Dry mouth

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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 and eating. It also leads to halitosis and a dramatic rise in the number of 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 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, medications, or alcohol, trauma to the salivary glands 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, and DXM.

Differential Diagnosis of the causes of Dry mouth

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 Diabetes 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 Eaton-Lambert syndrome 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)

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) Sjogren's syndrome 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

Complete Differential Diagnosis of the Causes of Dry mouth

(By organ system)

Cardiovascular	No underlying causes
Chemical / poisoning	3-Quinuclidinyl benzilate, Arsenic Poisoning,
Dermatologic	No underlying causes
Drug Side Effect	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,
Ear Nose Throat	Excessive mouth breathing,
Endocrine	Diabetes,
Environmental	Multiple chemical sensitivity,
Gastroenterologic	Zenker's diverticulum,
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	Radiation therapy,
Infectious Disease	Botulism,
Musculoskeletal / Ortho	No underlying causes
Neurologic	Ramsay Hunt syndrome type II,
Nutritional / Metabolic	Hyperglycemia,
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	Albuterol (patient information), Galantamine (patient information), Methylphenidate Transdermal (patient information), Omeprazole (patient information),
Psychiatric	Anxiety,
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	Sjogren's syndrome Eaton-Lambert syndrome
Sexual	No underlying causes
Trauma	Trauma to the salivary glands
Urologic	No underlying causes
Miscellaneous	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 decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping sugarless fluids frequently, chewing xylitol-containing gum, 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.

External links

• Oral Cancer Foundation
• University of Illinois at Chicago
• NIH
• Sjögren's Syndrome Foundation page on Dry Mouth

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