A dry mouth typically occurs due to decreased or malfunctioning in the production of saliva. It can occur at any age, but is most common in older women.

Dry mouth, which is also referred to as xerostomia, can occur for many reasons. Treatment is generally aimed at increasing saliva production through simple measures or through prescription medication.

Dry mouth when waking up may be a sign of mild dehydration, and therefore you should increase your water intake. If this symptom persists, however, you should see a doctor for assessment.

What causes a dry mouth?

The most common causes of a dry mouth include:

1. Nutritional deficiencies

A lack of vitamin A or B-complex vitamins can dry the mucous membranes in the mouth, leading to wounds in the mouth and on the tongue.

B-complex vitamins and vitamin A can be found in foods like fish, meat and eggs. Learn more about vitamin B12 deficiency and the symptoms associated with it.

What to do: You should consult a registered dietitian to assess the type of nutritional deficiency and advise how to replace these nutrients through supplements and diet. He or she can provide you with specific foods and quantitiies in order to address the deficiency to relieve this symptom.

2. Autoimmune disease

Autoimmune diseases are caused by the production of antibodies that attack the person’s own body, leading to widespread inflammation. Some antibodies may affect specific glands in the body, like the salivary glands, which can lead to decreased saliva production and dry mouth.

Some autoimmune disease that can cause dry mouth are systemic lupus erythematosus and Sjögren syndrome, which can also cause the sensation of sand in your eyes. These conditions are associated with a higher risk of infections like cavities and conjunctivitis.

What to do: Treatment should be guided by a rheumatologist, who may prescribe the use of artificial saliva to treat dry mouth, or other specific interventions for the autoimmune disease to be treated.

3. Medications

Some medications can cause dry mouth, like antidepressants, diuretics, antipsychotics, antihypertensives and cancer medication.

Certain treatments, like radiation therapy for cancer, can lead to dry mouth as a side effect. This can especially happen when radiation is applied to the head or neck, which can also cause wounds on the gums, depending on the radiation dose.

What to do: You should consult the prescribing doctor so that side effects can be assessed. If necessary, the doctor can reassess any dose changes necessary or alternative medications.

4. Thyroid problems

Hashimoto’s disease is characterized by the production of antibodies that attack the thyroid and cause inflammation. This leads to a hyperthyroid state, which is then followed by hypothyroidism, The signs and symptoms of a thyroid problem can emerge gradually and include dry mouth.

Read more about other symptoms of thyroid problems.

What to do: Treatment should be guided by an endocrinologist who may recommend hormone replacement therapy with levothyroxine. In some cases, surgery to remove the thyroid may also be necessary.

5. Hormonal changes

Hormonal changes, especially during menopause and pregnancy, can cause a series of imbalances that can affect saliva production and lead to dry mouth.

Dry mouth during pregnancy can occur due to inadequate fluid intake, as intake should increase during this time. Sufficient daily water is important for placenta formation and amniotic fluid. Therefore, if you were already drinking about 2 L of water per day, you should aim to increase your water intake to 3 L per day.

What to do: it is important to keep the body hydrated. You should drink at least 2 liters of water per day, in small sips to keep the oral mucosa moist. Women with menopause may be treated with hormone replacement therapy.

6. Respiratory problems

Some respiratory problems, like a deviated septum or an airway obstruction, can force you to breathe through your mouth. After many years of this type of breathing, it is possible to experience changes to facial anatomy and a higher risk for infections (because the nose is no longer filtering inhaled air). The constant entry and exit of air through the mouth can lead to dry mouth and bad breath.

What to do: You should consult an otorhinolaryngologist to diagnose any respiratory diseases and being the most appropriate treatment. A deviated septum, for example, can be corrected with surgery, while any obstructions should be carefully assessed and managed.

7. Lifestyle habits

Lifestyle habits, like smoking, eating sugary food or not drinking enough water can lead to dry mouth and bad breath. These habits can also cause more serious diseases, like emphysema in smokers, or diabetes in people who consume sugary foods.

A dry mouth in the context of diabetes is very common, and can be a result of polyuria (frequent urination). You can prevent dry mouth in this case by increasing you water intake, however the doctor may need to evaluate your medications and treatment, depending on the severity of this side effect.

What to do: You should increase your water intake, avoid smoking and avoid consuming sugary foods. Diabetics should follow treatment as advised by their endocrinologist, which may involve diabetes medication like oral pills and insulin.

How to treat dry mouth

One of the best way to treat dry mouth is to drink plenty of water throughout the day. You can also stimulate saliva secretion by:

Sucking on hard candy or chewing sugar-free gum
Eating more acidic or citric foods
Applying fluoride at the dentist
Brushing you teeth, using dental floss and using a mouthwash at least twice per day
Drinking ginger tea

Artificial saliva can also help to combat symptoms of dry mouth and help with chewing. The doctor can additionally prescribe medications like sorbitol or policarpine.

Another important consideration is to avoid licking your lips, as this can dry out your lips and mouth. You should instead hydrate your lips by using a moisturizer, a hydrating chapstick, or coconut butter.

Signs and symptoms of dry mouth

Having a dry mouth can occur with other symptoms, like dried and cracked lips and difficulties speaking, chewing, tasting and swallowing. People with persistent dry mouth have a higher probability of getting cavities and generally have foul breath. They may also experience headaches and an increased risk for oral infections, mostly caused by Candida Albicans.

You should see your family doctor if you experience dry mouth. He or she may refer you to an endocrinologist or gastroenterologist, depending on the underlying cause.