causes of xerostomia

Dry Mouth: Causes and Treatment

Dry mouth—also called “xerostomia”—can happen to almost any of us from time to time. But when dry mouth becomes an everyday problem, it can make things like swallowing or even wearing a denture difficult to do. A lack of saliva makes people prone to mouth sores, tooth decay, and even gum disease.

One of the best treatments for dry mouth is identifying what’s causing it, then taking steps to manage the symptoms. Here are some of the most common dry mouth risk factors to be aware of and how you can handle them.

Allergy Medication Can Cause Dry Mouth

Over-the-counter allergy medications, antihistamines, and decongestants are all known for drying you out. Including mucosal tissues. If you’re taking something to keep your nose from running every day or to avoid hay-fever-induced eye irritation, it might also be causing another problem: dry mouth.

If you read the labels on most over-the-counter drugs, you’ll see that dry mouth/xerostomia is one of the most common side effects of taking them. As long as you know that ahead of time, it can help you to take steps to prevent the side effects from having too much of a negative impact on your oral health. Especially if the trade-off is worth it.

Prescription Drugs

In addition to over-the-counter drugs, a wide variety of medications also cause dry mouth. Everything from depression medications or antipsychotics to diabetic or high blood pressure prescriptions can alter your saliva flow.

Chances are, you’ll notice a decrease in saliva within a few days of starting your new prescription medication. Since you likely need your medication to live life to the fullest, you’ll want to work with our Raleigh dentist to come up with a plan to eliminate the added risks that dry mouth side effects can have on your teeth. That’s one reason why we always ask to update your current list of prescriptions whenever you’re here for a checkup. Understanding what’s going on with the rest of your body will, by nature, help us to provide a more holistic approach to your smile’s ongoing care.

Alcohol (Drinks, Mouthwash, etc.)

Alcohol is a natural drying agent. So, whether you’re using a common over-the-counter mouth rinse that contains alcohol as an ingredient (which is extremely common) or indulging in an adult beverage of your choice, your mouth will start to feel it.

It’s best to avoid alcohol-containing mouth rinse if you have dry mouth in general. Take time to read the labels, as some of the more traditional brands include alcohol to stabilize the shelf life and keep the ingredients potent for longer. Popular brands that “burn” when you use them probably have alcohol in them. You can consider temporarily switching to one that’s alcohol-free to see if you notice a difference.

As far as alcoholic beverages go, you’re out of luck. It might help a bit to rinse your mouth out with water afterward or sip on water while you’re drinking, but the drying action will probably leave you with some “cotton mouth” the next morning.

Mouth Breathing = Dry Mouth

Are you a “mouth breather”? We can’t always help it, but sometimes we can. Do you breathe through your mouth while you’re sleeping, or during a hard workout? You’ll probably notice your mouth feeling sticky after a while if you do. People tend to breathe through their mouths when they have airway obstruction, sinus congestion, certain types of sleep apnea, or when they’re working out at the gym.

Try to make a conscious effort to breathe through your nose when you can. If you have sleep apnea or an overbite that’s contributing to your mouth breathing, be sure to have our Raleigh dentist perform a screening during your next exam. Investing in a sleep screening or even an orthodontic consultation could help to find ways that naturally improve your airflow.

Cancer Treatment

People undergoing treatment for various cancers will notice a lot of changes throughout their bodies. Dry mouth is one of them. Chemotherapy and especially radiation therapy (particularly near the head and neck) causes saliva glands to slow down production or stop working altogether. Some cancer treatments physically destroy the saliva glands while they attack the bad cells in your body.

Knowing to expect dry mouth going into cancer treatment can help you make a strategic plan for a healthier mouth during your therapy. Just be sure to communicate with your medical specialists and our Raleigh dental team to get a game plan into place ASAP. Most oncologists will instruct their patients to catch up on dental care before initiating cancer treatment anyway, so you’ll have a head start on managing dry mouth before it starts.

Changing Medications (Talk to Your Doctor)

It’s not always possible to change your medications just to fix dry mouth, but sometimes it’s an option. Your doctor or pharmacist may be familiar with drug alternatives that are less likely to cause decreased saliva flow. It’s worth asking if you really need to take something but notice xerostomia throughout the process.

Whatever you do, don’t stop taking your medication without first discussing the situation with your physician. There’s a reason why your doctor told you to take it, and the trade-off (as problematic as dry mouth can be) may still not be worth the risk of cutting off your medication cold turkey. Communication is key.

Drinking More Water

If you have a dry mouth, water is your best friend. You’ll want to rinse with water after meals to help cut down on acids, sugars, and food residue. But sipping on water frequently throughout the day will also help to keep your mouth lubricated. Most of us don’t get enough water intake anyway, so drinking more is good for our bodies overall.

For those of us who might not have the largest bladders, tiny sips here and there really won’t hurt all that much. But if they do, you still have the option of just rinsing your mouth every so often (like mid-day at the bathroom sink.)

Tip: if you’re drinking more water, try to get it straight from the tap. Tap water has regulated fluoride levels, making it better for your mouth and body in general. Some commercial bottled waters don’t have monitored fluoride content and can actually have a slightly acidic pH level, making them not as great for your enamel.

Using Products Tailored for Xerostomia

If you’re looking for some over-the-counter products that can help with dry mouth, look for xerostomia mouth rinse, toothpaste, lozenges, and sprays. Each of these products helps to moisturize the inside of your mouth, giving you the lubrication you need for everything to move around easily while you’re eating or talking.

Fair warning, dry mouth products might make your mouth feel a little “slimy” at first, especially if you’re not used to them. But if you can get over the slightly slick sensation, they can help immensely. Even if you’re wearing a denture or partial.

Chewing Sugar-Free Gum

Sometimes all your body needs is a little stimulation to get the saliva flow going. If you only struggle with dry mouth at certain times of the day, adding sugar-free gum to your routine can help. When your mouth is chewing, your brain naturally tells your saliva glands to start producing and secreting saliva, because saliva helps with digestion. Chewing gum is like cheating the system!

But not just any gum or mint will do. Many contain sugar or artificial sweeteners that still breed bacteria and feed acids, contributing to tooth decay. Look particularly for gum that contains xylitol. Xylitol physically cuts down on plaque inside your mouth. You can also buy it in spray form at some health food stores. We don’t recommend sucking on xylitol mints frequently throughout the day—once in a while is fine—because ingesting too much of it can irritate your stomach. That’s why it’s not recommended for baking or cooking.

Use Fluoride if You Have Dry Mouth

Last but certainly not least, make sure you’re supplementing with fluoride. An over-the-counter fluoride mouth rinse can definitely help to counteract the unwanted side effects of dry mouth (like tooth decay.) But if your xerostomia is severe, our Raleigh dentist will want to prescribe a stronger fluoride gel to use at night before you to go to bed. When you sleep, your saliva flow slows down even more, so it’s a great time to apply topical fluoride to your tooth enamel.

During your checkup, we’ll also apply a professional-grade fluoride varnish to your clean teeth. Although it’s a bit sticky, it works quite well!

Don’t Let Dry Mouth Destroy Your Smile

Chronic dry mouth can lead to serious tooth decay across your smile. It can also contribute to bad breath. If you notice a lack of saliva flow, talk to our Raleigh dentist about ways to reduce your risk of developing cavities. Frequent checkups and even prescription-strength fluoride can help you preserve healthy tooth enamel.

If it’s been longer than six months since your last checkup or you notice significant changes in your saliva flow, call Raleigh Dental Arts today to request an appointment.


Tarun Agarwal

Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a loving husband and dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.