DigestiveICD-10: R68.2Affects an estimated 10 to 30 percent of adults, rising with age and medication use

Dry Mouth (Xerostomia)

Also known as: Xerostomia, Cottonmouth

Dry mouth, known medically as xerostomia, is the feeling of insufficient saliva in the mouth. Saliva does far more than keep the mouth comfortable — it neutralizes acids, washes away food, fights bacteria, and helps with chewing, swallowing, and taste. When salivary flow drops, the result can be difficulty eating and speaking, bad breath, and a sharply increased risk of tooth decay and oral infections. Dry mouth is most often a side effect of medications, but it can also stem from medical conditions, dehydration, or cancer treatment.

At a Glance

Common symptoms
A dry, sticky feeling in the mouth, Thick or stringy saliva, Frequent thirst
Main treatments
Reviewing and adjusting causative medications when possible, Saliva substitutes and oral moisturizing gels or sprays, Prescription medications that stimulate saliva (pilocarpine, cevimeline)
Category
Digestive · Affects an estimated 10 to 30 percent of adults, rising with age and medication use
See a doctor if
Persistent dry mouth that does not improve with hydration

Symptoms

A dry, sticky feeling in the mouth
Thick or stringy saliva
Frequent thirst
Difficulty chewing, swallowing, or speaking
Bad breath
A dry or grooved tongue and altered sense of taste
Cracked lips and sores at the corners of the mouth
More frequent cavities and gum problems

Causes

  • Medication side effects (antihistamines, antidepressants, blood pressure drugs, and many others)
  • Dehydration
  • Autoimmune conditions such as Sjögren's syndrome
  • Radiation therapy to the head and neck
  • Chemotherapy
  • Nerve damage, diabetes, and certain infections
  • Mouth breathing, smoking, and alcohol use

Risk Factors

  • Older age (largely because of increased medication use)
  • Taking multiple medications
  • Cancer treatment involving the head and neck
  • Autoimmune disease
  • Uncontrolled diabetes
  • Tobacco and alcohol use

Diagnosis

  • Review of symptoms, medical history, and medications
  • Examination of the mouth and measurement of saliva flow
  • Blood tests if an autoimmune or systemic cause is suspected
  • Imaging or biopsy of salivary glands in selected cases
  • Testing for Sjögren's syndrome when indicated

Treatment

  • Reviewing and adjusting causative medications when possible
  • Saliva substitutes and oral moisturizing gels or sprays
  • Prescription medications that stimulate saliva (pilocarpine, cevimeline)
  • Sugar-free gum or lozenges to stimulate flow
  • Frequent sips of water and good hydration
  • Fluoride treatments and diligent dental care to prevent decay
  • Treating the underlying condition (e.g., diabetes, Sjögren's)

Prevention

  • Stay well hydrated throughout the day
  • Avoid tobacco, alcohol, and caffeine, which are drying
  • Breathe through your nose rather than your mouth
  • Use a humidifier at night
  • Maintain excellent oral hygiene and regular dental visits
  • Discuss drying side effects with your doctor before changing medications

When to See a Doctor

  • Persistent dry mouth that does not improve with hydration
  • Difficulty eating, swallowing, or speaking
  • Frequent mouth sores or oral infections
  • Dry eyes and dry mouth together, which may suggest Sjögren's syndrome
  • Increasing tooth decay despite good oral care

Frequently Asked Questions

Related Conditions

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