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Xerostomia (Dry Mouth)

What is It?

Xerostomia, more commonly known as dry mouth, is a symptom that often occurs when saliva production decreases or stops. It is not a disease but can be a symptom of many other diseases and conditions.

Saliva lubricates your mouth and helps you to swallow and taste the food. Saliva also is a natural cavity fighter because it washes away food and plaque from tooth surfaces, buffers acids in the mouth, and remineralizes teeth. When saliva production decreases and you experience dry mouth, your teeth and gums are at increased risk of tooth decay. People with xerostomia are more likely to experience illnesses that affect the soft tissues of the mouth, including oral yeast infections (thrush). In addition, your diet may be affected because you cannot taste food as you normally would.

Xerostomia may occur for several reasons. Some common causes include:

A side effect of medication – Dry mouth is a potential side effect of hundreds of nonprescription and prescription drugs, including pain relievers, decongestants, antidepressants, and antihistamines. Medications are the most common cause of xerostomia. Because of the number and types of medications that many older people take, xerostomia has an especially high rate of occurrence among the elderly.
A complication of diseases and infections – Diseases such as diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, and HIV infection can be associated with dry mouth. Xerostomia also occurs with Sjogren’s syndrome, an autoimmune disease in which the body’s antibodies attack the salivary and lacrimal (tear) glands. Some viral infections, such as mumps, also affect saliva production and result in xerostomia.
Dehydration – Any condition that leads to dehydration can also cause xerostomia. These conditions include fever, excessive sweating, vomiting, diarrhea, blood loss, or loss of water through the skin resulting from burns.
Radiation therapy – Xerostomia is a common side effect of radiation therapy to treat cancers in the head and neck.
Surgical removal of the salivary glands

Symptoms

Although xerostomia is a symptom in itself, it may occur with other associated symptoms, including:

Frequent thirst
Burning or tingling sensation, especially on the tongue
Red, raw tongue
Sores in the mouth or at corners of lips
Difficulty swallowing
Impaired taste
Sore throat and hoarseness
Bad breath
Problems speaking
Dry nasal passages
Dry, cracked lips
Increase in dental problems, such as cavities and periodontal disease
Difficulty wearing dentures
Recurrent yeast infections in the mouth

Diagnosis

Xerostomia is a symptom, not a disease. Tell your dentist and hygienist about your dry mouth. Your dentist will ask you about your medical history and will ask you to describe your symptoms. He or she will ask about any nonprescription drugs, herbal remedies, or prescription medications you are taking. He or she also will examine your mouth to assess salivary flow, cracks, and sores, and will look for signs of cavities and gum disease.

Expected Duration

Although the symptoms of xerostomia can be treated, the condition often remains a problem as long as its cause (medication, medical illness, dehydration) remains. The condition is permanent in cases in which the salivary glands have been removed or destroyed. Radiation therapy to treat cancer in the head or neck also may permanently affect the ability of the salivary glands to produce saliva.

Prevention

To prevent dry mouth, avoid things that cause it, if possible. For example, if dry mouth is related to a medication, your physician may be able to try a less-drying medication, depending on your condition. You can also take steps to prevent or manage the symptoms associated with dry mouth.

Treatment

The treatment of xerostomia focuses on three areas: relieving symptoms, preventing tooth decay, and increasing the flow of saliva, if possible. Your doctor will recommend that you practice good dental hygiene, including proper brushing and flossing, regular dental visits, and frequent topical fluoride treatments. Your physician may work in partnership with your dentist to manage your condition.

Treatment is based on the severity of your problem and the cause of your dry mouth. Fluoride treatments can be prescribed to help prevent cavities. Artificial saliva products are available over the counter in rinse, spray, and gel formulations. Depending on your medical condition and diagnosis, a doctor may prescribe a drug that causes more saliva to be released.

To relieve your symptoms, try the following:

Drink water frequently to keep your mouth moist. Carry water with you to sip throughout the day, and keep water by your bed at night.
Suck on sugar-free hard candies, ice chips or sugar-free ice pops. Some doctors believe sugary candies are as likely as dry mouth to cause cavities.
If you chew gum, try sugarless gum.
Use an over-the-counter oral moisturizer or saliva substitute.
Use mouth rinses or mouthwashes that do not contain alcohol.
Avoid salty foods, dry foods (crackers, cookies, toast), and foods and beverages with high sugar content.
Avoid drinks containing alcohol or caffeine. These increase water loss by triggering frequent urination.
Avoid smoking.
To minimize irritation of dry tissues, use a moisturizer on your lips and a soft-bristled toothbrush on your teeth and gums.

When to Call a Professional

Dry mouth symptoms can vary greatly. Only your dentist or physician can truly evaluate your mouth for xerostomia. If you feel the symptoms, discuss them with your dentist. Untreated xerostomia can lead to the rapid development of dental decay in an otherwise healthy mouth. If you have to sip water frequently throughout the day and need liquids to swallow dry foods, you should discuss this with your dentist.

Prognosis

With proper treatment, most patients with dry mouth can regain oral comfort and the ability to speak and taste the food. With good dental hygiene, people with xerostomia can reduce dental problems associated with dry mouth.