This section has been reviewed and approved by the PLWC Editorial
Dry mouth (xerostomia) occurs when the salivary
glands do not make enough saliva (spit) to keep the mouth moist. Because
saliva is needed for chewing, swallowing, tasting, and talking, these
activities may be more difficult with a dry mouth.
Dry mouth can be caused by chemotherapy or radiation treatment,
which damage the salivary glands. Dry mouth caused by chemotherapy
is usually temporary and normally clears up about two to eight weeks
after treatment ends.
Radiation treatment to the head, face, or neck can cause dry mouth and is
most common with radiation treatment to the oral cavity to treat head and
neck cancer. It can take six months or longer for the salivary glands to
start producing saliva again after the end of treatment. While some patients
do experience improvement in their dry mouth during the first year after
radiation treatment, many patients will continue to experience some level
of dry mouth indefinitely. This is especially true if the salivary glands
were irradiated directly.
Dry mouth and mouth sores (mucositis) can be
caused by graft-versus-host disease, when bone marrow or stem cells
attack the patient's own tissues as a result of a bone
marrow or stem cell transplantation. Certain types of medications,
including antidepressants, diuretics, and some painkillers, can also
cause dry mouth. Dry mouth can also be the result of a mouth infection
(such as a fungal infection) or dehydration.
Signs and symptoms
- Sticky, dry feeling in
- Thick, stringy saliva
- Pain or a burning sensation
in the mouth or on the tongue
- Cracks in the lips or at
the corners of the mouth
- A dry, tough tongue
- Difficulty chewing,
tasting, or swallowing
- Difficulty talking
- Difficulty wearing
- Mouth sores or mouth
- Tooth decay
Problems associated with dry mouth
In addition to difficulty with eating and talking, dry mouth can cause
dental problems. Saliva helps maintain a balance of bacteria in the mouth
and is protective against infections and cavities (dental decay). Without
enough saliva, the bacteria and other organisms in the mouth can grow too
quickly, causing infections and mouth sores. Saliva also washes away
acids and food particles left in the mouth after eating. Therefore, a
lack of saliva can cause cavities and gum disease.
Although dry mouth cannot be prevented, a couple of treatments can help.
Patients receiving radiation treatment to the head or neck may be
prescribed amifostine (Ethyol),
a radioprotectant medication that can reduce
the severity of dry mouth. In addition, an experimental treatment in
which a salivary gland is moved (transplanted) out of the field of
radiation is being tested in some patients. The following tips may help
with the management of dry mouth and the prevention of dental problems:
- Visit a dentist at least
two weeks before starting radiation treatment or chemotherapy to
check the health of the mouth and teeth.
- Brush the teeth at least
four times a day with a soft-bristle toothbrush and fluoride
toothpaste; soak the brush in warm water to make the bristles even
- Floss gently once a day.
- Rinse the mouth four to
six times a day, especially after meals, with a solution of salt and
baking soda (½ teaspoon of salt and ½ teaspoon of baking soda in 1
cup of warm water).
- Drink sips of water throughout
the day and use artificial saliva to moisten the mouth.
- Chew sugarless gum or
suck on sugarless candies to help increase saliva flow.
- Avoid mouthwashes and
other dental products that contain alcohol; products designed
especially for patients with dry mouth are available without a
- Use a cool mist
humidifier, especially at night.
- Some dentists may also
prescribe a fluoride gel to apply at bedtime, prescription
medication to increase saliva production, or rinses to fight
infections in the mouth.
Tips for eating with a dry mouth include the following:
- Drink at least eight
cups of water a day; consider carrying a bottle of water.
- Avoid alcohol, drinks
with caffeine (coffee, tea, cola), and acidic juices.
- Eat soft, moist foods that
are cool or at room temperature.
- Moisten dry foods with
broth, sauces, butter, or milk.
- Avoid dry, coarse, or
- Avoid acidic or spicy
foods that burn the mouth.
- Do not smoke or chew
- Avoid sticky, sugary
foods and drinks.