Dry Mouth

Overview

Saliva, or spit, plays an important role in keeping the mouth healthy. It moistens and breaks down food and helps you swallow. It also helps wash away food particles from the teeth and gums. Saliva keeps harmful germs in check. And it contains minerals such as calcium and phosphates that help keep teeth strong and fight tooth decay.

If the glands in your mouth (called salivary glands) do not make enough saliva to keep your mouth wet, you can get dry mouth, or xerostomia (ZEER-oh-STOH-mee-ah).

Almost anyone can have a dry mouth occasionally, such as if you’re feeling nervous or stressed.

However, dry mouth is not a normal part of aging. If you think you may have dry mouth, see your dentist or doctor to find out why your mouth is dry and get relief.

Signs and Symptoms

Dry mouth can cause many different symptoms. These include:

• A sticky, dry feeling in the mouth
• Trouble chewing, swallowing, tasting, or speaking
• A burning or itchy feeling in the mouth or throat
• A dry feeling in the throat
• Cracked lips
• Dry, rough, red, “hairy,” or deeply cracked appearance of the tongue
• Mouth sores
• Infections that keep coming back in the mouth or throat
• Bad breath

Related Health Effects

When your salivary glands do not work well, it can affect more than just how your mouth feels. Damaged or underactive salivary glands can result in reduced saliva in the mouth that can affect taste and make chewing and swallowing harder. It can also raise your risk for tooth decay, tooth loss, and mouth infections.

Dry mouth is also a main symptom of Sjögren’s (SHOW-grins) disease, an autoimmune disorder. Sjögren’s disease can affect other parts of the body too, causing joint and muscle pain, dry skin, dry eyes, fatigue, and a dry cough that does not go away.

Causes and Risk Factors

Many things can cause dry mouth. Common causes include:

• Side effects of some medicines: Hundreds of medicines can cause the salivary glands to make less saliva. For example, medicines for high blood pressure, depression, and bladder-control problems often cause dry mouth.
• Dehydration: Dehydration happens when you lose more fluids than you take in. People of all ages can become dehydrated, but older adults are especially prone to it.
• Certain disorders: Sjögren’s disease, HIV/AIDS, and diabetes can cause dry mouth. 
• Radiation therapy: Exposure to radiation during cancer treatment can damage the salivary glands leading to reduced saliva production.
• Chemotherapy and immunotherapy: Drugs used to treat cancer can make saliva thicker, causing the mouth to feel dry.
• Nerve damage: Injury to the head or neck can damage the nerves that tell the salivary glands to make saliva.
• Salivary gland obstruction: Small stones that form in the gland ducts may block the flow of saliva, causing the gland to swell and become painful, that can decrease saliva flow.

Prevention Guidance

If you have dry mouth, good oral care can help prevent oral health problems.

• Visit a dentist at least twice a year to have your teeth examined and cleaned.
• Use toothpaste with fluoride and gently brush your teeth, gums, and tongue after each meal and before bedtime.
• Floss your teeth regularly.
• Avoid sugary foods and drinks. If you do eat them, brush your teeth right after.
• Ask your dentist whether you need fluoride in a mouth rinse, gel, or varnish to protect your teeth from decay.

Diagnosis

Your doctor or dentist will examine your salivary glands and mouth, review your medical history, and ask about any medicines you take. They may also suggest blood tests or a test that measures how much saliva you produce.

If your doctor suspects a blockage in one of the glands, he or she may order X-rays or an ultrasound to find where the blockage is and what may be causing it.

If Sjögren’s disease is suspected, your doctor may order:

• Eye tests to see if you produce a normal amount of tears and to figure out if dryness has damaged your eyes
• Salivary gland tests to measure how much saliva your mouth produces. Ultrasound imaging and biopsy can help detect inflammation in the salivary gland tissues
• Blood tests to identify antibodies often present in people with Sjögren’s disease and other autoimmune disorders

Treatment and Management

Your doctor or dentist will first educate you on how to manage your symptoms. This may include drinking plenty of water, chewing sugarless gum, sucking on sugarless hard candy, avoiding caffeine, tobacco, and alcohol, maintaining good oral care, and visiting your dentist regularly for check-ups.

Your healthcare provider can recommend appropriate treatment depending on what is causing your dry mouth.

If medicine is the cause, your doctor or dentist may advise changing your medicine, adjusting the dose, or prescribing a saliva substitute.

Products to relieve dry mouth include:

• Artificial saliva or other special products to keep your mouth wet
• Saliva production stimulators — prescription medicines that cause salivary glands to make more saliva
• Anti-fungal medicines to treat fungal infections like thrush, which are more common in people with dry mouth

For Sjögren’s disease, treatment focuses on relieving symptoms and preventing complications. Treatment plans often include a mix of self-management and over-the-counter and prescription medicines. If you have joint pain, nonsteroidal anti-inflammatory drugs, like ibuprofen, may offer some relief. For more severe symptoms, corticosteroids (steroids) or immunosuppressive drugs may be prescribed. See a doctor or dentist if you notice symptoms of candidiasis, a fungal infection (also called thrush). Symptoms can include burning, soreness, and white patches inside your mouth.

Living With Dry Mouth

There are many steps you can take every day to ease dry mouth symptoms:

Stay hydrated:

• Drink plenty of water, 8 to 12 cups per day (64–96 ounces or 2–3 liters).
• Sip water or a sugarless drink during meals to make chewing and swallowing easier.
• Carry a water bottle and sip on it throughout the day.

Stimulate saliva:

• Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow; citrus, cinnamon, or mint-flavored candies are good choices.
• Some sugarless chewing gums and candies contain xylitol and may help prevent tooth decay.

Protect your mouth:

• Use a humidifier at night.
• Use lip balm if your lips are dry and cracked.
• Keep your mouth clean by rinsing before and after meals with plain water and brushing your teeth after meals.
• Avoid foods that stick to the roof of the mouth, like peanut butter or soft bread.
• Take small bites and chew your food well.

Avoid things that make dry mouth worse:

• Tobacco or alcohol
• Drinks with caffeine, such as coffee, tea, and some sodas
• Commercial mouthwashes and acidic drinks
• Spicy or salty foods, because they may cause pain or a burning feeling in a dry mouth

Good oral care at home and regular dental check-ups will help keep your mouth healthy.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on dry mouth.

Community Information

Sjögren’s Foundation educates patients and their families about Sjögren’s Disease, increases public and professional awareness of the condition, and encourages research into new treatments and a cure.

Note: This resource list is for informational purposes only. It is not comprehensive, and an organization’s inclusion does not constitute an endorsement by NIH.  

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.  

NIH actively supports research studies of dry mouth and salivary gland disorders.

Learn about how NIH-funded research is mimicking mother nature to grow an artificial salivary gland.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.