An Overview of Xerostomia (Dry Mouth)

Dry mouth is caused by many factors and can lead to health issues

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Dry mouth, which is medically referred to as xerostomia, is a common condition that can cause discomfort in the mouth and throat. In rare situations, xerostomia can lead to mouth sores and inflammation.

Dry mouth can occur as a result of a number of medical illnesses, as a medication side effect, or due to cancer treatment. And sometimes, a person just has a tendency to have a dry mouth, without a medical cause.

Diagnosing the cause of your dry mouth is based on a careful medical history and an examination of your mouth and throat. This condition can be managed, and if possible, it is best to treat the cause as well.

Symptoms

A dry mouth may feel obviously dry, but it also causes other symptoms that may not be so easily identified as being related to xerostomia.

It doesn't take long for these effects to start, so you can begin to experience symptoms of dry mouth within just a few days of the precipitating cause (such as taking a new medication).

If you have dry mouth, you may experience any of these symptoms:

  • Stickiness in your mouth
  • Thick saliva in your mouth
  • A dry sensation in your mouth or throat
  • Halitosis (bad breath)
  • Cracked lips or splits in the skin at the corners of your mouth
  • Trouble chewing or swallowing your food
  • An unpleasant taste in your mouth
  • Difficulty tasting your food
  • Decreased appetite
  • Sores in your mouth
  • White spots in your mouth
  • Raw or sore tongue
  • Dry nasal passages
  • Hoarse voice
  • Increased need to drink when eating and swallowing

Most of the time, these symptoms are mild—and they tend to come and go. In some situations, such as with radiation therapy, dry mouth can be more dramatic and can even result in food avoidance.

Complications

Besides the short term symptoms of dry mouth, this condition can also cause complications. Long terms effects of dry mouth include a predisposition to cavities, gingivitis (gum disease), and periodontal disease (advanced gum disease). In rare instances, an infection can progress into a tooth abscess or a mouth abscess.

Causes

Xerostomia results from diminished saliva in the mouth and throat. Saliva has many purposes and it is an important part of our overall health.

There are several causes of decreased saliva production, including:

  • Mouth breathing
  • Medical treatments and procedures such as bone marrow transplant, chemotherapy, and radiation therapy
  • Health conditions such as diabetes, HIV/AIDS, Sjögren’s Syndrome, depression, Parkinson's disease, thyroid disease, and dehydration.
  • Blocked salivary ducts
  • Stress and anxiety
  • Injury to nerves in the mouth due to trauma
  • Smoking, chewing tobacco, and smokeless tobacco products
  • A decrease in the production of saliva due to the natural aging processes
  • Medications used to treat a variety of medical conditions such as high blood pressure, depression, overactive bladder, and Parkinson's disease. More than 400 prescribed and over-the-counter medications list dry mouth as a side effect.

Saliva cleans your mouth by loosening and sweeping away food particles and it acts as a lubricant to protect the sensitive tissues inside your mouth and throat from sores and infections. This fluid contains enzymes that help digest food. It also 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.

Diagnosis

A visit to your dentist or physician can definitively detect xerostomia and can help identify why you have developed this condition. Your diagnosis is based on a careful medical history and a physical examination.

If you are complaining of any of the symptoms of dry mouth, there is a high chance that you have the condition, especially if you are taking a medication or undergoing a treatment that is normally associated with a dry mouth.

Your doctor may look in your mouth to observe your tongue, gums, and teeth, which can give an idea about whether you have a dry mouth. Your throat will be examined as well because it can also show dryness and inflammation if you have a dry mouth.

Dental Examination

Your dental examination includes an examination of your mouth, gums, and teeth. Your dentist can gauge whether you have less saliva than expected and can identify complications of dry mouth, such as ulceration, infection, tooth decay, bad breath, and gum disease.

Diagnostic Tests

In general, interventional diagnostic tests are not typically used in the evaluation of xerostomia, but you may need to have some diagnostic tests if there is a concern that your dry mouth could be caused by an undiagnosed medical condition. For example, a blood test can help identify diabetes, thyroid disease, and Sjögren’s Syndrome.

Treatment

There are a number of approaches for managing dry mouth, including maintaining your comfort, preventative strategies, and medication.

Comfort

Keeping your mouth moist often works as an immediate treatment that you can do at home. Sipping water regularly or sucking on ice chips throughout the day may help. You may also want to use a humidifier at night.

Lip balms and salves can help relieve dry and cracked lips. You may want to avoid salty foods, acidic juices, and dry foods, as they can irritate a dry mouth.

Lifestyle Strategies

Sugar-free chewing gums, sugar-free lemon drops, or lozenges can help to coax the production of saliva. It is important to limit sugar, as it can promote cavities, especially if you have a decrease in saliva.

Consistent oral hygiene is important if you have dry mouth. Regular brushing, flossing, and rinsing your mouth can help clear out food particles and prevent bacterial growth and gum disease.

Avoid smoking, alcohol, and caffeine when you have dry mouth. Alcohol, which is present in many types of mouthwash, may dry your mouth further and make your symptoms worse, so be sure to use an alcohol-free mouthwash.

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.

In some cases, artificial saliva can help lubricate your mouth, counteracting some of the effects of dry mouth. Prescription medications such as Evoxac (cevimeline) and Salagen (pilocarpine) can help stimulate the production of saliva, and your doctor may give you a prescription if you need it.

A Word From Verywell

Dry mouth is a relatively common condition. If you have a dry mouth or any of the other effects, you can speak with your doctor or dentist about it. At-home strategies are often helpful for managing the symptoms.

If your dry mouth is caused by a medical problem, however, it is best to follow your doctor or dentist's advice so that the condition will not continue to worsen—potentially resulting in complications.

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