Dry mouth (xerostomia)

Dry mouth is when your salivary glands don’t produce enough saliva to keep your mouth wet. It’s usually a side effect of treatment, but it can also happen with age or with certain conditions. Another name for dry mouth is xerostomia. Everyone has a dry mouth at times, like when you’re nervous or under stress. But when you don’t have enough saliva for an extended period, dry mouth causes discomfort and can lead to problems with swallowing or other complications. Treating the cause of dry mouth and using products like artificial saliva or taking medication can restore moisture to your mouth.

At Penn Medicine, our specialists have experience diagnosing dry mouth and conditions that affect how your salivary glands function. Our experts can also recommend effective treatments that will help you produce more saliva and make your mouth feel more comfortable.

Dry mouth can cause a range of symptoms that may include:

• Dryness or stickiness in your mouth
• A burning sensation in your mouth
• Thick saliva
• Bad breath
• Trouble speaking, chewing, swallowing, or wearing dentures
• Mouth sores
• A sore throat and a hoarse voice
• A dry tongue that might have grooves
• Cracked lips
• Changes in taste

Saliva plays an important role in your oral health. Over time, dry mouth causes tooth decay and can cause problems with digesting food.  This can happen because saliva washes away food from your teeth and gums and provides minerals that fight tooth decay. It also helps break down food for digestion.

Side effects from medications are a common cause of dry mouth. Hundreds of drugs can decrease the amount of saliva you produce. They include drugs that treat Parkinson’s disease, seizures, high blood pressure, depression, and anxiety. Chemotherapy, pain medication, and muscle relaxants also can cause dry mouth. Over-the-counter antihistamines, decongestants, and pain relievers can make your mouth dry, as well. Plus, tobacco, alcohol, and illegal drugs like methamphetamine can lead to dry mouth and tooth decay.

Another cause of dry mouth is radiation therapy to the head and neck, which can damage salivary glands. Sjogren syndrome, HIV, nerve damage in the head or neck, and uncontrolled diabetes can also affect how much saliva you have.

You might also notice that your mouth is drier as you get older, especially after age 65. Aging alone can increase the chances of having dry mouth, but dry mouth can also happen because you’re more likely to take medications or have conditions like diabetes as you get older.

To diagnose dry mouth, your health care provider will ask you about your symptoms and whether they’re triggered by stress or activities. Give your provider your complete health history, including if you’ve been treated with radiation and what prescriptions and over-the-counter medications you take. Your provider will also ask about your fluid intake and if you’ve had symptoms that can cause dehydration like vomiting or diarrhea. You’ll need an exam, and your provider may recommend tests to diagnose dry mouth and any conditions that could be causing dry mouth.

Dry mouth treatment depends on the cause of your symptoms. If a medication is making your mouth dry, your health care provider may recommend a lower dose or that you switch to another drug that doesn’t affect the salivary glands.

Your provider may also recommend prescription or over-the-counter products like mouth rinses, mouth sprays, artificial saliva, or toothpaste specifically made for dry mouth. Be sure that any products you buy from the store contain xylitol or other ingredients that lubricate the mouth instead of mouthwashes that contain alcohol or witch hazel that can dry out your mouth even more.

Taking steps to increase the moisture in your mouth throughout the day can also help.

• Carry a water bottle and sip water frequently.
• Chewing and sucking stimulates the flow of saliva, so chew sugar-free gum or suck on sugar-free hard candy or ice chips.
• Breathe through your nose instead of your mouth and get treated for snoring if you breathe through your mouth at night.
• Use a humidifier in your room while you sleep.
• Avoid caffeine, alcohol, and tobacco because they can dry your mouth.
• Don’t take antihistamines and decongestants unless recommended by your provider because they can make your mouth drier.

If you have severe dry mouth due to Sjogren syndrome or radiation therapy, your health care provider may recommend a prescription medication that helps your salivary glands produce more saliva.

As you use treatments to restore moisture to your mouth, be sure to brush your teeth with fluoridated toothpaste, floss, and go to regular dental visits. Good oral health can help you avoid complications of dry mouth like cavities and infections.