Dry Mouth

Dry Mouth induced by Medicine or Therapy

Dry Mouth or Xerostomia is the feeling that there is not enough saliva in your mouth – feeling like there is cotton wool or it is gritty. If you have a dry mouth most of the time and not just when you are stressed, nervous or upset then it may be as a result a side effect of drugs medicines or therapy. It can lead to serious health problems.

Dry Mouth is not a normal part of ageing, however it affects 20% of the elderly. Causes can include; medicines (over 400), radiation therapy, chemotherapy, nerve damage, salivary gland diseases (see Sjögren's syndrome), HIV/AIDS, diabetes, rheumatoid arthritis

Saliva includes; electrolytes, anti-microbials, enzymes and immunoglobulins. Saliva is important for routine oral function and provides mechanical cleansing, moistening and pre-digestion of food, removal of food debris from the oral cavity, lubrication, remineralisation of the teeth and importantly maintaining the integrity of the oral mucosa.

Symptoms of Dry Mouth include

  • A sticky feeling in the mouth
  • Stringy saliva
  • Trouble chewing, swallowing, tasting and speaking
  • A burning sensation
  • Constantly dry throat
  • Cracked lips
  • A dry, rough painful tongue
  • Difficulty with denture retention
  • Alterations to taste (often a persistent metal taste)
  • Mouth sores or ulcers
  • Oral thrush
  • General mouth infections (halitosis)
  • Avoid

  • Smoking
  • Caffeine
  • Alcohol
  • Mouth washes and fluoride rinses
  • Toothpastes with strong flavours and abrasives
  • Dry Mouth is a contributing factor in minor and serious health conditions. It affects oral hygiene and resultant dental problems and infections, general nutrition, psychological and social problems. Dry Mouth is the hidden cause of gum disease in 30% of cases. A dry mouth increases acidity increasing caries and the incidence of oral thrush.

    Conditions that may cause Dry Mouth

    The most common disease causing Dry Mouth is Sjögren's syndrome, a chronic inflammatory autoimmune disease that occurs predominantly in postmenopausal women. Sarcoidosis and amyloidosis are other chronic inflammatory diseases that cause Dry Mouth. HIV-salivary gland disease occurs in some individuals infected with HIV. Immuno-suppressive drug therapy after transplants.

    Other systemic diseases that can cause Dry Mouth include rheumatoid arthritis, systemic lupus erythematosus, scleroderma, diabetes mellitus, hypertension, cystic fibrosis, bone marrow transplantation, endocrine disorders, nutritional deficiencies, nephritis, thyroid dysfunction and neurological diseases such as Bell's palsy and cerebral palsy. Hyposecretory conditions, such as primary biliary cirrhosis, atrophic gastritis and pancreatic insufficiency, may also cause Dry Mouth. Psychogenic causes, such as depression, anxiety, stress or fear, can also result in Dry Mouth.

    Alzheimer's disease or stroke may alter the ability to perceive oral sensations. Trauma to the head and neck area can damage the nerves supplying sensation to the mouth, impairing the normal function of the salivary glands.

    Cancer Therapy

    Dry Mouth (Xerostomia) is the most common toxicity associated with standard radiation therapy to the head and neck. Acute Dry Mouth from radiation is due to an inflammatory reaction, while late xerostomia, which can occur up to one year after radiation therapy, results from fibrosis of the salivary gland and is usually permanent. A common early complaint following radiation therapy is thick or sticky saliva. The degree of permanent Dry Mouth depends on the volume of salivary gland exposed to radiation and the radiation dose.

    Certain cancer chemotherapeutic drugs can also change the composition and flow of saliva, resulting in Dry Mouth, but these changes are usually temporary. Dry Mouth may also occur during graft-vs.-host disease. Patients experiencing Dry Mouth from radiation therapy or cancer chemotherapy are at particular risk of infections from normal oral flora. Oral ulcerations can become the breeding place of invasive bacterial infections, and opportunistic infections with fungal organisms such as Candida can occur.