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Dry Mouth: A Salivary Gland Dysfunction

Dry mouth, also known as xerostomia, is an abnormal reduction in saliva production. This can be the result of several factors such as medication, disease or infection. While dry mouth may seem like nothing more than a minor inconvenience, a decreased amount of saliva can affect the overall health of your teeth as well as your ability to taste food and swallow.

The Salivary Glands

The salivary glands are found throughout your mouth, from underneath your tongue to your inner cheek to your lips. All of these salivary glands produce saliva, which keeps the mouth moist, helps with digestion and protects the teeth from bacteria and other microorganisms that cause decay.

The salivary glands can be divided into two different groups: the major and minor glands. The minor glands are tiny glands found throughout the mouth. The major glands consist of the:

parotid glands: one on each side, inside the mouth just in front of and below the ear. Saliva drains into the mouth through a duct, which empties near the upper second molar.
submandibular glands: found under the tongue
sublingual glands: found in the floor of the mouth.

Causes of Dry Mouth

One of the main causes of dry mouth is medication. Countless medications list dry mouth as a side effect, including antidepressants, anti-diarrhea medications, muscle relaxants and high blood pressure medications. Symptoms of dry mouth occur while the patient is on the medication, but usually disappear once the medication is stopped.

Age also contributes to the development of dry mouth. As people get older, the salivary glands produce less saliva. Other causes of dry mouth include:

Sjogren's syndrome—a systemic immunologic disorder—and other systemic diseases including diabetes, Alzheimer's disease, and Parkinson's disease
tumors of the salivary gland—very rare, and most often benign
surgical removal of the salivary glands
chemotherapy and radiation therapy, which may damage salivary glands
nerve damage, which may decrease saliva production in the salivary glands
salivary stones, which may block the flow of saliva
infections of the salivary glands or a nearby lymph node.

Symptoms of Dry Mouth

The major symptom of xerostomia is, of course, a dry mouth. Other symptoms of dry mouth include:

difficulty eating and swallowing food, especially dry food
bad breath
increased occurrence of plaque, gum disease or tooth decay
difficulty speaking
a burning sensation on the tongue
dry, cracked lips at the corners of the mouth
increased thirst
impaired taste.

Diagnosing Dry Mouth

Diagnosing xerostomia is not difficult. The doctor or dentist usually makes the diagnosis by examining the patient's mouth and reviewing the patient's medical history. Blood tests and imaging tests of the salivary glands may be used to confirm a diagnosis.

Treating Dry Mouth

The treatment for dry mouth depends on the cause. If medication is known to be the cause of dry mouth, the doctor may recommend that the patient stop taking the medication, or prescribe a different medication that does not have dry mouth as a side effect. If the medication cannot be discontinued, the doctor may prescribe an additional medication to stimulate the production of saliva.

Oral stimulation such as chewing gum may also stimulate saliva production.

Dietary changes may be recommended. Drinks containing caffeine or alcohol tend to decrease saliva production due to their dehydrating properties. Drinking more water and juice may re-hydrate the body and increase the production of saliva.

Resources

American Academy of Otalaryngology—Head and Neck Surgery. (2002). Salivary glands.

Chahin, F. (updated 2004). Salivary gland tumors, major, benign.

Dr. Joseph F. Smith Medical Library. (nd). Dry mouth.

Jaworski, M. & Klippenstein, M. A. (nd). Dry mouth.

Mayo Foundation for Medical Education and Research. (updated 2005). Dry mouth.

National Library of Medicine. (updated 2003). Sjogren syndrome. MedlinePlus Medical Encyclopedia.

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