher levels of inflammation and lupus flares. Tooth decay can even cause infections in the blood or lungs as the bacteria growing in the mouth leak elsewhere. This decay can be exacerbated by dry mouth, making it very important to deal with dry mouth. Mouth ulcers are another common oral symptoms of lupus that can worsen due to dry mouth, so it’s important to take care of the mouth carefully.

Frequent toothbrushing and flossingv can prevent bacteria from taking hold even in a dry mouth, at least twice a day but cleaning the teeth after every meal is recommended, especially if you have healing mouth ulcers. Waterpiks are flossing device that uses water jets to essentially powerwash food particles and plaque away from the teeth. This also helps add moisture to the mouth. Mouthwash is a good tool to use for oral health and will speed up healing and prevent tooth decay, but it can irritate the lining of the mouth, so use with care.

What Can you do About Dry Mouth?

Breathe through the nose to limit evaporation from the mouth. Air humidifiers add moisture to the air and reduce the evaporation of moisture from the body. Having a humidifier, especially in the wintertime when the air is cold and dry. Cold, dry air can make the mouth dryer faster, so warming the air and using humidifiers can help prevent dry mouth. Humidifiers can improve the health of the skin, nose, and lungs by preventing evaporation. Avoid smoking, since it – and secondhand smoke – dehydrates the mouth and airways, too.

Fruit is a tricky topic: Tart fruits (including apples, oranges, and other fruits) can help with dry mouth because they encourage the salivary glands to produce more saliva, wetting the mouth. They also provide water, fiber and other vitamins, so it is highly recommended that one eats fruit. However, they are sugary and should be eaten in moderation.

On the topic of eating, be sure to get plenty of calcium, magnesium, and vitamin D in your diet, too. 

Drinking Water, Dry Mouth, and Lupus

Drink lots of fluids. Alcohol can cause dehydration and dry out the mouth even more, so it is not a good refreshment for people with dry mouth. The best thing to drink for dry mouth is water, without anything in it. More water means better hydration, which can help to make up for damaged salivary glands. 

Putting the two together, fruit juice can add extra hydration and the sugars can help the body absorb and retain water, but the sugar levels in fruit juice is especially high, so the sugar can cause increased inflammation and flares. Sugar also feeds the bacteria in the mouth that cause cavities, so sugary foods should be eaten in moderation.

When a person is properly hydrated, it comes with a lot of additional benefits. The whole body runs just a little bit smoother overall, affecting every organ in the body, and helping to counteract the symptoms of lupus. You can read more about hydration here.