Dry mouth

The subjective feeling of a dry mouth (xerostomia) can arise as a result of loss of the mucous layer without clinical evidence of dryness. There is usually little relief with artificial saliva preparations or mucosal gel preparations in these patients.

Patients with dry mouth caused by drugs with antimuscarinic effects (tricyclic antidepressants, antipsychotics), diuretic drugs, irradiation of the head and neck region or by damage or disease of the salivary glands (e.g. Sjögren’s syndrome) may obtain symptomatic relief from artificial saliva preparations or other saliva-promoting medication. However, the effects tend to be of short duration. Where there is a considerable reduction in saliva production the use of lubricant gel preparations, applied to the oral mucosa, can give more-prolonged relief. Local measures can also be helpful. Topical fluoride should be prescribed for these patients and dietary advice provided.

Note that some proprietary artificial saliva or mucosal gel preparations may only be prescribed for patients with dry mouth that is associated with head and neck radiotherapy or autoimmune xerostomias such as sicca (primary Sjögren’s) syndrome. Saliva stimulating tablets may only be prescribed for patients with salivary gland impairment and patent (open) salivary ducts.