Xerostomia (Dry Mouth)

What is xerostomia?

Are you constantly thirsty? Do you have difficulty swallowing certain foods? Is your saliva thick, foamy, or dry? If you answered “yes” to any of these questions, you may have xerostomia. Xerostomia is a condition characterized by a decrease in saliva production. This happens when the salivary glands stop working or do not function properly, leaving the mouth dry and uncomfortable.

Why is xerostomia a problem?

Saliva is important because it helps with the digestion process, prevents tooth decay and gingivitis, and protects and lubricates the tongue and other delicate tissues inside the mouth. Saliva also plays an important role in helping us taste the foods we eat.

What causes dry mouth?

Prescription and over-the-counter medications are the most common cause of dry mouth, contributing to more than 90% of all cases. There are, however, many more factors that can play a role in this condition. Let’s explore all potential factors below:

Medications that cause dry mouth

• Antiparkinsonian
• Antiseizure (Epilepsy)
• Diuretics (blood pressure)
• Antihypertensives (blood pressure)
• Sedatives and tranquilizers
• Antidepressants
• Antihistamines (allergy)
• Antineoplastics/Cytotoxic agents (cancer)
• Muscle relaxers
• Painkillers (e.g., codeine)

Systemic conditions that cause dry mouth

• Sjögren’s syndrome (secondary Sjögren’s can be a symptom of
• Rheumatoid arthritis
• HIV and AIDS
• Diabetes
• Anemia
• Alzheimer’s disease
• Parkinson’s disease
• Stroke
• Cystic fibrosis
• Renal failure
• Dehydration (e.g., from vomiting, diarrhea, fever, and excessive sweating)
• Cancer, as a result of chemotherapy or radiation therapy to the head and neck

Other causes or contributing factors

• Tobacco
• Caffeine
• Carbonated beverages
• Alcohol
• Stress
• Anxiety disorders
• Endocrine disorders
• Hormonal changes during menopause
• Chronic snoring
• Mouth breathing

Signs and Symptoms

• Dry or sticky feeling in and around the mouth
• Constant thirst or desire to wet the mouth
• Difficulty eating, swallowing, or speaking
• Thick, foamy, or stringy saliva
• Sore throat or hoarseness
• Dry nasal passages
• Cracked or dry lips
• Burning of the oral tissues
• Dry, reddened, or irritated tongue
• Bad breath

At-Home Remedies

• Maintain good oral hygiene
• Limit sugar intake
• Quit smoking
• Avoid caffeine and alcohol
• Avoid mouth rinses with alcohol
• Avoid dry foods (e.g., toast, crackers)
• Drink a glass of water with each meal and sip water throughout the day
• Chew sugar-free gum to stimulate salivary flow
• Use moisturizer regularly on your lips
• Breathe through your nose instead of your mouth as often as possible
• Use a humidifier at night
• Avoid direct airflow from air conditioners and fans
• Mix ½ teaspoon of baking soda in 1 cup of warm water and rinse gently for 30 seconds several times a day

Dental Remedies

• Mouth rinses
• Sprays
• Gels (e.g., Oral Balance)
• Toothpastes (e.g., Biotene Dry Mouth, Prevident 5000 Plus)
• Lozenges (e.g., xylitol suckers from www.dr.johns.com)
• Custom fluoride trays
• Fluoride varnishes applied in-office
• Prescription sialogogues (e.g., Pilocarpine or Cevimeline, which could take months to work)