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10 Helpful Tips: Reducing Dry Mouth for Hepatitis C

Nicole Cutler L.Ac.

October 16, 2007

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Patients with Hepatitis C often experience a chronic dry mouth. Learn ten safe and valuable ways to reduce this uncomfortable symptom.

Although sources disagree on how many people are affected, health care professionals recognize that many people with Hepatitis C experience the chronic discomfort of a dry mouth. Known clinically as xerostomia, not having enough saliva to keep the mouth wet can be a serious problem. Luckily, there are some solutions for xerostomia that are safe for those with Hepatitis C.


Possibly causing problems with tasting, chewing, swallowing and speaking, a chronic dry mouth is often due to inadequate function of the salivary glands. In addition to lubricating the mouth to permit speech, taste and chewing food, saliva also prevents bacteria, viruses and fungi from causing mouth infections. Besides having a mouth that feels like it is stuffed with cotton, xerostomia patients may experience a sore tongue, gums or cheeks, frothy or foamy saliva, bad breath or sensitive teeth.

Gone untreated, a severe case of xerostomia can lead to increased levels of tooth decay and mouth infections. According to Dr. Martin Greenberg, chairman of the department of the School of Dental Medicine at the University of Pennsylvania, “If a patient has a dry mouth, the chance of dental caries (cavities) climbs.”

Drugs and Depression

Whether due to the physical aspects of Hepatitis C, its emotional associations, social impact or the virus’ treatment regimen, many people living with Hepatitis C confront depression. A common side effect of antidepressant medication, xerostomia is often seen in people battling depression. Additionally, depression can have its own influence on personal hygiene. According to Richard Darling, DDS, “One-third of hepatitis patients on medication suffer depression and, thus, impaired perception of self-care. They may take less care of their teeth, and problems will occur.”

While most antidepressants can cause xerostomia, drugs with significant anticholinergic activity are most likely to lead to oral complications. Anticholinergics such as tricyclic antidepressants are frequently implicated in dental problems because they have a prolonged effect on salivary function. Antipsychotic medications and antiparkinsonian drugs are other classes of drugs with anticholinergic properties likely to cause dry mouth. Newer antidepressants such as venlafaxine, reboxetine and the selective serotonin reuptake inhibitors (SSRIs) can also cause dry mouth, but this is likely to be mild and temporary. For those with Hepatitis C on a methadone treatment program, methadone is another substance known to cause xerostomia.

Hepatitis C Specific

For the most part, people with Hepatitis C do not have to worry about dental problems any more than the average person. “A hepatitis patient has the same responsibility to his or her teeth as every other citizen out there,” says Darling. “They simply need to keep their teeth clean and free of plaque.” However, one study published in the Australian Dental Journal in 2000, indicated some evidence showing that people with hepatitis are slightly more prone to tooth decay.

For a person with Hepatitis C who is at the end stage of liver disease, the poor dental health accompanying xerostomia can result in being rejected for a liver transplant. If you are on the transplant list, you already know that you have to be completely free of any dental disease undergoing an operation. “At the Department of Oral Medicine here at the University of Pennsylvania, we have a service where all transplant patients get a full dental evaluation,” says Dr. Greenberg. “We must eliminate any possible oral influences on infection. While dental problems are not as serious with a liver transplant as they might be with a bone marrow transplant, for instance, it is still an important issue.” All transplant centers offer some kind of dental care for their patients, from the smallest sign of infection to having every tooth removed.

10 Tips for Helping Xerostomia

Since saliva acts to protect your teeth from bacteria, there is plenty of reason to avoid a chronic dry mouth. While your doctor and dentist should be aware of your oral health issues, below are ten ways to help restore moisture in your mouth:

  1. Regularly sip water and sugarless drinks.
  2. During meals, sip water to help with chewing and swallowing.
  3. Chew sugarless gum or suck on hard sugarless candy to help stimulate saliva flow.
  4. Avoid caffeine, tobacco and alcohol because they all dry the mouth.
  5. During the night, use a humidifier.
  6. Avoid spicy and salty foods as these can exacerbate a dry mouth.
  7. Reduce bacteria and plaque in your mouth by brushing your teeth at least twice a day with fluoride toothpaste and flossing daily.
  8. Minimize sugary, sticky foods, and brush immediately after their consumption.
  9. Visit your dentist at least twice a year.
  10. Discuss a salivary substitute with your healthcare provider.

Even if a liver transplant is not in your near future, the importance of reducing xerostomia goes beyond the motive to minimize bad breath. By recognizing the possible consequences of a chronic dry mouth, you can work towards improving oral health. Taking such an initiative will save you from liver transplant rejection and from the added burden of oral diseases.


Coates EA, et. al., Hepatitis C infection and associated oral health problems, Australian Dental Journal, June 2000.

Henderson L., et al., Oral health of patients with hepatitis C virus infection: a pilot study, Oral Diseases, September 2001.

http://panicdisorder.about.com, What to do About My Dry Mouth, Cathleen Henning Fenton, About, Inc., 2007.

www.australianprescriber.com, Psychotropic Drugs and Dentistry, Michael M Page et al., Australian Prescriber, 2007.

www.hepccouncilsa.asn.au, Hepatitis C and Dental Health, B. Scopacasa BDS FRACDS, E. Coates MDS FADI FICD, R. Logan BDS MDS, Hepatitis C Council of SA, 2007.

www.liverhealthtoday.org, Open Wide, Tamra B. Orr, Liver Health Today, 2007.

www.medterms.com, Definition of Xerostomia, MedicineNet Inc., 2007.

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Posted by Nicole Cutler L.Ac. on October 16, 2007

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