An Overview of Xerostomia (Dry Mouth)

Dry mouth (medically referred to as xerostomia) is a common symptom caused by not having 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.

If you have dry mouth, it's important to find out what's causing it. Medical illnesses, medications, and cancer treatment can cause dry mouth. When no clear medical cause is identified, it may be related to certain lifestyle factors like smoking.

To diagnose a medical reason for dry mouth, your doctor will ask you questions about your medical history and examine your mouth and throat.

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.

Aside from having a mouth that feels dry, the effects of dry mouth can cause other symptoms. At first, you may not realize that these other symptoms are related to dry mouth.

People with dry mouth may also experience:

• "Sticky" feeling in your mouth
• Thick saliva
• A dry sensation in your mouth and throat
• Halitosis (bad breath)
• Cracked lips or splits in the skin at the corners of your mouth
• Trouble chewing or swallowing
• An unpleasant taste in your mouth
• Difficulty tasting your food
• Decreased appetite
• Sores or white spots in your mouth
• 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.

In addition to the short term symptoms, dry mouth can also have longterm effects. In some cases, it can even cause complications.

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

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

While it's primarily found in the mouth, saliva has many purposes and contributes to the overall health of the body.

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.

When you don't have an adequate amount of saliva in your mouth, the symptoms and long term effects of dry mouth can occur.

There are several causes of decreased saliva production, 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

A visit to your dentist or doctor can diagnose dry mouth and identify what is causing it. Your doctor will ask you about your health, the medications you take, and whether you are receiving any treatments associated with dry mouth.

They will also look inside your mouth and examine your tongue, gums, and teeth closely. Your throat can provide clues as to why you have developed dry mouth, especially if it appears dry or inflamed.

During a dental exam, a dentist thoroughly looks at your mouth, gums, and teeth. They will be able to determine if you have less saliva than expected, as well as identify ulceration, infection, tooth decay, bad breath, and gum disease.

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 for dry mouth mostly involves helping you manage your symptoms by reducing discomfort, learning preventative strategies, and possibly medications.

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

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

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.

Chewing gum, hard candies, and lozenges that are sugar-free can coax saliva production. When choosing these products, keep in mind that you'll want to limit your sugar intake to reduce the risk of cavities.

Consistent oral hygiene is another strategy for preventing and managing dry mouth. Regular brushing, flossing, and rinsing your mouth clear out food particles and helps inhibit bacterial growth and reduce 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.

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.

Dry mouth is relatively common, but before you can manage it you'll need to identify the cause. 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.