Natural vs. Artificial Dry Mouth Relief, Over-the-Counter vs. Prescription Treatments: What Are the Best Xerostomia Remedies?

Dry mouth, also known as xerostomia, is a fairly common phenomenon that affects about 20% of the population. To those who don’t suffer from it, dry mouth might not seem like a big deal, but those who do suffer from it experience a significant decrease in their quality of life. That’s why so many seek out different methods of dry mouth relief: lifestyle changes, prescription medications, electrostimulation, mouthwashes, and more. But which type of dry mouth remedy is best?  

In this article, we’ll discuss xerostomia causes, the wide array of treatment options, and the importance of working together with your healthcare professional to receive the best dry mouth therapy. 

Understanding Xerostomia Symptoms

Xerostomia is the clinical term for dry mouth, which is a feeling one experiences when the salivary glands don’t produce enough saliva. There are several reasons why this can happen, as we’ll discuss below, and like many medical afflictions, symptoms vary from person to person. 

The most common xerostomia symptoms are:

• A feeling of dryness in the mouth and/or nose
• Hoarseness
• Stickiness, itchy, or burning in the mouth or throat
• Difficulty chewing, swallowing, and speaking
• Change in taste
• Dry, cracked, or red lips and/or tongue
• Mouth sores
• Recurring mouth or throat infections
• Bad breath
• Trouble wearing dentures
• Increased thirst
• Rampant tooth decay

 

Not every person suffering from dry mouth experiences all of these symptoms — there is usually a mixture, which varies from person to person and can change as xerostomia persists. 

What Causes Xerostomia?

Xerostomia is caused when the salivary glands don’t produce enough saliva — but why does this happen? What causes the salivary glands to malfunction?

There are several reasons salivary glands cease to function normally:

 

• Certain medications: Decreased saliva production is a side effect of hundreds of medications used for a wide range of afflictions, including anxiety, depression, high blood pressure, bladder control, allergies, pain relief, and more.
• Disease: Sjögren’s syndrome and other autoimmune diseases, thyroid disease, HIV/AIDS, diabetes, dementia, and other illnesses can cause decreased saliva production.  
• Radiation therapy for head and neck cancers: Radiation usually severely damages the salivary glands. 
• Chemotherapy and immunotherapy: Cancer-treating drugs can change the viscosity of saliva, making it thicker and causing the sensation of dry mouth.
• Injury: Head or neck injuries can sometimes damage the nerves connected to salivary gland function.
• Dehydration: When the body is dehydrated, the salivary glands are unable to produce the correct amount of saliva.
• Mouth breathing: Breathing through the mouth doesn’t cause the salivary glands to malfunction, but the air flowing in and out can cause dry throat, gums, and lips. 

 

Does Aging Cause Xerostomia?

Some attribute dry mouth to the natural phenomenon of aging, but studies spanning the past decade show that, in general, aging causes xerostomia when it comes together with diseases and their treatment. For example, the population of people aged 65+ often take more medications and have higher rates of cancer than the younger population. That makes them more prone to xerostomia.

 

When It’s Time to See Your Doctor for Xerostomia Symptoms

Occasional dry mouth isn’t usually a big deal, and can be addressed by increasing your water intake, gum chewing, or consciously breathing through your nose. If, however, you feel that your mouth is constantly dry, it’s time to see a healthcare professional — usually, a dentist, oral medicine specialist, or oral and maxillofacial surgeon.

 

Additionally, if you are taking medications that are known to cause dry mouth, suffer from an autoimmune disease, have undergone cancer treatments, or had a neck or head injury, there’s no reason to wait to see a healthcare professional. Make an appointment so you can get started on a treatment plan. 

 

What to Expect When You Visit Your Healthcare Provider

During your appointment, your healthcare professional will review your medical history, including the medications you currently take, and examine your mouth. In some cases, you’ll be asked to take blood tests, imaging scans, biopsies, or other tests to determine the cause and severity of your xerostomia. These tests are important for your doctor’s diagnosis and treatment plan. 

 

The Best Xerostomia Remedies

Working together with your healthcare provider, you can draft a personalized xerostomia treatment plan. 

There are two main categories of xerostomia treatments:

• Natural dry mouth relief: In this category, dry mouth is relieved by increasing the output of natural saliva. These treatments include non-pharmacological treatments (electrostimulation of salivary glands) and pharmacological treatments (prescription medications), all designed to increase natural saliva production.
• Artificial dry mouth relief: These treatments don’t work by increasing natural saliva production, but by providing replacement (unnatural) saliva. The products under this category include mouthwashes, sprays, and throat lozenges.

Excluding prescription medications, all other available treatments and products are over-the-counter (OTC).

During your visit, you and your doctor should discuss which is the best treatment modality. 

Treatments Designed to Increase the Production of Natural Saliva

These treatments typically depend on the cause of xerostomia, as you can see in the table below.

Cause of Dry Mouth	Non-pharmacological treatments	Pharmacological Treatments
Medication side effects	Electrostimulation	Change of dosage or type of your medication.
Damaged salivary glands due to Sjögren’s syndrome or cancer treatment	Electrostimulation	Sialogogues, a specific category of substances that increase the flow rate of saliva. The most commonly used sialogogues are the prescription drugs pilocarpine and cevimeline.

Treatments Designed to Provide Artificial Saliva

These treatments include over-the-counter dry mouth products like alcohol-free mouthwash, lozenges, sprays, and more. While they don’t increase the body’s production of saliva, the replacement saliva sometimes offers relief from the discomfort of dry, cracked lips, and can also make chewing and swallowing easier. 

Lifestyle Changes to Improve Dry Mouth

There are also several lifestyle changes that may also help with the relief of dry mouth. 

• • Drink more water: If your doctor determines that your dry mouth is caused by dehydration, drinking more water on a daily basis should provide quick relief. (Here you can see recommendations for the right amount of water from the Harvard T.H. Chan School of Public Health.)
  • Decrease your daily caffeine and alcohol intake, both of which are diuretics.
  • Quit smoking: Studies show that smoking is a risk factor for decreased saliva production. 

• Chew sugar-free gum 

• Using a humidifier, when you sleep.

 

Patient-Doctor Collaboration is Key

When it comes to the question of what type of treatment is better for dry mouth, there is no uniform answer for every person. Many patients may prefer to rely on non-pharmacological remedies, but healthcare professionals often recommend a combination of non-pharmacological treatments and prescription medication. 

 

For example, your doctor may recommend electrostimulation together with lifestyle changes such as drinking more water, cutting down on caffeine and nicotine, nose-breathing, etc. Usually, xerostomia treatment is more effective when you implement a multimodal approach. 

 

Sharing information with your healthcare professional — including your medical history, current symptoms, medications, lifestyle habits, and more — will help them formulate the best treatment plan for you. Checking in and working together on a continual basis will ensure that you get the best ongoing care, which will ultimately relieve your xerostomia symptoms and improve your quality of life.