Dry Mouth (Xerostomia)

Xerostomia is the feeling of not having enough saliva (spit) in your mouth. Your salivary glands make saliva to lubricate your mouth and help keep it clean. Most people know this sensation as “dry mouth.”

Occasional dry mouth is common. For instance, your mouth gets dry when you’re dehydrated or stressed. But chronic dry mouth (when your mouth is dry all the time) may be a sign of a health condition. Most often, xerostomia (pronounced “ZEER-oh-STOH-mee-ah”) is a medication side effect. Common meds known to cause dry mouth include antihistamines, decongestants and some antidepressants.

Once your healthcare provider knows what’s causing dry mouth, they can recommend treatments that can help.

Symptoms of dry mouth

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

Other dry mouth symptoms include:

• Bad breath
• Sore throat and hoarseness
• Difficulty chewing, tasting, speaking or swallowing
• Dry feeling in your throat or nose
• Cracked lips and dry tongue
• Mouth sores or pain
• Trouble wearing dentures

Xerostomia causes

Dry mouth happens when something prevents your salivary glands from making enough saliva. Causes include:

• Medications (most common)
• Cancer treatments, like chemotherapy and radiation therapy to your head and neck
• Problems with your salivary glands, like salivary stones or inflammation
• Autoimmune diseases, like Sjögren’s syndrome and diabetes mellitus
• Neurological conditions, like Alzheimer’s disease or stroke
• Mouth breathing
• Dehydration
• Alcohol and tobacco use

Sometimes, the problem isn’t your salivary glands — it’s certain habits. For instance, sleeping with your mouth open or not drinking enough water can leave your mouth feeling dry.

Medications that cause dry mouth

Hundreds of medications (prescription and over-the-counter) can decrease saliva production. If you check the information that comes with your medicine, you might see “dry mouth” listed as a side effect.

Some meds known to cause dry mouth include:

• Anti-anxiety 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 high blood pressure medications
• Chemotherapy drugs
• Parkinson’s disease medications

Risk factors

The risk of dry mouth increases with age. This is likely because as we get older, we’re more likely to develop conditions or need meds that can cause dry mouth.

Complications

Chronic dry mouth leaves you with too little spit to do important work, like coating your mouth with a layer of moisture that protects the tissue. Spit also kills germs and flushes food debris out of your mouth. Without it, you’re more likely to develop:

• Cavities
• Gum disease
• Thrush (mouth fungal infection)

How doctors diagnose this condition

Your dentist will look for signs of dry mouth during a dental exam. For instance, your tongue and inner cheeks may look dry and textured rather than smooth, shiny and moist. To see how much saliva your mouth makes, your dentist may dab around your salivary glands with a piece of gauze. They’ll also look for cavities and gum disease, since both can happen if you have dry mouth.

If they notice dry mouth, they’ll ask about possible causes, like meds you’re taking.

How do healthcare providers treat xerostomia (dry mouth)?

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

Your healthcare provider will explain what to do for dry mouth based on what’s causing it. If they suspect that a medicine is to blame, they may adjust your dosage. Or you might be able to switch meds. (You should always talk to your healthcare provider before stopping a medication.) If the issue is a health condition, you’ll need treatment for it.

Other treatment options include:

• Saliva production stimulators, like cevimeline (Evoxac®) and pilocarpine (Salagen®)
• Saliva substitutes for xerostomia, like Biotène® dry mouth products or OraCoat XyliMelts®
• Surgical salivary gland repair (less common)

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. The sooner you get treatment, the less likely you are to have issues, like cavities and gum disease.

Does xerostomia go away?

Most people can manage dry mouth symptoms with treatment. 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 meds. They may refer you to a specialist if 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 the right treatment.

Is there anything I can do to feel better?

There are lots of things you can do at home to relieve your dry mouth. These include avoiding products that can lead to dehydration, like alcohol and caffeine. You can also do things to kick your salivary glands into gear, like chewing sugar-free gum that contains xylitol.

Ask your dentist about habits you can use to keep your mouth moist.

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

If your mouth still feels dry after drinking water, the problem is likely an issue with your salivary glands. It can be confusing because most of us think both spit and water do the same job: keeping our mouths wet.

But these two fluids aren’t the same. Saliva has properties that water doesn’t. Saliva coats your mouth and protects the lining in ways that water can’t. So, while sips of water may provide temporary relief, you can still have dry mouth if there’s an issue with your salivary glands.