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{{DiseaseDisorder infobox |
#redirect [[xerostomia]]
  Name          = Xerostomia |
  ICD10          = {{ICD10|K|11|7|k|00}}, {{ICD10|R|68|2|r|50}} |
  ICD9          = {{ICD9|527.7}} |
  ICDO          = |
  Image          = |
  Caption        = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  DiseasesDB    = 17880 |
}}
{{Search infobox}}
{{CMG}}
 
'''Associate Editor-In-Chief:''' {{MUT}}
 
{{Editor Help}}
 
'''Xerostomia''' is the medical term for a '''dry mouth''' due to a lack of [[saliva]]. Xerostomia is sometimes colloquially called pasties or cottonmouth.
 
Xerostomia can cause difficulty in [[Speech communication|speech]] and [[eating]]. It also leads to [[halitosis]] and a dramatic rise in the number of [[Dental caries|cavities]], as the protective effect of saliva is no longer present, and can make the [[mucosa]] of the mouth more vulnerable to infection. Notably, a symptom of [[methamphetamine]] abuse usually called "[[meth mouth]]" is largely caused by xerostomia.
 
==Causes==
It may be a [[sign (medical)|sign]] of an underlying [[disease]], such as [[Sjögren's syndrome]], poorly controlled [[diabetes]], or [[Eaton-Lambert syndrome]], but this is not always so.
 
Other causes of insufficient saliva include [[anxiety]], [[medication]]s, or [[alcohol]], [[Physical trauma|trauma]] to the [[salivary gland]]s or their ducts or nerves, [[dehydration]], excessive mouth breathing, previous [[radiation]] therapy, and also a natural result of aging.  The vast majority of elderly individuals will suffer xerostomia to some degree. Playing or exercising a long time outside on a hot day will often cause your saliva glands to simply dry up as your bodily fluids are concentrated elsewhere. Drugs have also been known to cause this problem, such as [[Cannabis (drug)|cannabis]], and [[DXM]].
 
==Differential Diagnosis of the causes of Dry mouth==
{{MultiCol}}
*[[3-Quinuclidinyl benzilate]]
*[[Abciximab (patient information)]]
*[[Acamprosate (patient information)]]
*[[Acitretin (patient information)]]
*[[Actiq]]
*[[Adderall]]
*[[Ajulemic acid]]
*[[Albuterol (patient information)]]
*[[Alfentanil Hydrochloride Injection (patient information)]]
*[[Anticholinergic]]
*[[Anxiety]]
*[[Arsenic Poisoning]]
*[[Azelastine]]
*[[Benzatropine]]
*[[Benztropine Mesylate Oral (patient information)]]
*[[Benzydamine]]
*[[Benzylpiperazine]]
*[[Bepridil (patient information)]]
*[[Bevacizumab Injection (patient information)]]
*[[Biperiden]]
*[[Botulism]]
*[[Brompheniramine (patient information)]]
*[[Budesonide]]
*[[Buprenorphine]]
*[[Bupropion]]
*[[Buspirone (patient information)]]
*[[Butorphanol Injection (patient information)]]
*[[Calcitriol (patient information)]]
*[[Calcium carbonate (patient information)]]
*[[Carbamazepine (patient information)]]
*[[Cetuximab Injection (patient information)]]
*[[Cevimeline]]
*[[Chlordiazepoxide (patient information)]]
*[[Chloropyramine]]
*[[Chlorpheniramine (patient information)]]
*[[Chlorpromazine (patient information)]]
*[[Chlorprothixene]]
*[[Clomipramine (patient information)]]
*[[Clonazepam (patient information)]]
*[[Clonidine]]
*[[Clozapine]]
*[[Codeine]]
*[[Cyclobenzaprine (patient information)]]
*[[Cyproheptadine (patient information)]]
*[[Dehydration]]
*[[Dextroamphetamine]]
*[[Diazepam (patient information)]]
*[[Dicyclomine (patient information)]]
*[[Diethylpropion (patient information)]]
*[[Diltiazem (patient information)]]
*[[Dimenhydrinate]]
*[[Diphenhydramine]]
*[[Diphenoxylate and Atropine (patient information)]]
*[[Dosulepin hydrochloride]]
*[[Doxylamine (patient information)]]
*[[Duloxetine]]
*[[Erlotinib (patient information)]]
*[[Esomeprazole (patient information)]]
*[[Estazolam (patient information)]]
*Excessive mouth breathing
*[[Exenatide Injection (patient information)]]
*[[Fencamfamine]]
*[[Fexofenadine (patient information)]]
*[[Flavoxate (patient information)]]
*[[Fluacizine]]
*[[Flucytosine]]
*[[Fluphenazine (patient information)]]
*[[Fosamprenavir (patient information)]]
*[[Frovatriptan (patient information)]]
*[[Gabapentin (patient information)]]
*[[Galantamine (patient information)]]
*[[Ganciclovir (patient information)]]
*[[Gatifloxacin (patient information)]]
*[[Glimepiride (patient information)]]
*[[Glipizide (patient information)]]
*[[Glyburide (patient information)]]
*[[Glycopyrrolate (patient information)]]
*[[Guanabenz (patient information)]]
*[[Guanethidine (patient information)]]
*[[Guanfacine (patient information)]]
*[[Haloperidol Oral (patient information)]]
*[[Hexamethonium]]
*[[Hydroxyzine (patient information)]]
*[[Hyoscyamine (patient information)]]
*[[Hyperglycemia]]
*[[Hyperosmolar syndrome]]
*[[Imipramine (patient information)]]
*[[Insulin Aspart (rDNA Origin) Injection (patient information)]]
*[[Interferon beta-1a Subcutaneous Injection (patient information)]]
*[[Ipratropium Oral Inhalation (patient information)]]
*[[Isocarboxazid (patient information)]]
*[[Isoetharine Oral Inhalation (patient information)]]
*[[Isoproterenol Oral Inhalation (patient information)]]
*[[Isosorbide (patient information)]]
*[[Ketorolac]]
*[[Ketotifen]]
*[[Levalbuterol Oral Inhalation (patient information)]]
*[[Levodopa and Carbidopa (patient information)]]
*[[Levomepromazine]]
*[[Lithium (patient information)]]
*[[Lofepramine]]
*[[Loperamide]]
*[[Loratadine (patient information)]]
{{ColBreak}}
*[[Lorazepam (patient information)]]
*[[Loxapine Oral (patient information)]]
*[[Meperidine (patient information)]]
*[[Meropenem Injection (patient information)]]
*[[Mesalamine (patient information)]]
*[[Mesoridazine Oral (patient information)]]
*[[Metaproterenol (patient information)]]
*[[Metformin (patient information)]]
*[[Methylphenidate Transdermal (patient information)]]
*[[Metoprolol (patient information)]]
*[[Metronidazole Oral (patient information)]]
*[[Miglitol (patient information)]]
*[[Moclobemide]]
*[[Modafinil (patient information)]]
*[[Moxonidine]]
*[[Multiple chemical sensitivity]]
*[[Nabilone (patient information)]]
*[[Nabumetone (patient information)]]
*[[Nalbuphine injection (patient information)]]
*[[Nateglinide oral (patient information)]]
*[[Nefazodone (patient information)]]
*[[Nialamide]]
*[[Nicardipine (patient information)]]
*[[Nitroglycerin ointment (patient information)]]
*[[Nortriptyline (patient information)]]
*[[Olanzapine (patient information)]]
*[[Omeprazole (patient information)]]
*[[Orphenadrine (patient information)]]
*[[Oxaliplatin injection (patient information)]]
*[[Oxazepam (patient information)]]
*[[Oxcarbazepine (patient information)]]
*[[Peginterferon alfa-2a (patient information)]]
*[[Peginterferon alfa-2b (patient information)]]
*[[Penbutolol (patient information)]]
*[[Pergolide (patient information)]]
*[[Perphenazine oral (patient information)]]
*[[Phentermine (patient information)]]
*[[Pimozide (patient information)]]
*[[Pindolol (patient information)]]
*[[Pioglitazone (patient information)]]
*[[Pirbuterol acetate oral inhalation (patient information)]]
*[[Pizotifen]]
*[[Pramipexole (patient information)]]
*[[Prazepam (patient information)]]
*[[Pregabalin (patient information)]]
*[[Procarbazine (patient information)]]
*[[Procyclidine (patient information)]]
*[[Propafenone (patient information)]]
*[[Propantheline (patient information)]]
*[[Protriptyline (patient information)]]
*[[Quetiapine (patient information)]]
*[[Quinethazone]]
*[[Rabeprazole (patient information)]]
*[[Radiation therapy]]
*[[Ramsay Hunt syndrome type II]]
*[[Rasagiline (patient information)]]
*[[Reboxetine]]
*[[Repaglinide (patient information)]]
*[[Reserpine (patient information)]]
*[[Ribavirin (patient information)]]
*[[Rilmenidine]]
*[[Risedronate (patient information)]]
*[[Risperidone (patient information)]]
*[[Rizatriptan (patient information)]]
*[[Ropinirole (patient information)]]
*[[Rosiglitazone (patient information)]]
*[[Salmeterol oral inhalation (patient information)]]
*[[Scopolamine patch (patient information)]]
*[[Selegiline (patient information)]]
*[[Sibutramine (patient information)]]
*[[Solifenacin (patient information)]]
*[[Sorafenib (patient information)]]
*[[Spironolactone (patient information)]]
*[[Sulpiride]]
*[[Sunitinib (patient information)]]
*[[Temazepam (patient information)]]
*[[Thioridazine (patient information)]]
*[[Thiothixene Oral (patient information)]]
*[[Tolazamide (patient information)]]
*[[Tolbutamide (patient information)]]
*[[Tolterodine (patient information)]]
*[[Topiramate]]
*[[Tranylcypromine (patient information)]]
*[[Trazodone (patient information)]]
*[[Triamterene (patient information)]]
*[[Triazolam (patient information)]]
*[[Tricyclic antidepressant]]
*[[Trifluoperazine Oral (patient information)]]
*[[Trihexyphenidyl (patient information)]]
*[[Trimipramine (patient information)]]
*[[Tripelennamine]]
*[[Trospium (patient information)]]
*[[Vicodin]]
*[[Vinpocetine]]
*[[Zaleplon (patient information)]]
*[[Zenker's diverticulum]]
*[[Zimelidine]]
*[[Zoledronic Acid Injection (patient information)]]
*[[Zolmitriptan]]
*[[Zolpidem (patient information)]]
*[[Zonisamide (patient information)]]
*[[Zopiclone]]
*[[Zotepine]]
{{EndMultiCol}}
 
===Complete Differential Diagnosis of the Causes of Dry mouth===
(By organ system)
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"|
[[3-Quinuclidinyl benzilate]],
[[Arsenic Poisoning]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"|
[[Abciximab (patient information)]],
[[Acamprosate (patient information)]],
[[Acitretin (patient information)]],
[[Actiq]],
[[Adderall]],
[[Ajulemic acid]],
[[Albuterol (patient information)]],
[[Alfentanil Hydrochloride Injection (patient information)]],
[[Anticholinergic]],
[[Azelastine]],
[[Benzatropine]],
[[Benztropine Mesylate Oral (patient information)]],
[[Benzydamine]],
[[Benzylpiperazine]],
[[Bepridil (patient information)]],
[[Bevacizumab Injection (patient information)]],
[[Biperiden]],
[[Brompheniramine (patient information)]],
[[Budesonide]],
[[Buprenorphine]],
[[Bupropion]],
[[Buspirone (patient information)]],
[[Butorphanol Injection (patient information)]],
[[Calcitriol (patient information)]],
[[Calcium carbonate (patient information)]],
[[Carbamazepine (patient information)]],
[[Cetuximab Injection (patient information)]],
[[Cevimeline]],
[[Chlordiazepoxide (patient information)]],
[[Chloropyramine]],
[[Chlorpheniramine (patient information)]],
[[Chlorpromazine (patient information)]],
[[Chlorprothixene]],
[[Clomipramine (patient information)]],
[[Clonazepam (patient information)]],
[[Clonidine]],
[[Clozapine]],
[[Codeine]],
[[Cyclobenzaprine (patient information)]],
[[Cyproheptadine (patient information)]],
[[Dextroamphetamine]],
[[Diazepam (patient information)]],
[[Dicyclomine (patient information)]],
[[Diethylpropion (patient information)]],
[[Diltiazem (patient information)]],
[[Dimenhydrinate]],
[[Diphenhydramine]],
[[Diphenoxylate and Atropine (patient information)]],
[[Dosulepin hydrochloride]],
[[Doxylamine (patient information)]],
[[Duloxetine]],
[[Erlotinib (patient information)]],
[[Esomeprazole (patient information)]],
[[Estazolam (patient information)]],
[[Exenatide Injection (patient information)]],
[[Fencamfamine]],
[[Fexofenadine (patient information)]],
[[Flavoxate (patient information)]],
[[Fluacizine]],
[[Flucytosine]],
[[Fluphenazine (patient information)]],
[[Fosamprenavir (patient information)]],
[[Frovatriptan (patient information)]],
[[Gabapentin (patient information)]],
[[Galantamine (patient information)]],
[[Ganciclovir (patient information)]],
[[Gatifloxacin (patient information)]],
[[Glimepiride (patient information)]],
[[Glipizide (patient information)]],
[[Glyburide (patient information)]],
[[Glycopyrrolate (patient information)]],
[[Guanabenz (patient information)]],
[[Guanethidine (patient information)]],
[[Guanfacine (patient information)]],
[[Haloperidol Oral (patient information)]],
[[Hexamethonium]],
[[Hydroxyzine (patient information)]],
[[Hyoscyamine (patient information)]],
[[Imipramine (patient information)]],
[[Insulin Aspart (rDNA Origin) Injection (patient information)]],
[[Interferon beta-1a Subcutaneous Injection (patient information)]],
[[Ipratropium Oral Inhalation (patient information)]],
[[Isocarboxazid (patient information)]],
[[Isoetharine Oral Inhalation (patient information)]],
[[Isoproterenol Oral Inhalation (patient information)]],
[[Isosorbide (patient information)]],
[[Ketorolac]],
[[Ketotifen]],
[[Levalbuterol Oral Inhalation (patient information)]],
[[Levodopa and Carbidopa (patient information)]],
[[Levomepromazine]],
[[Lithium (patient information)]],
[[Lofepramine]],
[[Loperamide]],
[[Lopinavir and Ritonavir (patient information)]],
[[Loratadine (patient information)]],
[[Lorazepam (patient information)]],
[[Loxapine Oral (patient information)]],
[[Meperidine (patient information)]],
[[Meropenem Injection (patient information)]],
[[Mesalamine (patient information)]],
[[Mesoridazine Oral (patient information)]],
[[Metaproterenol (patient information)]],
[[Metformin (patient information)]],
[[Methylphenidate Transdermal (patient information)]],
[[Metoprolol (patient information)]],
[[Metronidazole Oral (patient information)]],
[[Miglitol (patient information)]],
[[Moclobemide]],
[[Modafinil (patient information)]],
[[Moxonidine]],
[[Nabilone (patient information)]],
[[Nabumetone (patient information)]],
[[Nalbuphine injection (patient information)]],
[[Nateglinide oral (patient information)]],
[[Nefazodone (patient information)]],
[[Nialamide]],
[[Nicardipine (patient information)]],
[[Nitroglycerin ointment (patient information)]],
[[Nortriptyline (patient information)]],
[[Olanzapine (patient information)]],
[[Omeprazole (patient information)]],
[[Orphenadrine (patient information)]],
[[Oxaliplatin injection (patient information)]],
[[Oxazepam (patient information)]],
[[Oxcarbazepine (patient information)]],
[[Peginterferon alfa-2a (patient information)]],
[[Peginterferon alfa-2b (patient information)]],
[[Penbutolol (patient information)]],
[[Pergolide (patient information)]],
[[Perphenazine oral (patient information)]],
[[Phentermine (patient information)]],
[[Pimozide (patient information)]],
[[Pindolol (patient information)]],
[[Pioglitazone (patient information)]],
[[Pirbuterol acetate oral inhalation (patient information)]],
[[Pizotifen]],
[[Pramipexole (patient information)]],
[[Prazepam (patient information)]],
[[Pregabalin (patient information)]],
[[Procarbazine (patient information)]],
[[Procyclidine (patient information)]],
[[Propafenone (patient information)]],
[[Propantheline (patient information)]],
[[Protriptyline (patient information)]],
[[Quetiapine (patient information)]],
[[Quinethazone]],
[[Rabeprazole (patient information)]],
[[Rasagiline (patient information)]],
[[Reboxetine]],
[[Repaglinide (patient information)]],
[[Reserpine (patient information)]],
[[Ribavirin (patient information)]],
[[Rilmenidine]],
[[Risedronate (patient information)]],
[[Risperidone (patient information)]],
[[Rizatriptan (patient information)]],
[[Ropinirole (patient information)]],
[[Rosiglitazone (patient information)]],
[[Salmeterol oral inhalation (patient information)]],
[[Scopolamine patch (patient information)]],
[[Selegiline (patient information)]],
[[Sibutramine (patient information)]],
[[Solifenacin (patient information)]],
[[Sorafenib (patient information)]],
[[Spironolactone (patient information)]],
[[Sulpiride]],
[[Sunitinib (patient information)]],
[[Temazepam (patient information)]],
[[Thioridazine (patient information)]],
[[Thiothixene Oral (patient information)]],
[[Tolazamide (patient information)]],
[[Tolbutamide (patient information)]],
[[Tolterodine (patient information)]],
[[Topiramate]],
[[Tranylcypromine (patient information)]],
[[Trazodone (patient information)]],
[[Triamterene (patient information)]],
[[Triazolam (patient information)]],
[[Tricyclic antidepressant]],
[[Trifluoperazine Oral (patient information)]],
[[Trihexyphenidyl (patient information)]],
[[Trimipramine (patient information)]],
[[Tripelennamine]],
[[Trospium (patient information)]],
[[Vicodin]],
[[Vinpocetine]],
[[Zaleplon (patient information)]],
[[Zimelidine]],
[[Zoledronic Acid Injection (patient information)]],
[[Zolmitriptan]],
[[Zolpidem (patient information)]],
[[Zonisamide (patient information)]],
[[Zopiclone]],
[[Zotepine]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"|
Excessive mouth breathing,
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"|
[[Multiple chemical sensitivity]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|
[[Zenker's diverticulum]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"|
[[Radiation therapy]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|
[[Botulism]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"|
[[Ramsay Hunt syndrome type II]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"|
[[Hyperglycemia]],
 
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"|
[[Anxiety]],
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"|
[[Trauma]] to the [[salivary glands]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"|
[[Dehydration]],
[[Hyperosmolar syndrome]],
 
|-
|}
 
 
==Treatment==
 
Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients who have endured chemotherapy usually suffer from this post- treatment.
 
Patients with xerostomia should avoid the use of [[decongestant]]s and [[antihistamine]]s, and pay careful attention to [[oral hygiene]]. Sipping [[sugar]]less fluids frequently, chewing [[xylitol]]-containing gum<ref>Jensen JL, Langberg CW (1997): Temporary hyposalivation induced by radiation therapy in a child. Tidsskr Nor Loegeforen 21:3077-9</ref>, and using a [[carboxymethyl cellulose]] saliva substitute as a [[mouthwash]] may help. Aquoral may be prescribed to treat xerostomia. Non-systemic relief can be found using an oxidized glycerol triesters treatment used to coat the mouth.
 
==References==
<references/>
 
==External links==
*[http://www.oralcancerfoundation.org/dental/xerostomia.htm Oral Cancer Foundation]
*[http://www.uic.edu/classes/peri/peri343/xerost/xerost1.htm University of Illinois at Chicago]
*[http://www.nidcr.nih.gov/HealthInformation/DiseasesAndConditions/DryMouthXerostomia/DryMouth.htm NIH]
*[http://www.sjogrens.org/syndrome/dry_mouth.html Sjögren's Syndrome Foundation page on Dry Mouth]
 
 
{{Symptoms and signs}}
{{SIB}}
[[Category:Medical terms]]
[[Category:Symptoms]]
 
[[da:Xerostomi]]
[[de:Mundtrockenheit]]
[[es:Xerostomía]]
[[fr:Xérostomie]]
[[nl:Xerostomie]]
[[pt:Xerostomia]]
[[fi:Kserostomia]]
[[sv:Muntorrhet]]
 
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Latest revision as of 13:29, 27 October 2016

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