Brief Answer:
May be due to obstructive sleep apnoea (OSA)

Detailed Answer:
Hi. Thank you for writing to HCM.

A white pasty, thick saliva around the lips is commonly noted when the moth is open during sleep and the saliva around the oral cavity dries to become thick and pasty. It is also possible that one of the salivary ducts may be infected leading to purulent ( pus like) saliva, however this is usually associated with pain in the oral cavity, burning sensation in the mouth while eating food etc. Other causes of white pasty saliva is oral candidiasis or gingivitis which is associated with a white patch on the tongue as well along with burning sensation over the tongue and buccal mucosa.

Since you notice the white pasty saliva in the morning, it seems to be related to mouth opening while sleeping. In obstructive sleep apnoea the tongue relaxes during sleep and falls backwards thereby closing the entry of air. This forces you to keep your mouth open during sleep or snore. Some amount of acid reflux during sleep can also cause the saliva to be white and pasty.

In my opinion the following is recommended

1. If you have any other symptoms of OSA such as snoring, increased sleepiness throughout the day, excessive tiredness, weight gain, getting up during sleep etc then see an ENT to have your self evaluated. If not then you probably do not have OSA

2. Rinse your mouth with an antiseptic oral mouthwash before you go to bed every night for a week. If this brings it down then the white saliva may be due to an oral fungal infection of the gums or buccal mucosa.

3. Avoid spicy diet for about a week and drink up to 2 litres of water every day. Allow a gap of 2 hours between meals and lying down. This will reduce any acid reflux.

The white pasty saliva is generally not something to be too worried about. The above measures should help bring it down.

Hope this information was helpful. Do let me know if you have any further questions.

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Brief Answer:
May be related to age

Detailed Answer:
Hi. Thank you for writing back.

Age may be a contributing factor since the gingiva or gums start loosing their integrity. The debris may mix with saliva and cause the white pasty saliva.

Also with the lichen, it may be difficult to differentiate any other infection in the mouth since many of those cause burning sensation.

I would advice the antiseptic mouth washes and also a dentist's opinion to evaluate for the status of your gums or any other pathology.

Multivitamin supplements (vitamin B 12 and vitamin C) once daily for a month will help strengthen the gums and may reduce your symptoms.

Do let me know if you have any further questions.

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