Dry mouth (xerostomia)

What causes a dry mouth?

Xerostomia (or a dry mouth) may be seen due to a variety of causes. Salivary flow slows down with age and the explanation can be that simple. A number of medications can also cause dry mouth including antidepressant, blood pressure medications, proton pump inhibitors, bronchodilators, antihistamines and diuretics. Previous radiotherapy to the head and neck area may cause quite severe xerostomia.

How will this be investigated?

In many cases the cause is far from clear cut. I will often recommend routine blood tests including autoantibodies to screen for Sjogren’s Syndrome, an uncommon but significant potential cause. Sometimes this needs to be augmented with a labial gland biopsy, where a small number of minor salivary glands are harvested from the lower lip under a local anaesthetic and submitted for analysis.

What is the possible treatment?

In many instances, regardless of the underlying cause, salivary substitution is all that is warranted. This can take various forms including sprays and gels such as Glandosane® and Biotene® Oral Balance. In a minority of patients, a muscarinic agonist (pilocarpine) may be warranted. I will often work in conjunction with your General Practitioner (GP) to ensure a thorough medication review is also undertaken, exchanging any medications that might be contributory to your xerostomia.