The feeling of dryness in the mouth is something almost everyone experiences occasionally – after waking up, during stress, or due to dehydration. But when that discomfort becomes constant and affects daily functioning, it is called xerostomia – a medical condition referring to chronic dryness of the oral cavity.
Dry mouth is not only an unpleasant symptom but also a potential cause of serious oral-health complications.
In this article, we provide an overview of the most common causes, symptoms, available treatments, and tips to help relieve and manage this condition. A special emphasis is placed on xerostomia in older adults, as well as its growing occurrence among younger generations.
What is xerostomia?
Dry mouth – xerostomia – is a medical condition referring to oral dryness and a potential cause of serious oral-health complications.
Xerostomia (Latin: xerostomia) is a condition that describes a subjective feeling of dryness in the mouth, usually caused by reduced or completely stopped saliva production. Although it is not always accompanied by a measurable decrease in saliva, dry mouth almost always indicates a dysfunction of the salivary glands.
Saliva plays a key role in protecting the oral cavity: it maintains moisture, facilitates chewing and swallowing, aids in speech, protects against cavities, neutralises acids, and has antibacterial properties.
Reduced saliva production can lead to numerous problems – from bad breath to serious infections and tooth damage.
The most common causes of dry mouth
The causes of xerostomia can be temporary and reversible, but also chronic, especially when linked to long-term diseases or treatments.
1. Dehydration
The most common and simplest cause is low fluid intake or fluid loss (sweating, vomiting, diarrhoea, fever). Dehydration quickly reduces saliva flow.
2. Medications
Over 500 different medications can cause xerostomia as a side effect. The most common include:
• Antidepressants (SSRIs, tricyclic antidepressants)
• Antihypertensives
• Antihistamines
• Diuretics
• Analgesics
• Medications for Parkinson’s disease
3. Autoimmune diseases
Sjögren’s syndrome is the most common example – a chronic autoimmune disease that attacks exocrine glands, including salivary and tear glands.
4. Cancer therapies
Radiation to the head and neck, as well as chemotherapy, can permanently damage salivary glands, resulting in pronounced xerostomia.
5. Hormonal changes
In women during menopause and perimenopause, hormonal changes can affect the quality and quantity of saliva.
6. Stress and anxiety
Psychological factors such as nervousness, stress, or panic attacks can cause temporary but often pronounced oral dryness.
7. Smoking and alcohol consumption
Nicotine and alcohol irritate the mucosa and reduce salivation.
What are the symptoms of xerostomia?
Symptoms can be mild and uncomfortable, but over time, they become a serious challenge to quality of life. Common symptoms include:
• Sticky or dry feeling in the mouth
• Difficulty swallowing and chewing
• Speech difficulties
• Burning sensation on the tongue (so-called burning mouth syndrome)
• Cracked lips and mouth corners
• Bad breath (halitosis)
• Increased risk of cavities and infections
• Throat dryness, frequent need for water
• Problems wearing dentures (in older adults)
Xerostomia in older adults
Older adults are particularly prone to developing xerostomia due to a combination of factors:
• Taking multiple medications at once (polypharmacy)
• Common chronic diseases (e.g., diabetes, hypertension, Parkinson’s disease)
• Decreased ability of glandular tissue to regenerate
• Insufficient hydration
• Poor oral hygiene
It’s important to note that dry mouth in older adults should not be considered “a normal part of ageing” – it’s a condition that requires diagnosis and treatment to preserve oral health and function.
Diagnosis and when to visit the dentist
If dryness in the mouth persists for more than a few days and is accompanied by one or more symptoms listed above, it’s recommended to visit a dentist or oral-medicine specialist. The diagnostic process includes:
• Detailed medical history (illnesses, medications, lifestyle)
• Clinical examination of the mucosa and teeth
• Measuring saliva quantity (sialometry)
• Additional tests if a systemic disease is suspected (e.g., blood tests, salivary gland biopsy)
How is xerostomia treated?
Treatment depends on the cause, severity of symptoms, and the patient’s general condition. The goal is not only to relieve symptoms but also to prevent complications such as cavities, fungal infections, and mucosal damage.
1. Eliminating or adjusting the cause (if possible)
If a specific medication is identified as the cause of dry mouth, the physician may:
• Reduce the dosage
• Adjust the treatment plan
• Replace it with an alternative drug that has fewer side effects
This must always be done in consultation with the attending physician.
2. Stimulating saliva production
In patients with remaining gland function, natural salivation can be stimulated through:
• Chewing sugar-free gum or lozenges with mint, citrus, or cinnamon flavours
• Using moisturising oral sprays, gels, and lozenges
• Prescription medications such as pilocarpine in severe cases
3. Artificial saliva and moisturising products
For severe xerostomia, especially cases caused by radiation or autoimmune diseases, the following are recommended:
• Moisturising gels, sprays, and rinses
• Artificial saliva substitutes that mimic natural saliva’s physical properties
• Special alcohol-free toothpastes and mouthwashes that protect teeth and mucosa
4. Antimicrobial protection and hygiene
Because of the increased risk of cavities and fungal infections (e.g., candidiasis), patients are advised to:
• Use fluoride toothpastes and gels
• Undergo regular professional cleanings
• Brush thoroughly twice a day and floss daily
• Avoid mouthwashes containing alcohol
Tips for daily symptom control
Introducing simple habits can significantly reduce discomfort and prevent worsening:
• Drink water regularly throughout the day, even if you don’t feel thirsty
• Avoid caffeine, alcohol, and smoking – they all further dry the mucosa
• Sleep with a humidifier, especially in winter
• Avoid spicy and salty foods that irritate the mouth
• Carry water or a moisturizing spray when spending long periods outside
• Visit your dentist regularly for check-ups and professional guidance
Xerostomia in children and young people
Although most often associated with older adults, dry mouth can also occur in children and young people, especially due to:
• Medication therapy (e.g., for ADHD)
• Hormonal changes during puberty
• Psychological stress, anxiety, or dehydration
• Mouth-breathing habits (especially at night)
Parents should pay attention to signs such as bad breath, dry lips, reduced saliva, and difficulty swallowing. Timely action can prevent serious complications.
Complications of untreated xerostomia
If xerostomia is ignored, it can lead to:
• Increased risk of cavities and periodontal disease
• Fungal infections (most often Candida albicans)
• Difficulty wearing dentures and speaking
• Problems with swallowing and eating
• Persistent mucosal inflammation, ulcerations, and sores
In cases of Sjögren’s syndrome or radiation-induced gland damage, changes may be irreversible, so early diagnosis is essential.
Dry mouth is not a condition to ignore
Although xerostomia may seem benign, it can seriously affect quality of life and oral health. Timely identification of the cause and implementation of proper therapy are key steps in managing symptoms and preventing complications.
If you notice persistent dryness lasting more than a few days, it’s best to consult a dentist.
At Esthea Clinic, we offer an individualised approach to xerostomia diagnosis and therapy – aiming to restore comfort, health, and daily functionality.