Treatment Overview
Living with dry mouth, or xerostomia, involves more than just a fleeting feeling of thirst. For many, it is a persistent, uncomfortable condition where the mouth feels sticky, swallowing becomes difficult, and simply speaking can feel like a challenge. Waking up in the middle of the night with a tongue that feels like sandpaper or struggling to chew dry foods can significantly impact daily quality of life. Beyond discomfort, saliva is essential for neutralizing acids and washing away bacteria. Therefore, treating dry mouth is critical not only for comfort but also for preventing severe tooth decay, gum disease, and oral infections.
Because dry mouth is often a side effect of other medications, autoimmune disorders like Sjögren’s syndrome, or radiation therapy, treatment strategies vary widely. What works for a person with mild dehydration will differ from someone with permanent salivary gland damage. Successful management often requires a tailored approach based on the underlying cause and the remaining function of the salivary glands (National Institute of Dental and Craniofacial Research, 2023).
Overview of treatment options for Dry Mouth
The primary goals of treating dry mouth are to increase moisture in the oral cavity and protect the teeth from rapid decay. Treatment plans generally fall into three categories: managing the underlying cause (such as adjusting medications that cause dryness), replacing lost secretions with substitutes, and stimulating the body to produce more natural saliva.
For acute cases, simple lifestyle changes or over-the-counter remedies may suffice. However, for chronic or severe cases where salivary glands are damaged or underactive, prescription medications are often necessary. In addition to moisture management, preventing dental complications is a major component of care, often involving prescription-strength dental products alongside oral medications.
Medications used for Dry Mouth
Doctors use specific medications to either mimic natural saliva or chemically stimulate the glands to work harder.
Saliva Stimulants: Also known as sialogogues, these are the primary prescription drugs used to treat severe dry mouth, particularly in patients with Sjögren’s syndrome or those who have undergone radiation therapy for head and neck cancer. Drugs such as pilocarpine and cevimeline are systemic medications taken orally. Clinical experience suggests that these medications can significantly increase salivary flow if there is still functional glandular tissue remaining. Patients typically notice an improvement in moisture levels within a specific window after dosing, though it may take several weeks of consistent use to see the full benefit.
Artificial Saliva and Lubricants: While often available over the counter, doctors may prescribe specific formulations for severe cases. These products come as sprays, gels, or lozenges containing substances like carboxymethylcellulose or hydroxyethyl cellulose. They do not cure the condition but provide immediate, temporary relief by coating the mucous membranes.
Prescription Fluoride Treatments: Chronic dry mouth increases cavity risk because saliva defends against decay. Dentists commonly prescribe high-concentration fluoride products to harden enamel and prevent rapid deterioration, although these don’t treat the dryness itself.
How these medications work
The mechanisms of action for dry mouth treatments focus either on the nervous system or on physical lubrication.
Saliva Stimulants: Drugs like pilocarpine and cevimeline are muscarinic receptor agonists. They act as an “on” switch for exocrine glands, chemically signaling salivary glands to secrete fluid, mimicking natural signals.
Artificial Saliva: These preparations physically mimic natural saliva’s viscosity and electrolyte balance. They create a protective, lubricating film over the mouth and throat, easing swallowing and speaking.
Side effects and safety considerations
Treatments for dry mouth are generally safe, but systemic stimulants can have broader effects on the body.
Saliva Stimulants: Common side effects include excessive sweating, nausea, runny nose, frequent urination, and dizziness, due to widespread glandular stimulation. Use with caution in patients with uncontrolled asthma, glaucoma, or cardiovascular disease, as these drugs can affect heart rate and airway constriction.
Artificial Saliva: These are generally safe from systemic side effects as they are not absorbed. Patients may occasionally dislike the taste or texture.
Monitor for oral fungal infections (thrush), common with dry mouth. Seek immediate medical attention for difficulty breathing, severe abdominal pain, or vision changes while on stimulants. Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.
References
- National Institute of Dental and Craniofacial Research. https://www.nidcr.nih.gov
- Mayo Clinic. https://www.mayoclinic.org
- American Dental Association. https://www.ada.org
- Sjögren’s Foundation. https://www.sjogrens.org
Medications for Dry Mouth
These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Dry Mouth.