Dry Mouth & The Wonderful World of Spit.


Spit.  Humans spit a lot.  Some more than others.  Years ago, one of my grade-school pals could open his mouth, thrust his jaw forward and shoot a straight line of spit right to my eye.  It was a great side show, not for me, but for my other supposed “friends” who’d laugh their heads off, fingers pointing my direction.

Welcome to the wonderful world of spit.

In the medical world it’s called saliva.  ENT docs deal with it all day long.  Saliva is a necessary bodily function, and most animals create it.  Dogs obviously salivate, they do it a lot; you’ve seen drooling canines wandering about, rabies or not.  Even birds do it.  Bird saliva is the key ingredient in Chinese “Bird’s Nest Soup.”  I’m not kidding.  And of course, we humans do it all the time. 

Not to disgust you, but saliva has lots of wonderfully important substances mixed within its sliminess rendering it an intriguing subject of study.  It serves as a first line of defense against nasty pathogens—those tiny bad guys that cause infection and disease.  It starts the initial breakdown of food and aids in flavor perception, thereby serving both purpose and pleasure.   It helps keep teeth healthy.  Ongoing research into biomarkers in saliva is promising, ranging from noninvasive monitoring of blood sugar for diabetes (using saliva to check blood sugar) to the detection of oral cancers.

Reduced spit production is annoying and disturbing.  The mouth and throat become dry from lack of saliva, a condition called xerostomia.  This can lead to mouth and throat discomfort, altered sense of taste, sores in the mouth and throat and lead to teeth decay.  Various medications and certain medical conditions can lead to reduced saliva and xerostomia.  Unfortunately, age-related salivary changes exists, where our salivary glands produce less saliva and the composition of saliva changes as we get older.

There are means to help improve saliva production and reduce xerostomia.  These measures also are used to prevent other nastiness such as a salivary gland infections or salivary stones. 

Amongst these measures are:

1.  Drink plenty of fluids.  Caffeinated beverages do not count, since these act as a diuretic, causing you to lose more fluid.  Increase water intake, or use an electrolyte drink such as Gatoraid.

2.  Massage the gland(s) every 1-2 hours while awake with firm pressure, pushing and rubbing from front to back to move saliva out of the gland.    Once improved, you should then do this three times a day or more to prevent recurrence of blockage. 

The picture above shows a parotid massage.  The ones below show gland anatomy and submandibular massage:


3.  Sour candy (or sour sugarless candy if you are diabetic) 3-4 times a day, such as Lemon Drops or Skittles.  Adding lemon to your drinks also helps, or drinking very tart juices such s cranberry juice, with plenty of water.

4.  Gum chewing can help, but be carefully about chomping to vigorously or too frequently, otherwise you could end up with a TMJ problem.

5.  Warm compress the gland three times a day if having swelling or a gland infection.

Items #1, 2 and 3 should be done daily, even when not having the pain or discomfort.  These measures often help to reduce or prevent the recurrences of sialoadenitis or salivary stones, but also can help to maintain good saliva flow and reduce oral dryness.  Other OTC medications such as biotene (in the form of lozenges, gum or spray) can help.  There is also a product called Mouth Kote (an OTC spray that can be purchased on line) which does not improve saliva production, but is meant to improve oral moisture by direct application.

By the way, that grade-school chum did a version of the gland massage hands-free, contracting the neck and floor of mouth muscles around his submandibular gland, essentially compressing the gland and squirting the saliva from the duct under his tongue and yonder to his target, which often was my eye.  I understood this mechanism-of-action long after I got a little smarter in med school. 

©Randall S. Fong, M.D.


For more topics on medicine, health and the weirdness of life in general, check out the rest of the blog site at  randallfong.blogspot.com


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2.  A Focus on Oral Cancer Detection through Salivary Biomarkers. Biosensors 2021, 11, 396. https://doi.org/10.3390/bios11100396

3.  Aging-related changes in quantity and quality of saliva: Where do we stand in our understanding?  J Texture Stud. 2019 Feb;50(1):27-35 DOI: 10.1111/jtxs.12356