Dry Mouth

Dry mouth may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Dry mouth may accompany other symptoms affecting the mouth including:

• Bad breath

• Burning sensation in the mouth or on the tongue

• Cracks in the lips or at the corners of the mouth

• Difficulty chewing and swallowing

• Difficulty talking

• Dry, rough tongue

• Mouth sores or mouth infections, such as recurrent candidiasis

• Pain in the mouth or on the tongue

• Taste changes

• Thick, stringy saliva

• Tooth decay

In some cases, dry mouth may occur with other symptoms that might indicate a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care for dry mouth along with other serious symptoms including:

• Difficulty breathing

• Difficulty swallowing

• High fever (higher than 101°F)

Saliva, a product of the salivary glands, plays an important role in your mouth. It cleanses the mouth and removes food debris. Enzymes in saliva, combined with chewing, initiate the digestion process. Dry mouth occurs when the salivary glands don't work properly.

Because many over-the-counter and prescription medicines have dry mouth as a side effect, they are a common cause of the condition. In addition, some diseases, such as diabetes, Parkinson’s disease, and Sjogren’s syndrome, can reduce the function of the salivary glands, resulting in dry mouth.

Other causes of dry mouth include certain cancer treatments and damage to the glands’ nerve supply. Neural impulses are needed from the brain to stimulate the glands’ production of saliva. Any disease or disorder that affects these impulses will result in dry mouth.

In addition, the natural aging process may reduce the salivary glands’ ability to produce adequate saliva, resulting in dry mouth. The sympathetic nervous system’s response to stress that results from severe anxiety or depression can also cause a dry mouth. Without treatment, infection may develop in the salivary glands, mouth, or tongue due to increased bacterial growth.

Common causes of dry mouth include:

• Aging

• Cancer chemotherapy

• Radiation therapy

• Medications

• Snoring or sleeping with your mouth open

• Tobacco use

Certain diseases can also cause dry mouth including:

• Alzheimer’s disease

• Diabetes

• Parkinson’s disease

• Rheumatoid arthritis

• Sjogren’s syndrome (autoimmune disease characterized by dry eyes and mouth)

• Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)

In some cases, dry mouth may be a symptom of a serious or life-threatening condition that should be evaluated immediately in an emergency setting. These include:

• Adverse drug reactions

• Serious infections

In most cases, dry mouth is not serious. However, it can be very bothersome and lead to other dental problems. It can also be a sign of a serious underlying medical condition, such as diabetes or Sjogren’s syndrome. Make an appointment to see your doctor or dentist if you have persistent dry mouth or other symptoms, such as bad breath, thick saliva, or changes in the sense of taste.

To diagnose the underlying cause of dry mouth, your doctor or dentist may ask you several questions including:

• How long have you felt dryness in your mouth?

• When does your mouth feel dry? Do you have dry mouth at night or are you waking up with dry mouth?

• Is your dry mouth constant or does it come and go?

• Do you have any other symptoms, such as difficulty chewing or bad breath?

• What, if anything, seems to make your symptoms better or worse?

• What medications are you taking?

• Do you smoke, chew tobacco, or drink alcohol?

Your doctor or dentist may also examine your mouth and neck. Sometimes, it may be necessary to undergo testing including:

• Blood tests

• Imaging exams of the salivary glands, such as a sialogram or salivary scintigraphy. These tests use a dye or radioactive isotope, respectively, to measure the function of the salivary glands.

• Salivary gland biopsy to take a sample of cells for microscopic examination

It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

The dry mouth treatment you need will vary depending on the underlying cause of the problem. If a medication could be the cause, your doctor may recommend adjusting the dose or changing to a different drug. Treating any underlying cause, such as diabetes or rheumatoid arthritis, can also help resolve dry mouth. Otherwise, your doctor may use treatments including:

• Moisturizing products, such as artificial saliva and mouth rinses and lubricants. These products are available over the counter and by prescription.
  
• Saliva stimulants, including pilocarpine (Salagen) or cevimeline (Evoxac)
  
• Tooth and gum protectants to prevent cavities and gum disease, including chlorhexidine rinse, fluoride trays, and teeth sealants

There are several self-care strategies for relieving dry mouth. Finding the dry mouth remedy that works for you may take some trial and error. Here are several tips for coping with dry mouth:

• Avoid alcohol, caffeine, tobacco, antihistamines and decongestants.

• Chew sugarless gum or suck on sugar-free candy to stimulate saliva production.

• Drink water throughout the day or suck on ice chips if that works better for you. When chewing is difficult due to dry mouth, take sips of water as you eat.

• Humidify the air in your home, especially at night when you are sleeping. Using nasal strips while you sleep can also help by reducing snoring and mouth breathing.

• Lubricate your lips to avoid cracking and peeling.

• Moisten food with sauces, gravies, broth or butter. Avoid dry foods if possible.

• Practice good oral hygiene by flossing daily, brushing your teeth twice a day and after meals, and seeing your dentist twice a year. Avoid alcohol-based mouthwashes and ask your doctor about toothpastes that can help dry mouth.

Because dry mouth can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your healthcare professional design specifically for you to reduce the risk of potential complications including:

• Gingivitis (inflammation of the gums)  

• Spread of infection  

• Tooth decay  

• Tooth loss