If your mouth always feels dry and parched, you have a condition worthy of a medical name: xerostomia (from the Greek xero, for dry, and stoma, for mouth). If it’s bad enough, you may have trouble chewing, swallowing, and even speaking, and it may wake you at night.
Dry mouth is especially common among people over 65, since saliva production declines by as much as 40 percent with age, and many medications they take can cause or worsen the problem. However, the subjective feeling of mouth dryness doesn’t always correlate with an actual reduction in saliva. In some cases, for instance, the problem is not less saliva but a change in its composition, making it thicker and thus less functional.
You can have reduced saliva production and oral dryness (as objectively measured) and become aware of it only because of the troubles it causes, such as persistent bad breath, a cracked tongue or lips, and hoarseness. Worse yet, dry mouth can cause cavities and gum disease, since a plentiful supply of saliva is required for healthy teeth and gums; saliva lubricates the mouth and contains minerals that tooth enamel absorbs. Dry mouth also increases the risk of mouth sores and oral yeast infections.
If you have dry mouth, your doctor or dentist can evaluate the problem. If dryness occurs only at night, you may have a nasal obstruction that causes you to breathe through your mouth. Dry mouth can be a symptom of a variety of illnesses, including diabetes and Sjögren’s syndrome (an autoimmune disease), or a side effect of medication or medical treatments, notably radiation therapy for head or neck cancer.
Dealing with dry mouth
- First, protect your teeth and gums. Brush and floss regularly, especially after eating sugary and other tooth-decay-promoting foods. Clean along your gum line—ask your dentist which tool to use. Your dentist may recommend a brush-on fluoride treatment and a sealant. Get regular checkups.
- Avoid mouthwashes containing alcohol, which is drying.
- Chew sugarless gum or suck on sugarless candy to stimulate saliva flow.
- Drink fluids with meals and throughout the day, and avoid dry salty foods such as crackers and pretzels.
- Keep a glass of water at your bedside and take a sip if you wake up parched.
- Don’t smoke or use recreational drugs; limit alcohol.
- Talk with your doctor or pharmacist about the medications you take, since it’s estimated that 60 percent of commonly prescribed drugs can cause dry mouth. Leading culprits are antihistamines, blood pressure drugs, diuretics, antidepressants, anti-anxiety medication, and bronchodilators used for asthma. There may be alternatives that are less drying.
- Try OTC saliva substitutes, which come as sprays, liquids, gels, and lozenges. Some mouthwashes and toothpastes, such as Biotene, Orajel, Salivart, and Oasis, contain ingredients that stimulate saliva production. They won’t cure dry mouth, but they can reduce its symptoms. If these don’t help, talk to your dentist or doctor about prescription saliva stimulants, though these often have side effects and contraindications.