Dry Mouth: Causes and Relief

What dry mouth feels like

Saliva moistens food, starts digestion, washes away bacteria, neutralizes acid and protects tooth enamel. When there is too little, you may notice:

• a sticky, dry or rough feeling in the mouth and throat
• thick, stringy saliva
• difficulty chewing, swallowing or talking
• a changed sense of taste
• a burning tongue or a red, cracked tongue
• cracked lips and sore corners of the mouth
• bad breath
• dentures that rub or will not stay in

Common causes of dry mouth

Medicines

Medicines are the most common cause of persistent dry mouth, especially when several are taken together. Frequent culprits:

• antidepressants (tricyclics, SSRIs, SNRIs)
• antihistamines and decongestants
• blood pressure medicines, especially diuretics and beta-blockers
• bladder medicines for overactive bladder (oxybutynin, tolterodine)
• antipsychotics, anti-anxiety medicines and sleeping pills
• opioid pain relievers and muscle relaxants
• ADHD stimulants
• some inhalers for asthma and COPD

Do not stop a prescribed medicine on your own. Ask your doctor or pharmacist whether a different medicine, dose or timing is possible.

Dehydration

Not drinking enough, hot weather, exercise, fever, vomiting, diarrhea and alcohol all reduce saliva. Dehydration usually comes with thirst, dark urine and tiredness, and settles quickly with fluids.

Mouth breathing and snoring

A blocked nose, allergies, a deviated septum or sleeping with the mouth open dries the mouth, especially overnight. Waking with a very dry mouth is covered in more detail on mouth dryness.

Lifestyle

Smoking, vaping, cannabis, alcohol, caffeine and breathing dry indoor air in winter all contribute. Anxiety reduces saliva through the stress response.

Aging

Saliva production itself changes little with age, but older adults take more medicines and have more chronic illnesses, so dry mouth is common after 65.

Medical conditions that cause dry mouth

Dry mouth with hair loss, poor appetite and weight loss

This combination deserves a doctor's visit. It can be caused by uncontrolled diabetes, thyroid disease, Sjogren's syndrome and other autoimmune diseases, depression (and the medicines used to treat it), nutritional deficiencies, or cancer and its treatment. Blood tests are usually the first step.

How dry mouth is checked

Your doctor or dentist will look at your mouth and teeth, check the salivary glands, review your medicines, and ask about dry eyes, thirst and urination. Tests may include blood sugar and HbA1c, a full blood count, and autoantibody tests for Sjogren's syndrome. Saliva flow can be measured directly. For the medical side of chronic dryness, see xerostomia.

Dry mouth relief: what helps

Quick relief

• Sip water throughout the day and keep a bottle by your bed.
• Chew sugar-free gum or suck sugar-free lozenges, ideally with xylitol. Chewing stimulates saliva.
• Saliva substitutes: over-the-counter sprays, gels and rinses moisten and coat the mouth. Gels work well at night.
• Use a humidifier in the bedroom.
• Breathe through your nose, and treat nasal congestion or allergies.

Things to avoid

• Alcohol-based mouthwashes
• Caffeine, alcohol, tobacco and cannabis
• Sugary or acidic drinks and sweets, which rot teeth quickly when saliva is low
• Very salty, spicy or dry foods. Soften food with sauces and gravies.

Protect your teeth and mouth

• Brush twice a day with fluoride toothpaste and floss daily.
• Ask your dentist about high-fluoride toothpaste or fluoride varnish.
• See your dentist every 3 to 6 months while dryness persists.
• Use lip balm for cracked lips.

Medical treatments

For persistent dry mouth from Sjogren's syndrome or radiation, doctors may prescribe saliva-stimulating medicines such as pilocarpine or cevimeline, if some gland function remains.

Frequently asked questions

What is the main cause of dry mouth?

Medicines are the most common cause of persistent dry mouth, especially antidepressants, antihistamines, blood pressure pills and bladder medicines. Dehydration and mouth breathing are the most common short-term causes. Diabetes and Sjogren's syndrome are important medical causes.

How can I get rid of dry mouth fast?

Sip water, chew sugar-free gum or suck a sugar-free lozenge to stimulate saliva, and use an over-the-counter saliva substitute spray or gel. Avoid caffeine, alcohol and alcohol-based mouthwash. If dryness lasts more than a few weeks, look for the cause with your doctor.

Is dry mouth a sign of diabetes?

It can be. High blood sugar causes increased urination and dehydration, which leads to dry mouth and thirst. If you also urinate often, feel very thirsty, are tired or are losing weight, ask your doctor for a blood sugar test.

Can anxiety cause dry mouth?

Yes. The body's stress response reduces saliva, so dry mouth is common during anxiety, panic attacks or before public speaking. Anxiety medicines can also cause it. Mouth breathing during anxious, rapid breathing adds to the dryness.

Why does dry mouth cause bad breath and cavities?

Saliva washes away food and bacteria and neutralizes acid. Without enough saliva, bacteria multiply, causing bad breath, gum disease and fungal infections such as thrush. Acid attacks teeth for longer, so cavities develop quickly, often along the gumline.