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Xerostomia / Dry Mouth

Definition:
It takes two quick licks to seal an envelope. But, if you find that you're often reaching for tape because you don't have saliva to spare, you may have a condition called xerostomia (zeer-o-STO-me-uh) — the medical term for dry mouth.

Lack of saliva is a common problem that may seem little more than a nuisance, but a dry mouth can affect both your enjoyment of food and the health of your teeth. That's why it's important not to ignore a dry mouth.

Although the treatment depends on the cause, dry mouth is often a side effect of medication. Dry mouth may improve with an adjusted dosage or new prescription.

Causes:
On any given day, the average healthy adult produces about 3 pints of saliva. This secretion serves many purposes. Saliva helps prevent tooth decay. It washes away food and plaque from your teeth. Minerals found in saliva help repair early tooth decay. Saliva also limits bacterial growth that can dissolve tooth enamel or lead to mouth infections. And saliva neutralizes damaging acids in your mouth. Saliva enhances your ability to taste your food and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

As you get older, your salivary glands may secrete less saliva. Thirst and your perception of thirst also may change. Thirst receptors in your brain become less responsive to your body's need for fluids. But xerostomia is more often related to the medications taken by older adults rather than to the effects of aging.

Hundreds of medications, including some over-the-counter drugs, produce dry mouth as a side effect. Among the more likely types to cause problems are some of the drugs used to treat depression and anxiety, antihistamines, high blood pressure medications, anti-diarrheals, muscle relaxants, drugs for urinary incontinence, and Parkinson's disease medications.

Among the other causes of dry mouth are:
  • Cancer therapy. Chemotherapy drugs can change the nature of saliva and the amount produced. Radiation treatments to your head and neck can damage salivary glands, causing a marked decrease in saliva production.
  • Nerve damage. An injury or surgery that causes nerve damage to your head and neck area also can result in xerostomia.
  • Other health conditions. Dry mouth can be a consequence of certain health conditions — or their treatments — including the autoimmune disease Sjogren's syndrome, diabetes, Alzheimer's disease, stroke, anxiety disorders and depression.

In addition, smoking or chewing tobacco can affect saliva production, aggravating dry mouth. Snoring and breathing with your mouth open also can contribute to the problem.

Symptoms:
Aside from the sensation of dryness in your mouth, xerostomia may result in:
  • Saliva that seems thick, stringy
  • Sores or split skin at the corners of your mouth
  • Cracked lips
  • Bad breath
  • Difficulty speaking, swallowing
  • Sore throat
  • An altered sense of taste
  • Increased plaque, tooth decay and gum disease

In women, dry mouth may result in lipstick adhering to the teeth.


Diagnosis:
To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you'll need blood tests and imaging scans of your salivary glands to identify the cause.

Treatment:
If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn't cause a dry mouth. Your doctor may also consider prescribing pilocarpine (Salagen) or cevimeline (Evoxac) to stimulate saliva production.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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