Why is my mouth so dry? | Dr. Rich

Most of us have experienced the uncomfortable feeling of "cotton mouth" when we were really nervous, usually when having to speak in public. It's not a comfortable feeling, and for most of us, is easily solved by drinking a glass of water.

How would you like to have a dry mouth all the time? For many people, that is what they have to deal with on a daily basis. The technical term is xerostomia.

Whatever it's called, it is uncomfortable, and can result in an incredible amount of tooth decay in a short period of time. Saliva has a great protective effect, and buffers the acids in your mouth. It also lubricates the food you eat, making it easier to swallow and resulting in a lot less food debris building up around your teeth.

When your saliva flow is greatly reduced, the acids in the foods and beverages you ingest attack your tooth enamel with much greater effect. Also, the bacterial plaque you have in your mouth gets much stickier and builds up on your teeth. The waste product of all that bacteria is also very acidic. The end result is a much greater risk for massive tooth decay!

So why do some people have plenty of saliva and others have mouths that feel more like Death Valley? There are many causes, including simple things like not drinking enough water. However, there are many other causes. Talk with your physician if you are on medications that seem to cause your mouth to feel dry. Sometimes there are alternatives.

The most common classes of drugs to cause problems are those that treat depression and anxiety, as well as some cold and allergy medications that contain antihistamines or decongestants. Some pain medications and muscle relaxants also can cause a dry mouth. Smoking or using chewing tobacco can also cut down on your saliva production.

Age can play a factor, as older people are often on multiple medications and may have other health conditions that can cause a dry mouth. They also tend to drink less water as their mobility decreases, since it cuts down on trips to the bathroom.

Cancer treatment can cause dry mouth issues, with chemotherapy drugs causing a temporary problem, and radiation treatment to the head and neck area often causing permanent damage to the saliva glands. Let your dentist know if you will be undergoing cancer treatment, as they may recommend special concentrated fluoride products and custom made trays to keep a protective fluoride gel in contact with your teeth for 30 minutes per day. The fluoride can remineralize and toughen up the acid-damaged enamel.

Xerostomia can also be a consequence of some autoimmune diseases like Sjogren's syndrome. If you notice you seem to be developing unexplained dry eyes and a dry mouth, you may want to consult with your doctor to be tested for this condition. Those of you who snore, or have a bed partner who is constantly elbowing you in the ribs to quiet you down or jumpstart your breathing, likely wake up with a very dry mouth.

Snoring, morning headaches and a general feeling of waking up unrested are signs that you may have something called Obstructive Sleep Apnea, a life-threatening condition much more serious than just a dry mouth! Your risk of a heart attack or stroke, among other issues, is much higher if this condition is left untreated. Ask your physician for a referral to a sleep medicine specialist or see a dentist specially trained to screen for the condition.

Some of the worst decay I have ever seen in my practice is in patients who have abused methamphetamines. The term "meth mouth" was created by dentists to describe the horrifying damage to a person's teeth that can occur in a relatively short period of time once someone becomes entangled in this form of drug abuse. It is caused by a combination of a significant reduction in saliva production, the acidity of meth itself, and the general lack of concern for any type of self-care that seems to be common in users of methamphetamines.

If you feel like you are developing a dry mouth, review the list above to see if any of these categories fit you. Take immaculate care of your teeth, include flossing and avoid acidic foods and beverages. Consider using dry mouth products like Biotene to reduce some of the dryness and get evaluated by your physician and dentist right away. Early intervention and prevention are critical to avoid destruction of your teeth, and thousands of dollars in repair.

Stuart Rich, DDS, is the owner of Simply Smiles, a general practice in Auburn, and enjoys writing on a variety of dental topics. He and his team, including associate Dr. Jennifer Fields, treat patients of all ages. He also assists sleep specialist physicians in providing an alternative to the CPAP machine for those with Obstructive Sleep Apnea. Should you have further questions about dentistry or sleep apnea, you may visit them on the web at or You may also contact him at or reach the office by calling 253-939-6900.

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