DEAR DOCTOR K:

My mouth and throat are always parched, even though I'm constantly sipping water. It's very uncomfortable. I'd appreciate any advice you can offer.

DEAR READER:

Most of the time dry mouth, also called xerostomia, causes more discomfort than damage. But severe cases can cause complications. Dry mouth can rob you of your sense of taste and can make chewing slow and swallowing difficult. Also, since saliva is important for dental health, dry mouth can contribute to tooth decay and periodontal disease. My colleague Dr. Harvey Simon recently wrote about dry mouth in the Harvard Men's Health Watch. Here's what he and I advise.

First, be sure you're well-hydrated. It sounds like you drink plenty of water. Still, the membranes in your mouth and throat can dry out if you breathe dry air through your mouth. That's especially true at night. Usually, the reason people breathe through their mouth at night is that their nose is congested. If mouth breathing contributes to your problem, nasal decongestants may help restore nose breathing. Also, a bedroom humidifier can add moisture to the air you breathe.

Medications are common culprits. Many commonly used medicines have what's called "anticholinergic" effects, which cut the flow of saliva, producing a dry mouth. Common offenders include antihistamines, tricyclic antidepressants, antispasmodics, and certain drugs used for Parkinson's disease, overactive bladder and chronic bronchitis. Take an inventory of your medications. If you round up a few suspects, discuss them with your doctor.

Medical conditions are much less likely to be responsible for a dry mouth. Still, your doctor should check for oral yeast infection (thrush) and for problems that affect the salivary glands themselves, such as Sjogren's syndrome.

Even if you can't correct the underlying cause of your dry mouth, you can do things to promote comfort. Chew sugarless gum or suck on sugarless candy to stimulate the flow of saliva. Avoid dry or very spicy foods. Drink plenty of water, but steer clear of alcoholic and caffeinated beverages. And don't forget regular dental care.

Finally, try using artificial saliva products. These are available over-the-counter as sprays, swabs and solutions. Though not identical to natural saliva, artificial saliva can help moisten the tissues in your mouth and throat.

The most memorable case of a dry mouth I ever saw was an 84-year-old woman. I was her daughter's doctor, and one day her daughter brought her mother with her to my office. She told me her mother had started sucking on apricot pits all the time, something she had never done before. Her mother wouldn't say why; she just wanted to do it. I figured out that it was because her mouth was very dry, and sucking on apricot pits helped produce saliva.

But why was her mouth so dry? It wasn't because of mouth breathing at night or medicines. It was because she had developed diabetes. Her sugar level was so high, and she was so dehydrated, that I immediately hospitalized her. She almost died, but recovered and lived to be 99 years and 4 months old.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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