xerostoomia

Xerostomia, commonly known as dry mouth, is the subjective feeling of oral dryness. It can result from reduced saliva production (hyposalivation) or changes in saliva composition. Saliva protects teeth, mucosal tissues, and the mouth’s antimicrobial defenses, so decreased saliva increases the risk of tooth decay, infections, and irritation of the oral surfaces.

Causes include medications such as anticholinergics, antidepressants, antihypertensives, and decongestants; medical conditions such as Sjögren's syndrome, diabetes, and other autoimmune diseases; cancer therapies to the head and neck; dehydration; mouth breathing; smoking, alcohol, and caffeine use; and poor hydration or nutritional status. Age itself is not the cause, but older people often take more medications that can reduce saliva.

Symptoms and complications commonly associated with xerostomia include a gritty or sticky sensation in the mouth, difficulty speaking or swallowing, altered or metallic taste, thirst, and a dry or cracked tongue. Longstanding dry mouth increases the risk of dental caries, gum disease, candidiasis, mucosal irritation, and discomfort with dentures.

Diagnosis is based on medical history and clinical examination. Clinicians may assess salivary flow rates (sialometry) and review medications; further testing is guided by suspected underlying conditions, such as autoimmune diseases.

Management focuses on symptom relief and oral protection. Strategies include proper hydration, avoiding caffeine and alcohol, saliva substitutes or humidifiers, sugar-free gum or lozenges to stimulate saliva, and good oral hygiene with regular fluoride use. In selected cases, prescription medications that stimulate saliva (for example, pilocarpine or cevimeline) may be used, under medical supervision. Addressing the underlying cause, such as adjusting medications or treating radiation-related damage, is important. Regular dental follow-up is advised.