Xerostomia
Also known as Dry mouth
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is xerostomia?
Xerostomia is the sensation of a dry mouth, usually from reduced saliva production. Saliva protects teeth, aids swallowing and controls oral bacteria, so persistent dryness leads to rapid tooth decay, oral infections and difficulty eating and speaking. Medication side effects are by far the commonest cause.
Causes
- Medicines including antidepressants, antihistamines and diuretics
- Sjogren syndrome and other autoimmune disease
- Radiotherapy to the head and neck
- Dehydration
- Diabetes
- Anxiety and mouth breathing
- Ageing combined with polypharmacy
Symptoms
- Persistent dry sticky feeling in the mouth
- Difficulty chewing, swallowing or speaking
- Altered or reduced sense of taste
- Burning sensation of the tongue
- Cracked lips and mouth corners
- Rapidly progressing dental decay
- Recurrent oral thrush
- Difficulty wearing dentures
Risk factors
- Taking multiple medicines
- Older age
- Head and neck cancer treatment
- Autoimmune conditions
- Smoking and alcohol use
- Uncontrolled diabetes
Diagnosis
- Clinical history including full medication review
- Oral examination for dryness, decay and candidiasis
- Salivary flow measurement
- Autoantibody testing for Sjogren syndrome
- Blood glucose testing
- Salivary gland imaging or biopsy in selected cases
Treatment
- Reviewing and adjusting causative medicines where possible
- Frequent sips of water and sugar free gum to stimulate saliva
- Saliva substitutes and oral moisturising gels
- High fluoride toothpaste and regular dental review
- Pilocarpine to stimulate saliva in selected patients
- Treating oral thrush promptly
- Avoiding alcohol based mouthwashes, caffeine and smoking
Self care
- Sip water frequently through the day
- Chew sugar free gum to stimulate saliva
- Use saliva substitutes or oral moisturising gels
- Use high fluoride toothpaste and see a dentist regularly
- Avoid alcohol based mouthwashes, caffeine and smoking
- Use a humidifier at night
- Moisten food and avoid very dry or salty foods
When to see a doctor
Book an appointment if:
- Persistent dry mouth affecting eating or speaking
- Rapidly developing dental decay
- Recurrent oral thrush
- Dry eyes alongside dry mouth
- Salivary gland swelling
- To review medicines that may be responsible
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Review and minimise medicines that cause dry mouth
- Maintain excellent oral hygiene and regular dental visits
- Stay well hydrated
- Avoid tobacco and limit alcohol
- Use fluoride products preventively if at risk
- Manage diabetes well
Outlook
Dry mouth from medication often improves when the drug is changed or the dose reduced. Radiation induced and Sjogren related xerostomia tends to persist and needs ongoing management. The main risk is rapid dental decay, so intensive preventive dentistry substantially changes long term outcomes.
Common questions
Why does dry mouth damage teeth so quickly?
Saliva neutralises acid, washes away food debris and supplies minerals that repair early decay. Without it, cavities can develop rapidly, including in areas that are usually well protected.
Which medicines commonly cause it?
Antidepressants, antihistamines, diuretics, some blood pressure medicines, opioids, antipsychotics and bladder anticholinergics are frequent culprits, and the effect compounds when several are taken together.
What is Sjogren syndrome?
An autoimmune condition in which the immune system attacks moisture producing glands, causing dry mouth and dry eyes, often alongside fatigue and joint pain. It requires specific diagnosis and management.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.