Xerostomia is a medical term used for dry mouth due to lack of saliva; there is not enough saliva to keep the mouth wet or there is reduced or absent saliva flow.
The condition is also informally known as pasties, cottonmouth, drooth, doughmouth or des (from desert). It is usually a subjective complaint - the patient complains about it and subsequently sees the doctor.
This article will look at the causes, symptoms, diagnosis and treatment of xerostomia.
Contents of this article:
Fast facts on xerostomia
Here are some key points about xerostomia. More detail and supporting information is in the main article.
- Xerostomia is not life-threatening but can have substantial knock-on effects
- Dry mouth is more prevalent in the aging population
- Xerostomia is commonly a side effect of drugs
- Sometimes xerostomia is due to an underlying disease such as sarcoidosis or amyloidosis
- Symptoms of xerostomia include cracked lips, bad breath and sticky saliva
- Some cancer treatment can produce an excessively dry mouth
- Smoking or sleeping with the mouth open increases the chances of developing xerostomia
- Sialometry can help diagnose xerostomia
- Individuals with dry mouth should avoid spicy foods and sugary drinks
- Breathing through the nose rather than the mouth can help keep the mouth moist.
What is xerostomia?
Experts say xerostomia is usually caused by the inadequate function of the salivary glands.
Xerostomia can have a number of effects on general health and well-being.
Xerostomia can lead to speech and eating difficulties, halitosis (bad breath), an increase in the number of dental cavities (saliva helps prevent tooth decay), and infections in the mouth, such as thrush.
An individual with xerostomia typically finds it harder to enjoy food.
Xerostomia is a common problem. It is frequently a side effect of medication, which may improve with a new prescription or an adjustment of dosage.
We all get a dry mouth sometimes - when we are upset, under stress or extremely frightened. Xerostomia is different - the individual's mouth is dry most of the time.
Some patients may think dry mouth is a normal part of aging - it is not. It is, however, more commonly found among the elderly. Experts say the main reason is that elderly people take more medications compared to the rest of the population, and some of these medications cause xerostomia.
Xerostomia may be a symptom of a serious systemic disease, such as systemic lupus erythematosus, rheumatoid arthritis, scleroderma, sarcoidosis, amyloidosis, Sjögren's syndrome and hypothyroidism. A systemic disease is one that affects the entire body.
In fact, xerostomia is not a disease; it is a symptom, just like headache is a symptom and not a disease.
Symptoms of xerostomia
Signs and symptoms of xerostomia may include:
- Bad breath
- Cheilitis - inflammation and fissuring of the lips
- Cracked lips
- Cracking and fissuring of the oral mucosa (inner lining of the cheeks and lips)
- Dryness in the mouth
- Dysgeusia - taste disorders
- Fungal infections in the mouth, such as thrush
- Glossodynia - 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 - salivary gland infection
- Sore throat
- Sticky saliva
- Stringy saliva
- The skin at the corners of the mouth may split, or be sore.
Causes of xerostomia
Xerostomia may be a sign of an underlying disease or condition, such as Sjogren's syndrome, diabetes (poorly controlled), or Lambert-Eaton syndrome. It may also be caused by some medications. Some possible causes include:
Xerostomia is often a side effect of pharmaceutical drugs.
Medications - many prescription and OTC (over-the-counter, no prescription required) medications cause dry mouth, including antihistamines, hypertensive medications (for high blood pressure), anti-diarrheals, muscle relaxants, urinary continence drugs, some Parkinson's disease medications, as well as a number of antidepressants.
Age - even though old age is not a dry mouth risk factor, elderly individuals tend to take more medications than the rest of the population. Many of the medications taken by seniors cause dry mouth.
Cancer treatment - radiotherapy (radiation therapy) to the head and neck can damage the salivary glands, resulting in less saliva being produced. Chemotherapy can alter the nature of the saliva, as well as how much of it the body produces.
Injury or surgery - which results in nerve damage to the head and neck area, can result in dry mouth.
Tobacco - either chewing or smoking tobacco increases the risk of dry mouth symptoms.
Dehydration - caused by lack of sufficient fluids.
Exercising or playing in the heat - the salivary glands may become dry as the bodily fluids are concentrated elsewhere in the body. Dry mouth symptoms are more likely if the exercise or playing continues for a long time.
Some health conditions, illnesses and habits - such as:
- Anxiety disorders
- Parkinson's disease
- Poorly controlled diabetes
- Sjögren's syndrome
- Sleeping with the mouth open
- Stroke and Alzheimer's disease - more likely to cause a perception of dry mouth.
On the next page, we look at the diagnosis and treatment of xerostomia.