xerostomi

Xerostomi, also known as xerostomia or dry mouth, is a condition characterized by reduced saliva production leading to a dry oral mucosa. Saliva normally lubricates the mouth, aids in digestion, cleanses teeth, and protects against bacteria, so reduced flow can affect comfort, eating, swallowing, and dental health. Xerostomi is a symptom that may arise from a temporary state or a chronic condition.

Common causes include medications with anticholinergic effects (such as many antihistamines, antidepressants, and certain blood pressure drugs), aging, dehydration, mouth breathing, tobacco and alcohol use, and radiation therapy to the head and neck. Systemic diseases such as Sjögren's syndrome and diabetes can also contribute, as can nerve damage or anxiety.

Symptoms and complications extend beyond a dry sensation and may include sticky saliva, thick or tacky mouth feel, altered taste, difficulty speaking or swallowing, cracked lips, mouth ulcers, and increased susceptibility to dental caries, periodontal disease, and oral infections such as candidiasis. Dentures may feel uncomfortable, and bad breath is common.

Diagnosis relies on patient history and clinical examination, sometimes supplemented by measurements of saliva production (unstimulated and stimulated sialometry) and tests to identify underlying conditions. Imaging or referral to specialists may be needed for complex cases.

Management focuses on addressing underlying causes, when possible, and alleviating symptoms. Treatments include saliva substitutes and stimulants (for example, pilocarpine or cevimeline in suitable patients), good hydration, meticulous oral hygiene, topical fluoride, and avoiding irritants. Regular dental follow-up helps prevent complications.