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Xerostomia: Dry Mouth.

Updated: Jan 12


Xerostomia can be associated with systemic diseases, such as Sjogren's syndrome, systemic lupus erythematosus, and rheumatoid arthritis; and it can be a side effect of medication and poor dental hygiene.

Xerostomia results from inadequate function of the salivary glands, such as the parotid glands. Treatment involves adequate intake of water, use of artificial saliva, and good dental care. Untreated, severe dry mouth can lead to increased levels of tooth decay and thrush.



Dry mouth is often due to the side effect of certain medications or aging issues or as a result of radiation therapy for cancer.

Less often, dry mouth may be caused by a condition that directly affects the salivary glands.


Saliva helps prevent tooth decay by neutralizing acids produced by bacteria, limiting bacterial growth and washing away food particles. Saliva also enhances your ability to taste and makes it easier to chew and swallow. In addition, enzymes in saliva aid in digestion.


Decreased saliva and dry mouth can range from being merely a nuisance to something that has a major impact on your general health and the health of your teeth and gums, as well as your appetite and enjoyment of food.

Treatment for dry mouth depends on the cause.


Symptoms


If you're not producing enough saliva, you may notice these signs and symptoms all or most of the time:


  • Dryness or a feeling of stickiness in your mouth

  • Saliva that seems thick and stringy

  • Bad breath

  • Difficulty chewing, speaking and swallowing

  • Dry or sore throat and hoarseness

  • Dry or grooved tongue

  • A changed sense of taste

  • Problems wearing dentures

  • In addition, dry mouth may result in lipstick sticking to the teeth.

Causes

Dry mouth is caused when the salivary glands in the mouth don't make enough saliva to keep your mouth wet. These glands may not work properly as the result of:


Medications. Hundreds of medications, including many over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression, high blood pressure and anxiety, as well as some antihistamines, decongestants, muscle relaxants and pain medications.


Aging. Many older people experience dry mouth as they age. Contributing factors include the use of certain medications, changes in the body's ability to process medication, inadequate nutrition, and having long-term health problems.


Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount produced. This may be temporary, with normal salivary flow returning after treatment is completed. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production. This may be temporary or permanent, depending on the radiation dose and area treated.


Nerve damage. An injury or surgery that causes nerve damage to your head and neck area can result in dry mouth.


Other health conditions. Dry mouth can be due to certain health conditions, such as diabetes, stroke, yeast infection (thrush) in your mouth or Alzheimer's disease, or due to autoimmune diseases, such as Sjogren's syndrome or HIV/AIDS. Snoring and breathing with your mouth open also can contribute to dry mouth.


Tobacco and alcohol use. Drinking alcohol and smoking or chewing tobacco can increase dry mouth symptoms.


Recreational drug use. Methamphetamine use can cause severe dry mouth and damage to teeth, a condition also known as "meth mouth." Marijuana also can cause dry mouth.


Complications


If you don't have enough saliva and develop dry mouth, this can lead to:

Increased plaque, tooth decay and gum disease

Mouth sores

Yeast infection in your mouth (thrush)

Sores or split skin at the corners of your mouth, or cracked lips

Poor nutrition from having problems with chewing and swallowing


Treatment

Your treatment depends on the cause of your dry mouth. Your doctor or dentist may:

Change medications that cause dry mouth.

If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn't cause a dry mouth.


Recommend products to moisturize your mouth. These can include prescription or over-the-counter mouth rinses, artificial saliva or moisturizers to lubricate your mouth. Mouthwashes designed for dry mouth, especially ones with xylitol, can be effective, such as Biotene Dry Mouth Oral Rinse or Act Dry Mouth Mouthwash, which also offer protection against tooth decay.


If you have severe dry mouth, your doctor or dentist may:


Prescribe medication that stimulates saliva. Your doctor may prescribe pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.


Protect your teeth. To prevent cavities, your dentist might fit you for fluoride trays, which you fill with fluoride and wear over your teeth at night. Your dentist may also recommend weekly use of a chlorhexidine rinse to control cavities.