DEAR DR. DONOHUE: Please help. My mouth is so very dry. What do you suggest? – A.B.

Saliva is one of those things no one thinks about until it’s gone. Then people can think of nothing else.

Salivary glands pump out about 3 pints (1.5 liters) of saliva every day. Not only does it moisten the mouth, but it prevents cavities by keeping down the population of mouth bacteria and by neutralizing mouth acids. It also begins the digestive process by breaking down carbohydrates.

Before thinking of treatment, think about causes. One is Sjogren’s (SHOW-grins), the condition where the immune system attacks salivary glands and sometimes tear glands. Other illnesses where dry mouth is a notable symptom include Parkinson’s disease rheumatoid arthritis, lupus and diabetes. Treatment of dry mouth in those illnesses centers on treating the disease.

Medicines are another cause for dry mouth. Some antidepressants, antihistamines, epilepsy-control drugs and water pills can dry the mouth.

While looking for a cause, you can start chewing sugarless gum on a regular basis. Carry with you at all times a plastic squeeze bottle filled with water, and don’t be embarrassed to use it as often as you need. Artificial salivas are on the shelves of every drugstore. The pharmacist can help you find one.

Don’t drink alcohol and don’t use alcohol-based mouthwashes. Alcohol dries.

Become best friends with your dentist. Without constant vigilance, a dry mouth rots teeth. Use a fluoride mouthwash and fluoride toothpaste.

Evoxac and Salagen are two prescription medicines that get sluggish salivary glands working. Ask the doctor who is looking for the causes of your dry mouth if either of them would benefit you.

DEAR DR. DONOHUE: In our small city, a large medical facility and our hospital are controlled by a group of businessmen. Office visits are limited to 15 minutes, and then patients are told “Your 15 minutes are up.” In our hospital, patient care is very limited. There are no daily baths or washing of hands and face. If patients are confined to bed, they are not given a basin of water to bathe or even a wet washcloth to clean their hands. Preparing patients to sleep at night doesn’t exist. There is no straightening of the bed. Patients are on their own. A friend who was recently in this hospital read an entire book one night because he couldn’t sleep. No one ever checked to see why his light was on. As a person who once worked as a hospital aide, I am shocked by all of this. Am I that far out of the loop that I just don’t understand this new approach to patient care? – M.Y.

You are not far out of the loop. Such practices are becoming common because the people in charge have an eye only for the profit column.

I don’t know how I can help you or what either of us can do about the crassness that has invaded medical practice. An aroused public is the only hope of effecting change.

Medicine’s foundation lies in altruism and not in economics. Medical personnel have to be aware of costs, but service ought not to be cut so thin that people suffer from their treatment as well as their illness.

Medicine’s role is to mitigate human suffering. If any other consideration is placed before that principle, we have debased what should be a noble endeavor.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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