Ear, Nose and ThroatPublic HealthSeniors / Aging

What to know about dry mouth

Dry mouth is a symptom which results in a lack of saliva. Dry-mouthed people do not have enough saliva to keep their mouth wet.

Often known informally as xerostomia, pasties, cotton-mouth, drooth, doughmouth, or des.

This article looks at the causes, signs, diagnosis and dry mouth care.

Fast facts on dry mouth

Here are a few key points about dry mouth. The main article provides more specifics and supporting material.

  • 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

Causes

Dry mouth is often a side effect of pharmaceutical drugs.
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 (high blood pressure) medicines, antidiarrheal medicines, muscle relaxants, urinary continence medicines, some Parkinson’s disease medicines, and a number of antidepressants.

Age: While dry mouth is not a normal part of aging, older people appear to take more medications than the rest of the population. Many of the medications that seniors take trigger dry mouth.

Cancer treatment: Radiotherapy (radiation therapy) to the head and neck can damage the salivary glands, resulting in the development of less saliva. Chemotherapy can alter the saliva’s composition, as well as the amount that the body produces.

Injury or surgery: This can cause nerve damage to the area of the head and neck, which can lead to dry mouth.

Tobacco: The risk of dry mouth symptoms is increased by either chewing or smoking tobacco.

Dehydration: This is caused by a lack of enough fluids.

Exercising or playing in the heat: The salivary glands may become dry as the concentration of body fluids elsewhere in the body. Symptoms of dry mouth are more likely if the workout or play lasts for long periods of time.

Some health conditions, diseases, and behaviors can cause dry mouth, for instance:

  • 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

Symptoms

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

Remedies

There are a variety of ways to keep your mouth lubricated to avoid dry mouth symptoms.

These include:

  • sipping non-carbonated, sugar-free fluids
  • chewing gum that contains xylitol.
  • using a carboxymethyl cellulose saliva substitute as a mouthwash may help
  • avoiding mouthwashes that contain alcohol.
  • 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.

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 intake should be kept to a minimum or stopped entirely, and only mild usage should be made of caffeine.

Treatment

Often, xerostomia is treated by addressing the underlying causes.
Often, xerostomia is treated by addressing the underlying causes.

Dry mouth care depends on many factors such as whether the patient has an underlying disorder or disease, or is taking other dry mouth-causing drugs.

If an underlying cause is identified it is important to take measures to mitigate its impact.

Medications: When a certain drug is believed to cause the dry mouth, the doctor may either alter the dose or prescribe another medicine which is less likely to cause dry mouth.

Stimulating the production of saliva: Medicine can be administered to stimulate saliva production, such as pilocarpine (Salagen) or cevimeline (Evoxac).

Experts say symptomatic dry mouth treatment usually covers four areas:

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

A dry-mouthed person should pay careful attention to oral / dental hygiene. It involves removing plaque, and treating gingival diseases, inflammation, and dental caries. It’s important to regularly brush the teeth and floss.

Diagnosis

The physician or dentist is likely to examine the patient’s mouth and study their medical history. The salivary glands can also be requested for blood tests and imaging scans.

Sialometry: This is a simple procedure which measures saliva flow rate. Collection devices are mounted over saliva gland duct orifices, and the production of saliva is stimulated by citric acid.

Saliography: This is an analysis of the salivary glands and ducts by radiograph. This may be useful when distinguishing stones and masses of the salivary gland.

Biopsy: A small sample of tissue from the salivary glands is taken. The treatment of Sjögren syndrome is also used. If it is suspected of being malignant (cancer), the doctor can order a biopsy as well.

Many doctors say that the oral mucosa still tends to be moist while the patient complains of extreme dry mouth. It could be the other way round less often – the oral mucosa appears dry but the patient does not complain about the symptoms of dry mouth.

What is xerostomia?

Occasionally, dry mouth is called xerostomia.

Researchers claim that the insufficient activity of the salivary glands typically induces xerostomia.

A person with xerostomia would usually find it more difficult to enjoy food.

One common issue is xerostomia. It is a common side effect of the drug, which can change with a new prescription or dose modification.

Occasionally we all get a dry mouth-when we’re angry, stress, or really afraid. Xerostomia is special-much of the time the mouth of the patient is dry.

Some patients may think that dry mouth is a common part of aging, but not. Nonetheless, it’s seen more frequently in older adults. Experts believe the biggest explanation is that older people are taking more medications relative to the rest of the population, and some of these medications cause xerostomia.

Xerostomia can be a sign of serious systemic disease, such as systemic lupus erythematosus, rheumatoid arthritis, scleroderma, sarcoidosis, amyloidosis, Sjögren syndrome, Parkinson’s, Diabetes, or hypothyroidism. A systemic illness is one which affects the whole body.

Dry mouth is a symptom of certain disorders and not a disease.

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