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Dry Mouth and Diabetes: Causes and Management

Dry mouth is a condition that affects an estimated 13.2% of Australians, and is exactly what it sounds like – a feeling of dryness in your mouth [1]. 

Although dry mouth can affect people of all ages and health statuses, it’s particularly common in people with diabetes, affecting roughly a quarter of all diabetic individuals.  Dry mouth can cause problems with eating, swallowing and speaking, and can lead to serious oral health conditions like periodontitis.      

In this article, we’ll explain what dry mouth and diabetes are, how diabetes causes dry mouth, and what you can do to relieve the symptoms of diabetes-induced dry mouth.

What is dry mouth?

What is dry mouth?

Dry mouth, medically known as ‘xerostomia’, is when your salivary glands don’t produce enough saliva to keep your mouth moist [2].  It’s most common in older people, and affects more women than men [2].

People affected by dry mouth often have difficulty swallowing, chewing and speaking, and may also experience a changed sense of taste [2].  Dry mouth also causes a range of oral health conditions, including [2]:

  • Burning mouth syndrome
  • Bad breath
  • Dry cheeks and tongue
  • Inflamed tongue (glossitis)
  • Cracked, dry lips
  • Oral thrush
  • Dental caries

Is dry mouth a symptom of diabetes?

Diabetes Awareness

Diabetes mellitus, normally just known as ‘diabetes’, is a chronic health condition that affects over one million Australians [3].  It occurs when your pancreas doesn’t produce enough insulin, or when your body can’t effectively use the insulin that it does have [4].

There are three main types of diabetes.

Type 1 Diabetes

Type 1 diabetes is an autoimmune condition.  When you have type 1 diabetes, your body doesn’t produce enough insulin, and many people with type 1 diabetes need to have daily insulin replacement therapy [5].  Around 10% of Australians with diabetes have type 1 diabetes [3]. 

Type 2 Diabetes

Type 2 diabetes accounts for roughly 80% of all diabetes cases [5].  It’s normally caused by being overweight or obese, although having a genetic predisposition can also put you at risk [5].  Roughly 5% of Australians have type 2 diabetes [3].

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is a type of hyperglycaemia that occurs during pregnancy, and can often lead to type 2 diabetes [5].  Roughly 7% of pregnant women have gestational diabetes, of which around 25% are later diagnosed with type 2 diabetes [5].

All three types of diabetes can cause dry mouth. 

A 2003 study found that, of surveyed participants with diabetes, 26.3% suffered from dry mouth [6].  A 2018 study found that 27.7% of participants with diabetes had dry mouth, while a 2017 study of participants aged 65–91 years found that 49.2% of participants had moderate to severe dry mouth [7, 8].     

While not everyone with diabetes has dry mouth, and not everyone with dry mouth has diabetes, xerostomia can be a symptom of diabetes.  Consult a healthcare professional if you’re experiencing persistent dry mouth, especially if you’re overweight or have a family history of diabetes.   

How Diabetes Can Cause Dry Mouth

So how exactly does diabetes lead to dry mouth?

Diabetes can cause a wide range of health problems, including lots of different oral conditions like periodontitis, dental caries, oral mucosal lesions, oral cancer, taste disturbance, burning mouth syndrome, and many more [9].

It’s also known to cause dry mouth, although exactly how it does this isn’t completely known.  Let’s take a look at what the current evidence says.

High Blood Sugar Levels

High Blood Sugar

Hyperglycaemia (high blood sugar levels) is thought to be one of the main reasons for people with diabetes having dry mouth. 

Some studies on animals have suggested that high blood sugar levels could cause dryness in certain glands, including the salivary glands, but the science is still out on whether that’s a cause of diabetes-related dry mouth in humans [9].

Hyperglycaemia can also cause polyuria and osmotic diuresis, which can lead to dehydration, a major cause of dry mouth [10].    

Medication

Medication and Dry Mouth

Medication for diabetes and for diabetes-related conditions, like hypertension, could also cause dehydration and feelings of dry mouth [9].  Anti-hypertensive drugs and certain classes of anti-diabetic drugs, like SGLT-2 inhibitor, may lead to dry mouth [9, 11].

Other Causes of Dry Mouth

Dry mouth can also be caused by a variety of other factors, like [2]:

  • Dehydration
  • Radiation treatment for cancer
  • Certain types of medication
  • Extremely dusty or dry environmental conditions
  • Overconsumption of alcohol, sugar or caffeine
  • Smoking cigarettes or recreational drugs
  • Trauma to the salivary glands
  • Lots of talking (lecturing, teaching, telemarketing)
  • Pregnancy
  • Old age
  • Autoimmune diseases, like Sjögren syndrome, rheumatoid arthritis, scleroderma and primary biliary cirrhosis
  • Infections, like HIV, hepatitis C, Epstein-Barr virus and T-lymphotropic virus type 1
  • Other health conditions, like tuberculosis, graft-versus-host disease, kidney disease, hemochromatosis and Parkinson’s disease

To find out more about why dry mouth occurs, head over to What Causes Dry Mouth?

Managing Dry Mouth Caused by Diabetes

There are a few different ways to manage the effects of dry mouth caused by diabetes.  For a detailed breakdown of management tips, check out one of our other articles, 5 Natural Remedies for Treating Dry Mouth.

Managing Dry Mouth Caused by Diabetes
  • Drink more water to prevent dehydration.  Slowly sip between eight and 10 glasses of water a day.
  • Suck on ice cubes throughout the day to keep your mouth moist and cool.
  • Avoid dry mouth triggers like caffeine, alcohol, sugar, salt, alcohol-based mouthwashes and smoking.  Hyperglycaemia is strongly linked to dry mouth, so manage your blood sugar levels by avoiding sugary foods, drinks, and other high GI consumables.
  • Brush and floss twice a day.
  • Use a humidifier, especially if you live or work in an air-conditioned building.
  • Change your medication.  If your GP or specialist has prescribed you antidiabetic or antihypertensive medication, ask them whether it could be causing dry mouth as a side-effect.  If there are other medications available to treat your condition, considering asking your GP or specialist to prescribe you a non-xerogenic alternative (an alternative that doesn’t cause dry mouth).
  • Add water to meals or eat soft foods.  This can help moisten your mouth when eating, and can make dry, hard foods easier to swallow.    
  • Use anti-xerogenic medications like oral pilocarpine or cevimeline, if prescribed by your healthcare professional.

Use Osmist Dry Mouth Spray 

Osmist is an Australian-made dry mouth spray enriched with active natural ingredients like papaya enzymes and grapeseed oil.  Papaya enzymes help promote saliva production and thin out thick saliva, while grapeseed oil coats the inside of your mouth, providing instant dry mouth relief for up to three hours. 

At $12.95 per bottle, it won’t break the bank, either, and it’s effective against the symptoms of medication-induced dry mouth, which are notoriously difficult to manage.  Osmist comes in a discreet 50-millilitre bottle that can easily fit in your bag or pocket – when your mouth feels dry, pump two quick sprays directly into your mouth, and use your tongue to spread the moisture over your cheeks and gums. 

The best part?  Osmist is free of unpleasant chemicals, making it a safe, healthy option for people with diabetes who need a long-term dry mouth solution.

Do Dry Mouth Sprays Actually Work?

Dry Mouth at Night and Diabetes 

Dry Mouth at Night and Diabetes

It’s pretty common to experience a dry mouth at night, especially if you sleep on your back or breathe through your mouth.  For people with diabetes, overnight dry mouth can be particularly unpleasant.

Although it’s normal to have reduced salivary flow at night, you can help minimise the effects of overnight dry mouth by installing a humidifier.  This can help raise the humidity of the air in your bedroom, reducing how quickly your mouth dries out, and is particularly important over winter (low humidity and cold, dry air) and summer (when dehumidifying air conditioning is often used). 

You can also use Osmist Dry Mouth Spray directly before bed.  In conjunction with a humidifier, Osmist can keep your mouth moister for longer, and prevent the cracked, parched feeling that often accompanies overnight dry mouth. 

     

Conclusion

Although chronic dry mouth is often a permanent symptom of diabetes, there are plenty of management options that can afford relief.  Better hydration, less high-GI foods, and use of products like Osmist Dry Mouth Spray can all contribute to your mouth staying moister for longer.     

To find out whether your might have dry mouth, use our free dry mouth self-assessment tool.

If you have a persistent dry mouth, consult a healthcare professional like a dentist, speech pathologist or GP.

Medical information on Osmist.com.au is merely information and is not the advice of a medical practitioner. This information is general advice and was accurate at the time of publication. For more information about oral care and your individual needs, seek the advice of a qualified medical professional.

References

[1] Jamieson, L. M. & Thomson, W. M. (2020) Xerostomia: its prevalence and associations in the adult Australian population. Australian Dental Journal. 65(S1), S67–S70. DOI: 10.1111/adj.12767 

[2] Millsop, J. W., Wang, E. A. & Fazel, N. (2017) Etiology, evaluation, and management of xerostomia. Clinics in Dermatology. 35(5), 468–476. DOI: 10.1016/j.clindermatol.2017.06.010 

[3] Hill, K., Ward, P., Grace, B. S. & Gleadle, J. (2017) Social disparities in the prevalence of diabetes in Australia and in the development of end stage renal disease due to diabetes for Aboriginal and Torres Strait Islanders in Australia and Maori and Pacific Islanders in New Zealand. BMC Public Health. 17(1). DOI: 10.1186/s12889-017-4807-5 

[4] Velasco-Ortega, E., Delgado-Ruiz, R. A. & López-López, J. (2016) Dentistry and Diabetes: The Influence of Diabetes in Oral Diseases and Dental Treatments. Journal of Diabetes Research. 2016, 1–1. DOI: 10.1155/2016/6073190 

[5] Lima, A. L., Illing, T., Schliemann, S. & Elsner, P. (2017) Cutaneous Manifestations of Diabetes Mellitus: A Review. American Journal of Clinical Dermatology. 18(4), 541–553. DOI: 10.1007/s40257-017-0275-z 

[6] Blanco, J. J. A., Villar, B. B., Martinez, E. J., Vallejo, P. S. & Blanco, F. J. A. (2003) Bucco-dental problems in patients with Diabetes Mellitus (I) : Index of plaque and dental caries. Medicina Oral. 8, 97–109.

[7] Carramolino-Cuéllar, E., Lauritano, D., Silvestre, F.-J., Carinci, F., Lucchese, A. & Silvestre-Rangil, J. (2018) Salivary flow and xerostomia in patients with type 2 diabetes. Journal of Oral Pathology & Medicine. 47(5), 526–530. DOI: 10.1111/jop.12712 

[8] Lima, D. L. F., Carneiro, S. D. R. M., Barbosa, F. T. de S., Saintrain, M. V. de L., Moizan, J. A. H. & Doucet, J. (2017) Salivary flow and xerostomia in older patients with type 2 diabetes mellitus. PLOS ONE. 12(8. DOI: 10.1371/journal.pone.0180891 

[9] Verhulst, M. J. L., Loos, B. G., Gerdes, V. E. A. & Teeuw, W. J. (2019) Evaluating All Potential Oral Complications of Diabetes Mellitus.  Frontiers in Endocrinology. 10(56). DOI: 10.3389/fendo.2019.00056

[10] Ship, J. A. & Fischer, D. J. (1997) The Relationship Between Dehydration and Parotid Salivary Gland Function in Young and Older Healthy Adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 52A(5), M310–M319. DOI: 10.1093/gerona/52a.5.m310 

[11] Collamati, A., Martone, A. M., Poscia, A., Brandi, V., Celi, M., Marzetti, E., Cherubini, A. & Landi, F. (2015) Anticholinergic drugs and negative outcomes in the older population: from biological plausibility to clinical evidence. Aging Clinical and Experimental Research. 28(1), 25–35. DOI: 10.1007/s40520-015-0359-7 


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