Xerostomia

Last revised by Rohit Sharma on 11 Jun 2019

Xerostomia is the medical term for a dry mouth, and is most commonly due to hyposalivation.

Xerostomia is the most frequently observed salivary abnormality in clinical practice 1.

  • dryness of the mouth
  • uncomfortable swallowing
  • vocalisation difficulties: tongue may adhere to the palate impairing speech
  • taste disturbances: ageusia and dysgeusia
  • fetor oris

A chronic lack of saliva can result in several sequelae, with potentially serious morbidity:

Most people experience a dry mouth from time to time, whether related to 'nerves' or because they are mildly dehydrated. 

  • anxiety
  • "mouth-breathers"
  • old age: reduced saliva production
  • medication
    • anticholinergic activity
      • anticholinergics: atropine, hyoscine
      • proton pump inhibitors (PPIs), e.g. omeprazole
      • antidepressants, e.g. tricyclics, SSRIs
      • benzodiazepines, e.g. diazepam
      • opioids
      • antihistamines
    • agents affecting sympathetic system
      • sympathomimetic ​agents: e.g. ephedrine
      • antihypertensives 
    • agents promoting fluid depletion
      • diuretics
  • radiotherapy: including radioiodine for thyroid disease
  • graft-versus-host disease
  • treat underlying cause e.g. Sjögren syndrome
  • artificial saliva
  • optimal oral hygiene
  • sialogogues

Xerostomia is derived from the Classical Greek, ζηρος (xeros) meaning dry, and στομα (stoma) meaning mouth 2,3.

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