Xerostomia is the medical term for a dry mouth, and is most commonly due to hyposalivation.
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Epidemiology
Xerostomia is the most frequently observed salivary abnormality in clinical practice 1.
Clinical presentation
dryness of the mouth
uncomfortable swallowing
vocalisation difficulties: tongue may adhere to the palate impairing speech
taste disturbances: ageusia and dysgeusia
Complications
A chronic lack of saliva can result in several sequelae, with potentially serious morbidity:
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infections
cheilitis
oral candidiasis
Pathology
Etiology
Most people experience a dry mouth from time to time, whether related to 'nerves' or because they are mildly dehydrated.
Physiological
anxiety
"mouth-breathers"
old age: reduced saliva production
Iatrogenic
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medication
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anticholinergic activity
anticholinergics: atropine, hyoscine
proton pump inhibitors (PPIs), e.g. omeprazole
antidepressants, e.g. tricyclics, SSRIs
benzodiazepines, e.g. diazepam
opioids
antihistamines
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agents affecting sympathetic system
sympathomimetic agents: e.g. ephedrine
antihypertensives
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agents promoting fluid depletion
diuretics
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radiotherapy: including radioiodine for thyroid disease
Disease states
thirst due to volume depletion: commonest cause
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salivary gland pathology
agenesis/hypoplasia of the salivary glands: rare 1
psychosomatic: no objective evidence of salivary dysfunction
Treatment and prognosis
treat underlying cause e.g. Sjögren syndrome
artificial saliva
optimal oral hygiene
sialogogues
History and etymology
Xerostomia is derived from the Classical Greek, ζηρος (xeros) meaning dry, and στομα (stoma) meaning mouth 2,3.