Dry Mouth (Xerostomia)
What is dry mouth?
Dry mouth, or xerostomia, is the sensation you may feel when you don’t have enough saliva (spit). Saliva is the fluid produced by the salivary glands in your mouth.
Dry mouth is a symptom of a condition, not a condition itself. Most often, it’s a side effect of certain medications, such as antihistamines or decongestants that you take for allergies or colds.
Why is saliva important for the body?
Saliva keeps the mouth and teeth healthy. It cleans your mouth, keeps it moist and removes food. Lack of saliva can cause problems including:
- Bad breath (halitosis).
- Oral hygiene problems, including cavities, tooth decay and other mouth diseases.
- Problems wearing dentures.
- Trouble with speech and swallowing.
How common is dry mouth?
Dry mouth is common, especially among older adults. It affects about one in five older adults. Older people are more likely to take medications that can cause dry mouth.
What are the most common causes of dry mouth?
Dry mouth happens when something causes the salivary glands to produce less saliva. The most common causes of dry mouth are:
Hundreds of medications (prescription and over-the-counter) can reduce your body’s saliva production. If you check the information that comes with your medication, you may see “dry mouth” listed as a side effect.
Some medicines known to cause dry mouth include:
- Antianxiety drugs and antidepressants.
- Anticholinergics, drugs used to treat many conditions, such as urinary incontinence, overactive bladder and chronic obstructive pulmonary disorder.
- Antihistamines, decongestants and some pain medicines.
- Certain drugs for high blood pressure.
- Chemotherapy drugs for cancer treatment.
- Parkinson’s disease medications.
Other causes include:
- Dehydration: Sometimes, your body lacks enough fluids. For example, if you’re sick, don’t drink enough, or sweat a lot, you may get dehydrated.
- Mouth-breathing: You may breathe through your mouth at night, especially if you have a stuffy nose (nasal congestion).
- Medical conditions: Dry mouth can be a sign of a more serious condition, such as diabetes, Alzheimer’s disease, stroke and Sjogren’s syndrome. Sjogren’s syndrome (SHOW-grins) is an autoimmune disease that causes the body to attack the glands that produce moisture. It occurs mostly in women who have gone through menopause.
What other symptoms come with dry mouth?
- Bad breath.
- Constant sore throat.
- Difficulty eating, speaking or swallowing.
- Dry feeling in your nose.
- Increased thirst.
- Lip, tongue and mouth sores or pain.
- Taste disorders.
- Trouble wearing dentures.
More severe symptoms include:
Care and Treatment
How is dry mouth treated?
The goal of dry mouth treatment is to:
- Manage any underlying condition causing dry mouth.
- Prevent tooth decay.
- Increase saliva flow.
Dry mouth treatment often involves several steps. First, your healthcare provider will review your medications in case they could be causing your dry mouth. You may be able to take a different drug instead.
If not, you can try these steps to ease dry mouth:
- Avoid decongestants and antihistamines when possible.
- Sip water before swallowing capsules or tablets. The water moistens your mouth.
- Take medication in the morning, not at night. Dry mouth at night is more likely to cause mouth problems such as cavities.
- Try easy-to-swallow formulas, such as liquids. Avoid under-the-tongue forms.
Even if you think a prescription medication is causing your dry mouth, don’t just stop taking it. Talk to your healthcare provider first.
For dry mouth, your healthcare provider may prescribe:
- Cevimeline (Evoxac®) to treat dry mouth in people with Sjogren’s syndrome.
- Pilocarpine (Salagen®) to increase your natural saliva production.
Researchers are continuing to work on ways to repair damaged salivary glands. They’re also developing an artificial salivary gland that can be implanted into the body.
What can I do at home to treat dry mouth?
Oral hygiene is essential if you have a dry mouth. Brush your teeth twice a day, and use mouthwash. Doing so will help prevent tooth decay. Cavities and decay are more common for people with dry mouth.
It’s also important to promote saliva production. Saliva protects your mouth and teeth from decay and disease. Some dry mouth remedies can help you produce more saliva and improve symptoms.
Chewing and sucking help stimulate saliva flow. Try:
- Ice cubes or sugar-free ice pops.
- Sugar-free hard candy or sugarless gum that contains xylitol.
- Water or other sugarless fluids, sipped frequently throughout the day.
These products may also help:
- Artificial saliva products to help you produce more saliva. These products are often available over-the-counter as a rinse or spray.
- Toothpastes and mouthwashes specially made for dry mouth.
- Lip balm.
- Cool-mist humidifier, especially if you breathe through your mouth at night.
Try to avoid:
- Acidic, spicy, salty, dry and sugary foods and beverages.
- Alcohol, caffeine and carbonated drinks.
- Mouthwashes with alcohol or peroxide, which may dry your mouth even more.
How can I prevent dry mouth?
You may not be able to prevent all causes of dry mouth. But you can prevent some. Try to:
- Drink plenty of water. Aim for about eight glasses of water a day, sipping frequently.
- Use a humidifier, especially in your bedroom, to prevent dry mouth at night.
- Breathe through your nose, not your mouth.
- Over-the-counter medications that can cause dry mouth, such as antihistamines and decongestants. Ask your healthcare provider about a different treatment or medication.
- Caffeine, tobacco and alcohol.
Dry mouth treatments and at-home remedies can help you feel your best. Keeping up with your oral hygiene routine is essential, including regular dental visits. Taking care of your mouth and teeth can prevent long-term damage from dry mouth. If dry mouth is a symptom of a more serious condition, such as Sjogren’s syndrome, diabetes or cancer, then your prognosis depends on the treatment for that condition.
When to Call the Doctor
When should dry mouth be treated by a healthcare provider?
If you have:
- Severe symptoms: See a provider right away.
- Risk factors for HIV: If you have dry mouth and any HIV risk factors, see your healthcare provider.
- Tooth decay: See your dentist for an examination.
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