Xerostomia

Xerostomia
SJÖGREN'S syndrome: Along with the symptoms of keratoconjunctivitis sicca and xerostomia. This woman has marked enlargement of the left parotid gland and slight enlargement of the right parotid gland. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology
ICD-10	K11.7, R68.2
ICD-9	527.7
DiseasesDB	17880

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Xerostomia is the medical term for a dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties or cottonmouth.

Xerostomia can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva is no longer present, and can make the mucosa of the mouth more vulnerable to infection. Notably, a symptom of methamphetamine abuse usually called "meth mouth" is largely caused by xerostomia.

Causes

It may be a sign of an underlying disease, such as Sjögren's syndrome, poorly controlled diabetes, or Eaton-Lambert syndrome, but this is not always so.

Other causes of insufficient saliva include anxiety, medications, or alcohol, trauma to the salivary glands or their ducts or nerves, dehydration, excessive mouth breathing, previous radiation therapy, and also a natural result of aging. The vast majority of elderly individuals will suffer xerostomia to some degree. Playing or exercising a long time outside on a hot day will often cause your saliva glands to simply dry up as your bodily fluids are concentrated elsewhere. Drugs have also been known to cause this problem, such as cannabis, and DXM.

Complete Differential Diagnosis for Xerostomia

In alphabetical order.

With parotid gland swelling

• Heerfordt's Disease
• Sicca Syndrome
• Sjögren's Syndrome

Without parotid gland swelling

• Advance age
• Alcoholism
• Antihistamines
• Antihypertensives
• Antiparkinsonian drugs
• Antispasmodics
• Atropine
• Bronchodilators
• Continuous vomiting
• Decongestants
• Diabetes Mellitus
• Diarrhea
• Diuretics
• Infections with high fever
• Lithium
• MAOIs
• Neuroleptics
• Psychogenic
• Radiation therapy
• Salivary gland surgery
• Tricyclic antidepressants

Treatment

Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients who have endured chemotherapy usually suffer from this post- treatment. Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping sugarless fluids frequently, chewing xylitol-containing gum, and using a carboxymethyl cellulose saliva substitute as a mouthwash may help. Aquoral may be prescribed to treat xerostomia. Non-systemic relief can be found using an oxidized glycerol triesters treatment used to coat the mouth.

External links

• Oral Cancer Foundation
• University of Illinois at Chicago
• NIH
• Sjögren's Syndrome Foundation page on Dry Mouth

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