The Joplin Globe, Joplin, MO

April 7, 2010

Dr. Debra Buckler: Finding relief for dry eyes and dry mouth

As people age, it is not uncommon for them to develop a sensation of dryness in their eyes, sometimes accompanied by dryness of the mouth. Severity can range from a minor annoyance to a threat to vision and the ability to swallow. This dryness can have many causes, but most commonly relates to a condition known as Sjögren’s syndrome. This article will review some of the common causes of dry eyes and mouth and look at available treatments.

Let’s begin with Sjögren’s syndrome, a condition in which the body’s own immune system attacks the glands in the eye and mouth that produce tears and saliva respectively. While this disease, in its more aggressive form, can attack other organs of the body and threaten life, it most commonly produces dry eyes and a dry mouth. Formal diagnosis of this condition is done with blood tests, biopsies of the salivary glands of the mouth, and tests for tear production in the eyes.

Other causes of dry eyes include decreased levels of vitamin A, chronic eye inflammation associated with a skin condition known as rosacea, and impaired blinking due to neurologic diseases affecting the muscles of the eyelids. Dry eyes can also occur with excessive eye strain from overuse of computers, lack of adequate rest, or need for appropriate eyeglasses.

In addition to Sjögren’s syndrome, dry mouth can occur as a side effect of many commonly used drugs such as antihistamines, some antidepressant medications, some heart and blood pressure medications, and some antiseizure drugs. Diseases of the salivary glands and chronic infections, such as HIV and hepatitis C, can also cause dry mouth.

While treatment of Sjögren’s syndrome in its more severe forms might require some specialized medications usually ordered by a rheumatologist, treatment of dry eyes and dry mouth usually begins with over-the-counter preparations. Treatment of severe dry eyes may require input from an ophthalmologist, or eye doctor, as well.

The mainstay of treatment for dry eyes involves the use of moisturizing eye drops, many available over the counter. Some eye drops contain preservatives that can irritate a dry eye. If this is the case for you, you may want to try a preservative-free solution. Persons suffering from dry eyes often need to try several different preparations to find the ones that work the best for them. When trying the different preparations, read the contents in the small print to avoid wasting money on the same drug with different brand names. Prescription eyedrops are also available; these reverse the attack on the tear glands seen in Sjögren’s syndrome.

Some patients benefit from the use of eye ointments as a supplement to eyedrops. The ointments can impair vision when first applied to the eye and should usually be used only at bedtime. Use very small amounts of these ointments, about one-eight of an inch per eye, to prevent blocking the tear ducts near the eyelashes. Some patients benefit from small plugs, called punctal plugs, that block the drainage of tears from the eyes. These normally require a doctor’s order.

In regard to dry mouth, treatment usually begins with stopping any medications that might contribute to the problem. Some patients benefit from sucking on sugarless candy or dried fruit slices to stimulate saliva flow as well. Chewing gum can also help; however, people with dry mouth are very prone to cavities and should always choose sugarless products. Sipping water throughout the day helps too. Some people find relief with saliva substitutes, available over the counter in several varieties. Your pharmacist should be able to help you make a selection. Prescription medications are available for more severe cases.  

People with dry mouth form cavities easily and should see a dentist often. They also may find that toothpastes cause a burning sensation. Several dental care products are made especially for people with dry mouth. If these products are too expensive, try brushing with a children’s toothpaste or baking soda. 

In summary, people suffering from dry mouth, dry eyes, or both, should see a healthcare provider to evaluate the condition, review medications, and rule out more serious disease. For most, treatment with an over-the-counter preparation usually works adequately, except in particularly severe cases or when the person has a more serious illness.