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Dry mouth is a symptom that leads to a lack of saliva. Individuals with dry mouth do not have enough saliva to keep the mouth wet.

The condition is also informally known as xerostomia, pasties, cottonmouth, drooth, doughmouth, or des.

This article will look at the causes, symptoms, diagnosis, and treatment of dry mouth.

Fast facts on dry mouth

Here are some key points about dry mouth. More detail and supporting information is in the main article.

  • Dry mouth is more prevalent in the aging population
  • It is commonly a side effect of medications.
  • Symptoms include cracked lips, bad breath, and sticky saliva
  • Individuals with dry mouth should avoid spicy foods and sugary drinks

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Dry mouth is often a side effect of pharmaceutical drugs.

Possible causes include:

Medications: Many prescription and OTC medications cause dry mouth, including antihistamines, decongestants, hypertensive medications (for high blood pressure), antidiarrheals, muscle relaxants, urinary continence drugs, some Parkinson's disease medications, as well as a number of antidepressants.

Age: Even though dry mouth is not a natural part of aging, older adults tend to take more medications than the rest of the population. Many of the medications taken by seniors cause dry mouth.

Cancer treatment: Radiotherapy (radiation therapy) to the head and neck can damage the salivary glands, resulting in less saliva being produced. Chemotherapy can alter the nature of the saliva, as well as how much of it the body produces.

Injury or surgery: This can result in nerve damage to the head and neck area can result in dry mouth.

Tobacco: Either chewing or smoking tobacco increases the risk of dry mouth symptoms.

Dehydration: This is caused by lack of sufficient fluids.

Exercising or playing in the heat: The salivary glands may become dry as bodily fluids are concentrated elsewhere in the body. Dry mouth symptoms are more likely if the exercise or playing continues for a long time.

Some health conditions, illnesses, and habits can cause dry mouth, such as:

  • anxiety disorders
  • depression
  • HIV/AIDS
  • Parkinson's disease
  • poorly controlled diabetes
  • Sjögren's syndrome
  • sleeping with the mouth open
  • snoring
  • stroke and Alzheimer's disease, although these are more likely to cause a perception of dry mouth even when the salivary glands are functioning appropriately

Signs and symptoms of dry mouth may include:

  • bad breath
  • cheilitis, or inflammation and fissuring (splitting or cracking) of the lips
  • cracking and fissuring of the oral mucosa, or inner lining of the cheeks and lips, in which skin at the corners of the mouth may split or become sore
  • dryness in the mouth
  • dysgeusia, or taste disorders
  • fungal infections in the mouth, such as thrush
  • glossodynia, or a painful tongue
  • increased need to drink water, especially at night
  • inflammation of the tongue, tongue ulcers
  • lipstick sticking to teeth
  • more frequent gum disease
  • more tooth decay and plaque
  • problems speaking
  • problems swallowing and chewing - especially dry and crumbly foods, such as crackers or cereals
  • problems wearing dentures - problems with denture retention, denture sores, and the tongue sticking to the palate
  • sialadenitis, a salivary gland infection
  • a sore throat
  • sticky saliva
  • stringy saliva

There are many ways to keep the mouth lubricated and prevent the symptoms of dry mouth.

These include:

  • sipping non-carbonated, sugar-free fluids
  • chewing gum that contains xylitol, available for purchase online.
  • using a carboxymethyl cellulose saliva substitute as a mouthwash may help
  • avoiding mouthwashes that contain alcohol. A range of alcohol-free mouthwash is available for purchase online.
  • not wear dentures during sleep.
  • eating foods such as carrots or celery
  • breathing through the nose, as this does not dry the mouth to the same extent as breathing through the mouth does.
  • using a humidifier to add moisture to a bedroom, which may help reduce dry mouth symptoms that develop during sleep. Humidifiers are available for purchase online.

Individuals should avoid:

  • chewing or smoking tobacco
  • sugary foods or drinks
  • acidic foods or drinks
  • dry foods
  • spicy foods
  • astringents
  • excessively hot or cold drinks

Alcohol consumption should be kept to a minimum or avoided altogether, and caffeine should be only be consumed in moderation.

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Often, xerostomia is treated by addressing the underlying causes.

Treatment for dry mouth depends on several factors such as whether the patient has an underlying condition or disease, or is taking certain medications that may be causing dry mouth.

If an underlying cause is found, steps need to be taken to minimize its effect.

Medications: If the dry mouth is thought to be caused by a particular medication, the doctor will either alter the dosage or prescribe another drug which is less likely to cause dry mouth.

Stimulating saliva production: Medication may be prescribed to stimulate the production of saliva, such as pilocarpine (Salagen) or cevimeline (Evoxac).

Experts say that symptomatic treatment for dry mouth typically includes four areas:

  • increasing the flow of saliva
  • replacing lost secretions
  • controlling dental caries
  • specific measures, such as treating infections

A person with dry mouth should pay special attention to oral/dental hygiene. This includes plaque removal and treatment of gingival infections, inflammation, and dental caries. Brushing teeth and flossing regularly is important.

Diagnosis

The doctor or dentist will probably examine the patient's mouth and review their medical history. Blood tests and imaging scans of the salivary glands may also be ordered.

Sialometry: This is a simple procedure that measures the flow rate of saliva. Collection devices are placed over duct orifices of the saliva glands, and saliva production is stimulated with citric acid.

Saliography: This is a radiographic examination of the salivary glands and ducts. It may be useful in identifying salivary gland stones and masses.

Biopsy: A small sample of salivary gland tissue is taken. Often used in the diagnosis of Sjögren's syndrome. If malignancy (cancer) is suspected, the doctor may also order a biopsy.

Many doctors report that often, even though the patient complains of severe dry mouth, the oral mucosa appears to be moist. Less frequently, it may be the other way round - the oral mucosa appears dry, but the individual does not complain of dry mouth symptoms.

What is xerostomia?

Dry mouth is sometimes referred to as xerostomia.

Experts say that xerostomia is usually caused by inadequate function of the salivary glands.

An individual with xerostomia typically finds it harder to enjoy food.

Xerostomia is a common problem. It is a frequent side effect of medication, which may improve with a new prescription or an adjustment of dosage.

We all get a dry mouth sometimes - when we are upset, under stress, or extremely frightened. Xerostomia is different - the individual's mouth is dry most of the time.

Some patients may think dry mouth is a normal part of aging, but it is not. It is, however, more commonly found in older adults. Experts say the main reason is that elderly people take more medications compared with the rest of the population, and some of these medications cause xerostomia.

Xerostomia may be a symptom of a serious systemic disease, such as systemic lupus erythematosus, rheumatoid arthritis, scleroderma, sarcoidosis, amyloidosis, Sjögren's syndrome, Parkinson's, Diabetes, or hypothyroidism. A systemic disease is one that affects the entire body.

Dry mouth is not a disease but a symptom of other conditions.