Dry Mouth (Xerostomia)

What is xerostomia (dry mouth)?

Xerostomia (dry mouth) is the sensation you may feel when you don’t have enough saliva (spit). The salivary glands in your mouth produce saliva to lubricate your mouth and help keep it clean.

Occasional dry mouth is normal. For instance, your mouth gets dry when you’re dehydrated. But chronic dry mouth (when your mouth is dry all the time) could point to an underlying health condition. Most often, xerostomia is a side effect of certain medications, including antihistamines, decongestants and some antidepressants.

How common is xerostomia (dry mouth)?

Dry mouth is common, affecting about 1 in 5 people. Your risk for dry mouth increases with age.

What are the symptoms of xerostomia (dry mouth)?

The hallmark symptom of xerostomia is a feeling of stickiness in your mouth due to a lack of saliva. When you speak, it might feel like your tongue sticks to the roof of your mouth.

Other possible dry mouth symptoms include:

• Bad breath.
• Constant sore throat.
• Difficulty eating, speaking or swallowing.
• Dry feeling in your nose.
• Hoarseness.
• Increased thirst.
• Lip, tongue and mouth sores or pain.
• Taste disorders.
• Trouble wearing dentures.

More severe symptoms could include:

• Tooth decay.
• Dry eyes and skin.
• Skin rash.
• Joint pain.

What causes xerostomia (dry mouth)?

Xerostomia happens when something causes your salivary glands to produce less saliva.

Dry mouth causes include:

• Certain medications.
• Underlying health conditions.
• Radiation therapy, especially for head and neck cancer.
• Chemotherapy drugs.
• Dehydration.
• Mouth breathing.

Medications that cause dry mouth

Hundreds of medications (prescription and over-the-counter) can decrease 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 conditions like urinary incontinence, overactive bladder and chronic obstructive pulmonary disorder).
• Antihistamines, decongestants and some pain medicines.
• Certain drugs for high blood pressure.
• Parkinson’s disease medications.

Health problems that cause dry mouth

Certain medical conditions are more likely to cause dry mouth, including:

• Salivary stones (sialolithiasis).
• Salivary gland inflammation (sialadenitis).
• Diabetes.
• Alzheimer’s disease.
• Stroke.
• Sjogren’s syndrome.

What are complications of xerostomia (dry mouth)?

When you have chronic dry mouth, you’re more likely to develop:

• Cavities.
• Gum disease.
• Mouth sores.
• Cracked lips.
• Oral thrush.

How can a dentist tell if you have dry mouth?

During an examination, a dentist will look for signs of xerostomia. For instance, your tongue and inner cheeks may look dry and textured rather than smooth, shiny and moist. To see how much saliva you produce, your dentist may dab around your salivary glands with a piece of gauze. They’ll also look for signs of cavities and gum disease, which can both occur as a result of dry mouth.

How do healthcare providers treat xerostomia (dry mouth)?

The main goal of dry mouth treatment is to increase saliva production. This will, in turn, reduce your risk for tooth decay and gum disease.

Specific dry mouth treatment depends on the underlying cause. For instance, if your provider suspects a medication is causing dry mouth, they’ll see if they can adjust your dosage. Or you might be able to switch to another medication altogether. (You should always talk to your healthcare provider before stopping a medication.) If you developed dry mouth as a symptom of a health condition, treating the underlying issue may help.

Other treatment options include:

• Prescription-strength dry mouth lozenges like Sorbitol (Numoisyn®).
• Saliva production stimulators like Cevimeline (Evoxac®) and Pilocarpine (Salagen®).
• Surgical salivary gland repair (less common).

Can I prevent xerostomia (dry mouth)?

There’s not a miracle cure for dry mouth, but there are things you can do to reduce your risk. Most importantly, practice good oral hygiene and visit your dentist regularly for cleanings and exams.

In addition, try these dry mouth remedies at home:

• Chew sugarless gum to stimulate saliva production.
• Suck on ice cubes or sugarless ice pops.
• Use a mouth wash formulated for dry mouth (like Biotene®).
• Avoid decongestants and antihistamines when possible.
• Sip water before swallowing capsules or tablets. This helps moisten your mouth.
• Take medications that cause dry mouth in the morning, not at night. Dry mouth at night is more likely to cause cavities and other dental issues.
• Use a cool-mist humidifier, especially if you breathe through your mouth at night.
• Keep lip balm handy.
• Drink plenty of water.

You should try to avoid:

• Smoking.
• Carbonated drinks.
• Beverages containing alcohol.
• Acidic, spicy, dry and sugary foods.

Does xerostomia go away?

You can successfully manage dry mouth symptoms with treatment. And in some cases, xerostomia may go away completely. Most of the time, it takes trial and error to figure out a solution. Your provider may adjust your medications. Or they may refer you to a specialist if they suspect you have an underlying condition.

The best thing you can do is stay in touch with your provider and let them know about any new symptoms. In many cases, your dentist and primary care physician will work together to find appropriate treatment.

When should I see my healthcare provider?

Everyone gets dry mouth on occasion. But when you have persistent dry mouth, it’s time to call a healthcare provider. Early diagnosis and treatment can reduce your symptoms before they worsen.

What questions should I ask my healthcare provider?

If you have dry mouth, here are some questions you might want to ask your provider:

• What’s causing dry mouth?
• Do I need to change my medications or adjust their dosage?
• Do I have an underlying condition that needs treatment?
• How often should I have teeth cleanings?
• What dry mouth products do you recommend?

Why is my mouth dry even though I drink a lot of water?

If your mouth still feels dry after drinking plenty of water, you might have xerostomia. This means your salivary glands don’t produce enough saliva — so your mouth still feels dry even when you stay hydrated.