Dry Mouth

Dry Mouth

The Tupi Guarani Indians of Brazil have a plant called jaborandi that causes salivation. In fact, in the Tupi language, jaborandi means "that which causes slobbering."

When researchers at the National Institute on Dental Research (NIDR) heard about jaborandi from some ethnobotanists, they got all excited. (An ethnobotanist is a plant specialist who studies the medicinal uses of plants in other cultures.) Lots of people suffer from dry mouth syndrome, medically known as xerostoma, so the folks at NIDR are always on the lookout for new substances that stimulate salivation. Jaborandi sounded promising.

The ingredient in jaborandi (Pilocarpus, various species) that causes salivation is a compound called pilocarpine. Good studies have shown that pilocarpine increases production of saliva up to tenfold, easily relieving the uncomfortable sensation of oral dryness. Clearly jaborandi deserves more study.

Drooling over the Possibilities

Actually, when I learned about jaborandi, I got pretty excited myself. I imagined incorporating it into a chewing gum that could relieve dry mouth, providing easy relief for millions of people.

But there was a catch, both for me and for the NIDR. Brazil has a virtual monopoly on the supply of pilocarpine, which is also used to treat certain types of glaucoma, and they don't want any of their precious living source leaving the country. If they control the supply, they control the price. They are happy to export the pilocarpine they extract from jaborandi, but the government prohibits the export of living plants for fear that someone else will start extracting pilocarpine from them and sell it more cheaply. As a result, I was never able to get any jaborandi out of Brazil.

And Lord knows, I tried. I hooked up with a Johns Hopkins ophthalmologist and some of his friends, who had an interest in jaborandi's anti-glaucoma action, and we went chasing through the bush country of Brazil in search of the precious plants. But our efforts came to a halt when we were blocked by the authorities.

Some time later, I succeeded in obtaining a related species of Pilocarpus from Paraguay. But again there was a catch. Some of my colleagues at the U.S. Department of Agriculture (USDA) were concerned that my jaborandi citrus relative might harbor viruses that could decimate the U.S. citrus industry. They destroyed my plant.

A year later, I managed to get one jaborandi plant into the United States for research purposes. Again, the USDA got nervous about viruses, but this time I succeeded in persuading them not to destroy the precious plant. Instead they placed it under quarantine at the Beltsville Research Station where I worked. My jaborandi sat there for quite a while, and my hopes of ever retrieving it faded.

After I retired, I learned that the quarantine had been lifted. I picked up my jaborandi and transplanted it to my backyard. It's a nice plant.

Meanwhile, MGI Pharma of Minneapolis developed a pilocarpine-based mouth-moistening drug that it hopes to call Salagem; it's awaiting approval from the Food and Drug Administration (FDA). It looks like they'll get rich while a perfectly effective nondrug solution languishes in my backyard and in Brazil.

Caught High and Dry

Dry mouth is not only uncomfortable, it's also not good for you. Saliva helps control bacteria populations in the mouth, and in doing so it helps prevent tooth decay, gum disease and mouth infections.

An estimated 25 percent of older Americans complain of dry mouth. The condition is common among public speakers like me, hence the inevitable water glass at the podium. It is also related to aging and is a side effect of more than 400 widely used medications, including many prescribed for high blood pressure and depression.

In addition, dry mouth is a symptom of Sjögren's syndrome, a condition often associated with rheumatoid arthritis that also causes dry eyes.

Green Pharmacy for Dry Mouth

If you're ever caught with dry mouth in Brazil, you could try chewing some jaborandi. Here in the states, until the pilocarpine medication wins FDA approval, sip water frequently, especially when eating or speaking. Avoid coffee and sugary beverages, both of which can aggravate dry mouth. Also avoid alcohol, tobacco and salty foods. In addition, try these herbs.

Echinacea (Echinacea, various species). One compound in echinacea, echinacein, is a proven saliva producer. I recommend taking a dropperful of tincture in juice. If you have access to the fresh plant, you can also chew the root. In addition to stimulating salivation, echinacea tends to numb the mouth, but this effect is temporary and harmless.

Evening primrose (Oenothera biennis). Oil from the evening primrose (EPO) is a rich source of a compound known as gamma-linolenic acid (GLA). Few reviewing the medical literature can have any doubts that GLA is a potent treatment for autoimmune disorders, which are caused by a confused immune system attacking the body itself. Sjögren's syndrome is thought to be an autoimmune disorder.

If I had dry mouth caused by Sjögren's, I would try EPO. You can buy capsules of EPO in natural food stores. Simply follow the package directions.

Multiflora rose (Rosa multiflora). In China, people simmer two to four teaspoons of the dried flower per cup of boiling water to make a tea for treating dry mouth.

Red pepper (Capsicum, various species). Capsaicin, the fiery compound in hot pepper, stimulates not only salivation but also other watery discharges--sweat and tears. The hotter the pepper, the more capsaicin it contains. You can add red pepper to food or stir it into juice or tea.

Yohimbe (Pausinystalia yohimbe). This herb is an African folk aphrodisiac that stimulates both erection and salivation. Currently, many American men are taking yohimbine, an extract of yohimbe, to treat erection impairment, so it's readily available. If you want to try this herb to treat dry mouth, I recommend asking your doctor for a prescription for yohimbine. Using the herb itself--a dried bark--can be hazardous.