What Is Dry Mouth (Xerostomia)?

Dry mouth (xerostomia) occurs when you don't have enough saliva. Your mouth and throat will feel dry and you may have other symptoms, especially related to your teeth. Rarely, dry mouth can lead to mouth sores and inflammation. Medical illnesses, medications, and cancer treatments can cause dry mouth. When no clear medical cause is identified, it may be related to certain lifestyle factors like smoking.

Once the cause of dry mouth is found, it can usually be treated. Even if no medical cause is found, the symptom can be managed.

Dry Mouth Symptoms

Saliva's main job is to clean your mouth by loosening and sweeping away food particles. The fluid acts as a lubricant to protect the sensitive tissues inside your mouth and throat from sores and infections.

Saliva also contains enzymes needed to digest food and helps prevent tooth decay by neutralizing acids in your mouth and controlling bacteria, viruses, and fungi.

This illustrates why an inadequate amount of saliva can have effects beyond a dry mouth. At first, you may not realize that these other symptoms are, in fact, related to xerostomia.

People with dry mouth may also experience:

• "Sticky" feeling in the mouth
• Thick saliva
• Halitosis (bad breath)
• Cracked lips or splits in the skin at the corners of the mouth
• Trouble chewing or swallowing
• An unpleasant taste in the mouth
• Difficulty tasting food
• Decreased appetite
• Sores or white spots in the mouth
• A raw or sore tongue
• Dry nasal passages
• Hoarse voice
• Increased need to drink when eating and swallowing

Dry mouth symptoms are usually mild and tend to come and go. In some situations, such as with radiation therapy, dry mouth can be more dramatic and may contribute to food avoidance.

Complications

Dry mouth contributes to a predisposition for developing cavities, gingivitis (gum disease), and periodontal disease (advanced gum disease). Rarely, oral infections may progress into a tooth abscess.

Having dry mouth may also make someone more likely to develop oral thrush (a fungal infection of the mouth).

Causes

There are several causes of decreased saliva production and, therefore, dry mouth, including:

• Mouth breathing
• Medical treatments and procedures such as a bone marrow transplant, chemotherapy, and radiation therapy
• Health conditions (such as diabetes, HIV/AIDS, Sjögren’s syndrome, depression, bipolar disorder, Parkinson's disease, thyroid disease, and dehydration)
• Blocked salivary ducts
• Stress and anxiety
• Injury or trauma to nerves in the mouth
• Smoking, chewing tobacco, and smokeless tobacco products
• Decreased saliva production due to the natural aging process
• Medications used to treat high blood pressure, depression and bipolar disorder, overactive bladder, and Parkinson's disease

While dry mouth isn't the same as dehydration, it can be an early sign of dehydration caused by factors such as sweating, infection, and vomiting.

Diagnosis

If you have a persistently dry mouth, it's important to find out what's causing it. You can talk to your dentist or doctor about it. You will be asked questions about your symptoms, medical history, medications you take, and any treatments you receive.

They will also look at your mouth and throat, examining your tongue, gums, and teeth closely. Systemic issues and those specifically related to the mouth, gums, or teeth will be considered.

Know, too, that dentists routinely look for signs of dry mouth when conducting routine dental exams. That is, they may catch signs of xerostomia before you do, including less saliva than expected, ulceration, infection, tooth decay, bad breath, and gum disease.

The next steps—whether your doctor or dentist will treat or refer you—depend on your preliminary findings.

Diagnostic Tests

In general, interventional diagnostic tests are not typically used in the evaluation of dry mouth. However, if your doctor suspects your dry mouth is being caused by an undiagnosed medical condition, you may need more tests.

For example, a blood test can help identify conditions that can have dry mouth as a symptom, such as diabetes, thyroid disease, and Sjögren’s syndrome.

Treatment

Treatment for dry mouth mostly involves managing your symptoms by reducing discomfort, employing preventive strategies, and possibly taking medications.

Home and OTC Remedies

Keeping your mouth moist is an immediate treatment for dry mouth that you can do on your own. Sipping water regularly or sucking on ice chips throughout the day can help keep your mouth from getting too dry.

Chewing gum, hard candies, and lozenges that are sugar-free can coax saliva production. Some products, like ACT dry mouth lozenges and BasicBites are branded for dry mouth because they're soft or contain moisturizing liquid components.

When choosing any of these products, keep in mind that you'll want to limit your sugar intake to reduce the risk of cavities.

Lip balms and salves can soothe dry and cracked lips. You may want to avoid salty foods, acidic juices, and dry foods, as they can irritate your lips, mouth, and throat.

Lifestyle Strategies

Consistent oral hygiene is another strategy for preventing and managing many dental and gum problems, as well as dry mouth. Regular brushing, flossing, and rinsing your mouth clears out food particles, helps keep your mouth lubricated, inhibits bacterial growth, and reduces the risk of gum disease.

Avoid smoking, alcohol, and caffeine if you have dry mouth. Alcohol is present in many types of mouthwash, which may worsen your symptoms. If you have dry mouth, look for alcohol-free mouthwashes.

You may also want to use a humidifier if the air in your home tends to be dry or if you notice your dry mouth is worse in the morning.

Medication

If your dry mouth is due to a medication side effect, your doctor may be able to adjust your dosage or change your prescription.

Artificial saliva can lubricate your mouth and counteract the effects of dry mouth. Your doctor may prescribe medications such as Evoxac (cevimeline) and Salagen (pilocarpine) to stimulate the production of saliva.

A Word From Verywell

Dry mouth is relatively common, but you'll need to identify its cause before you can expect to effectively manage it. Your doctor or dentist can figure out why you have developed dry mouth and recommend treatment.

There are at-home strategies you can use to manage the symptoms of dry mouth, but if there is a medical cause, you may need other treatments. To control your symptoms and prevent complications, carefully follow your doctor or dentist's recommendations.