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Dry Mouth |
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Dry Mouth, the absence or decrease of saliva, is caused by medications, disease or injury that affect the salivary glands. Dry Mouth is professionally referred to as xerostomia. Although there are many causes of dry mouth, the most common ones are prescription and non-prescription drugs and medications, accounting for about 40% of the cases of dry mouth. Hundreds of products can cause or contribute to this oral condition.
The most common classifications of medications that cause Dry Mouth are: anti-anxiety drugs, anti-depressants, diuretics, anti-hypertensives (blood pressure medicines), decongestants, antihistamines, bronchodilators, anti-inflamatory/analgesics, anti-nauseants, anti-parkinsonian drugs, anti-convulsants, muscle relaxants, and sedatives.
Table I (see below) lists some categories and names of some of the more common drugs and medications that can cause Dry Mouth. It is always helpful to know the brand and generic names of medications that you may take. Your physician, dentist, pharmacist or health care provider should be consulted to help identify medications or drugs that can cause Dry Moth. There are many prescribed and over the counter drugs and medications that cause dry mouth.
Table I Categories of Drugs and Medications that Can Cause Dry Mouth*
* Anti-anxiety (medications used to treat anxiety or stress)
Brand Generic
Ativan Lorazepam
Centrax Prazepam
Librium Chlordiazepoxide
Valium Diazepam
Xanax Alprazolam
* Antidepressants (medications used to treat depression)
Brand Generic
Celexa Citalopram
Effexor Venlafaxine
Elavil Amitriptyline
Marplan Isocarboxazid
Paxil Paroxetine
Prozac Fluoxetine
Serzone Nefazodone
Tofranil Imipramine
Wellbutrin Bupropion
Zoloft Sertraline
* Diuretic (cause an increase in urination)
Brand Generic
Aldactone Spirnolactone
Diamox Acetazolamide
Dyazide Triamterene
Esidrix Hydrochlorothiazide
Hygroton Chlorthalidone
Lasix Furosemide
* Anti-hypertensive (blood pressure medications)
Brand Generic
Accupril Quinapril
Betapace Sotalol
Capoten Captopril
Coreg Carvedilol
Corgard Nadolol
Flomax Tamsulosin
Hytrin Tarazosin
Inderal Propanolol
Lopressor Metoprolol
Minipress Prazosin
Norvasc Amlodipine
Tenormin Atenolol
Vasotec Enalapril
* Decongestants
Brand Generic
Sudafed Pseudoephedrine
* Antihistamines (allergy pills)
Brand Generic
Allegra Fexofenadine
Astelin Azelastine
Benadryl Diphenhydramine
Chlor-Trimeton Chlorpheniramine
Claritin Loratadine
Hismanal Astemizole
Tavist Clemastine
Vistaril Hydroxyzine
* Anti-diarrheal
Brand Generic
Lomotil Diphenoxylate with atropine
Immodium AD Loperamide
* Bronchodilators (medications that assist breathing)
Brand Generic
Atrovent Ipratropium
Proventil Albuterol
Ventolin Albuterol
* Anti-inflammatory/Analgesic
Brand Generic
Motrin Ibuprofen
Naprosyn Naproxen
* Anti-nauseant
Brand Generic
Antivert Meclizine
Dramamine Dyphenhydramine
* Anti-Parkinsonian
Brand Generic
Akineton Biperiden
Permax Pergolide
Tasmar Tolcapone
* Anti-convulsant
Brand Generic
Neurontin Gabapentin
Tegretol Carbamazepine
* Muscle relaxants
Brand Generic
Flexeril Cyclobenzaprine
Lioresal Baclofen
* Sedatives
Brand Generic
Dalmane Flurazepam
Halcion Triazolam
* Laclede, Inc.
In addition to drugs and medications, autoimmune and systemic diseases or conditions such as the following can also contribute to a decrease in salivary flow:
1. Sjogrens Syndrome-This autoimmune disease affects salivary glands and lacrimal glands. The patient experiences dry mouth and dry eyes. Sometimes this condition is associated with other conditions such as Rheumatoid Arthritis or Systemic Lupus.
2. Diabetes- In patients with diabetes, the salivary glands can become underactive and there can be swelling of the Parotid glands in particular. These patients may also experience Dry Mouth.
3. Parkinson’s Disease-This chronic nervous condition is characterized by tremors, muscular weakness and rigidity. The medications taken to treat this condition can cause Dry Mouth because the salivary flow is decreased.
4. Cancer Patients/Chemotherapy and Radiation Therapy-These patients are more prone to infection since they have a suppressed immune system. Chemotherapy and radiation treatment to the head and neck clearly cause a decrease in salivary flow. Cancer patients may also experience inflammation of the soft oral tissues (mucositis), a yeast infection (candidiasis), episodes of oral ulceration and an increase in dental caries, especially at the gum line (gingival margin) of teeth.
Additionally, patients with HIV and AIDS, asthma, stroke, thyroid dysfunction, renal failure and kidney dialysis, nerve damage to head or neck, multiple sclerosis and myasthenia gravis all may exhibit Dry Mouth due to their medical condition or the medications that they take to treat the condition.
Oral symptoms of patients with Dry Mouth can include those listed in Table II.
Table II Oral Symptoms of Dry Mouth
* Dryness throughout the mouth (including lips, cheeks, tongue, surfaces under the tongue and throat)
* Bad breath
* Desire for constant moisture
* Need for fluids during the night
* Mouth breathing
* Candidiasis (yeast infection) especially on the tongue and palate
* Gingivitis (inflammation of the gums) or bleeding gums
* Increase in dental decay (caries)
* Ulcerations (mouth sores)
* Bacterial infection
* Cracked lips (especially in the corners of the lips)
* Speech problems
* Changes in taste and sensation
* Burning mouth/tongue
* Difficulty eating, chewing and swallowing
* Difficulty taking medications (especially swallowing pills)
* Difficulty wearing dentures
Note: Dehydration and tobacco use contribute to Dry Mouth.
It is very important to provide your dentist and dental hygienist with a thorough medical/health history. Medications and medical conditions can clearly impact on dental care and treatment. These health professionals are also able to recommend products for reducing the symptoms of Dry Mouth.
Some useful products include sodium laurel sulfate free toothpastes, alcohol-free mouth rinses, oral moisturizers and fluorides. They are listed in Table III.
Table III.
Toothpastes without Sodium Laurel Sulfate Company
* Biotene Dry Mouth Toothpaste…Laclede, Inc.
* Closys II Toothpaste…Rowpar Pharmeceuticals, Inc.
* Rembrandt Extra Whitening Toothpaste Sensitive Teeth…The Gillette Company
* Controlrx…Omnii Oral Pharmaceuticals
Alcohol-Free Mouth Rinses Company
* Biotene Alcohol Free Mouthwash…Laclede, Inc.
* Crest Pro-Health Rinse…Procter and Gamble, Cincinnati, Ohio
* Oxyfresh Unflavored Mouth Rinse…Oxyfresh Worldwide, Inc.
* Natural Oral Moisturizing Mouthwash…Tom’s of Maine
Oral Moisturizers and Saliva Substitutes Company
* Omnii Oral Care Products with Xylitol (TheraSpray) …Omnii Oral Pharmaceuticals
* Oralbalance Mouth Moisturizing Gel…Laclede, Inc.
* Salivart Oral Moisturizer…Gebauer Co.
Fluoride Products Company
· Colgate PreviDent 5000 Booster…Colgate Oral Pharmaceuticals, Inc.
· Colgate PreviDent 5000 Plus…Colgate Oral Pharmaceuticals, Inc.
· Colgate Prevident Gel…Colgate Oral Pharmaceuticals, Inc.
· Fluoridex Daily Defense…Discus Dental
Dry Mouth is a condition frequently encountered in the dental office. Dental professionals can recommend products that decrease symptoms and discomfort to enhance the patient’s quality of life. Research is ongoing in the development of drugs to treat Dry Mouth.
Olga A. C. Ibsen is an Adjunct Professor at the University of New Haven in West Haven, Connecticut. Formerly an Adjunct Professor at New York University College of Dentistry in the Department of Oral Pathology, Olga has made significant contributions to the Dental Hygiene Profession as an educator, clinician, author and editor. She has been a part of the clinical practice of Dental Hygiene for over thirty years. Olga has co-authored the text “Oral Pathology for the Dental Hygienist” published by WB Saunders. She is a Consultant Member of the North East Regional Board of Dental Examiners and a member of The Dental Hygiene Subcommittee on Examinations. Additionally, she serves on the editorial advisory boards for “Dimensions of Dental Hygiene” and “The Journal of Practical Hygiene.”
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Issue Five 
