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Dry Mouth Management: A Complete Guide to Xerostomia
Dry mouth, also known as xerostomia, can often be managed through a combination of treating or addressing the underlying cause, stimulating any remaining natural saliva, using saliva substitutes or mouth moisturisers and protecting the teeth and soft tissues of the mouth.
The most appropriate treatment depends on why the mouth is dry, how severe the symptoms are and whether the salivary glands are still producing saliva.
Drinking water can provide temporary relief, but people with persistent dry mouth may need additional support to keep the mouth comfortable and protect their oral health.
What is dry mouth?
Dry mouth, or xerostomia, describes the feeling of having insufficient moisture in the mouth. It can occur when the salivary glands produce less saliva or when saliva does not adequately keep the mouth moist.
Saliva does much more than make the mouth feel comfortable. It helps with speaking, chewing, swallowing and tasting food, while also helping protect the teeth and oral tissues.
Persistent dry mouth can therefore affect both everyday comfort and oral health.
What causes dry mouth?
Dry mouth has many possible causes.
Common causes include:
- Medicines
- Dehydration
- Breathing through the mouth, particularly during sleep
- Anxiety
- Diabetes
- Hormonal changes associated with menopause
- Sjögren's syndrome and other conditions affecting the salivary glands
- Cancer treatment, including radiotherapy and some chemotherapy
Some people experience more than one contributing factor.
Medicines are a particularly common cause of dry mouth. NHS Specialist Pharmacy Service identifies examples including some anticholinergic medicines, antidepressants and opioids.
If you think a prescribed medicine is causing dry mouth, do not stop taking it without speaking to a healthcare professional. NHS guidance recommends seeking medical advice about suspected medicine-related dry mouth.
How is dry mouth treated?
There is no single treatment that is best for everyone.
Dry mouth management generally involves one or more of the following:
- Identifying and addressing the underlying cause
- Stimulating natural saliva where salivary function remains
- Replacing or supplementing moisture with saliva substitutes
- Protecting the teeth, gums and oral tissues
- Managing situations in which symptoms are worse, such as during the night or at mealtimes
The right approach depends on the individual and the cause and severity of their dry mouth.
1. Identify the underlying cause
Understanding why the mouth is dry is an important first step.
For example, management may differ for someone experiencing dry mouth because of medication compared with someone whose salivary glands have been affected by Sjögren's syndrome or head and neck radiotherapy.
Persistent dry mouth may therefore require assessment by a GP, dentist or other healthcare professional.
Where medication is suspected, a healthcare professional may review whether changes are appropriate. Medication should not be stopped or altered without professional advice.
2. Stimulate natural saliva where possible
If the salivary glands are still functioning, saliva stimulation may help increase natural saliva flow.
Options can include:
- Sucking sugar free sweets or lozenges
- Chewing sugar free gum
Products containing xylitol may also be found in dry mouth oral care products and sugar free lozenges.
Sugar free chewing gum can stimulate salivation where residual salivary function remains.
Important distinction: a saliva stimulant and a saliva substitute are not the same thing. A stimulant encourages the person's own salivary glands to produce saliva, whereas a saliva substitute provides moisture when natural saliva is insufficient.
3. Use saliva substitutes and mouth moisturisers
For people who do not produce enough saliva, saliva substitutes, sometimes referred to as artificial saliva products, can provide symptomatic relief by helping moisturise the mouth.
They do not restore salivary gland function. Their role is to help replace some of the lubrication and moisture that natural saliva would normally provide.
Saliva substitutes and dry mouth moisturisers are available in several formats, including:
Dry mouth sprays
Sprays are portable and can be used to moisturise the mouth when dryness occurs throughout the day and night.
Dry mouth gels
Gels have a thicker consistency and can coat the oral tissues. They can be particularly useful when longer lasting moisturisation is wanted, including before sleep.
Mouthwashes
A mouthwash designed for dry mouth can help moisturise and refresh the mouth as part of an everyday oral care routine.
Lozenges
Lozenges can be convenient when away from home and may help stimulate remaining natural saliva while providing oral comfort, depending on their formulation.
Different formats can therefore serve different needs rather than necessarily competing with one another.
What is the difference between water and a saliva substitute?
Water is important for hydration and can temporarily moisten a dry mouth.
However, water and saliva substitutes perform different roles.
Water provides fluid but only short term moisture. A saliva substitute or mouth moisturiser is specifically formulated to provide lubrication or moisture within the mouth when natural saliva is insufficient.
4. Protect your teeth and gums
Treating the uncomfortable sensation of dry mouth is only part of its management.
Reduced saliva can increase the risk of:
- Tooth decay
- Gum disease
- Oral infections
- Oral thrush
- Soreness and irritation
NHS Specialist Pharmacy Service specifically identifies these increased risks in people with chronic dry mouth.
People with dry mouth should therefore pay particular attention to preventive oral care.
This can include:
- Brushing teeth twice daily with fluoride toothpaste
- Maintaining good oral hygiene
- Attending regular dental appointments
- Limiting frequent sugary foods and drinks
- Using an alcohol free mouthwash where appropriate
A dentist may recommend additional fluoride measures for people at increased risk of dental decay.
5. Managing dry mouth at night
Dry mouth can become particularly noticeable at night because saliva production naturally decreases during sleep.
Symptoms may also be worsened by:
- Sleeping with the mouth open
- Snoring
- Nasal congestion
- Dehydration
- Medicines
- Underlying medical conditions
Keeping water beside the bed may provide temporary relief. NHS advice specifically recommends regular water intake and keeping water by the bed at night.
For people who need additional moisture, a dry mouth gel or spray may provide another option before sleep.
Oralieve Moisturising Dry Mouth Relief Gel is designed to moisturise the mouth and can be used as part of a dry mouth care routine.
Related guide: Why is my mouth dry at night?
6. Managing dry mouth when eating and swallowing
Saliva helps lubricate food and contributes to comfortable chewing and swallowing.
When saliva is reduced, some people may find foods:
- Difficult to chew
- Difficult to swallow
- Dry or sticky
- Uncomfortable to eat
Practical measures may include choosing softer foods, adding sauces or gravies to dry foods, taking appropriate fluids with meals and moistening the mouth before eating.
Persistent difficulty eating or swallowing should be discussed with an appropriate healthcare professional.
Related guide: Dry Mouth and Dysphagia: The Hidden Link Affecting How We Eat and Drink
Which type of dry mouth product should I choose?
The most appropriate format depends on when and how dry mouth affects you.
| Need | Product format that may be useful |
| Occasional dryness during the day | Spray |
| Longer lasting moisturisation | Gel |
| Dryness before or during sleep | Gel or spray |
| Everyday oral care routine | Dry mouth toothpaste and mouthwash |
| Portable support when away from home | Spray or lozenge |
| Remaining natural saliva that can be stimulated | Lozenge |
Individual suitability depends on the product formulation and the person's needs, so advice from a dentist, pharmacist or healthcare professional may be appropriate.
This is also an area where formulation matters. NHS SPS advises that artificial saliva products vary in composition and that product selection requires consideration of individual needs.
How Oralieve supports dry mouth care
Oralieve offers a range of products specifically designed for people experiencing dry mouth.
Rather than relying on a single product, different formats can support different parts of a daily dry mouth routine:
Moisturising Dry Mouth Relief Spray
Oralieve Moisturising Dry Mouth Relief Spray provides convenient, portable moisturising support for people experiencing dry mouth. It can be used throughout the day whenever additional moisture is needed, making it particularly useful when travelling, working or spending time away from home.
Moisturising Dry Mouth Relief Gel
Oralieve Gel has a gel-based formulation designed to help moisturise and soothe a dry mouth. It can be particularly useful when longer lasting comfort is needed, including before bedtime when dry mouth symptoms may become more noticeable.
Mouthwash for Dry Mouths
Oralieve Mouthwash is designed to support everyday oral hygiene while helping moisturise and refresh the mouth. It can be incorporated into a daily oral care routine alongside a suitable toothpaste to help maintain oral comfort.
Oralieve Ultra Mild Mint & Flavour Free Toothpaste
Oralieve Ultra Mild Mint and Flavour Free Toothpastes are designed for people experiencing dry mouth who may prefer a gentler brushing experience. They offer options for those who prefer a mild mint flavour or a flavour-free alternative, helping make everyday oral care more comfortable.
Oralieve Soothing Lozenges
Oralieve Soothing Lozenges provide a convenient option for managing dry mouth while away from home. They can help stimulate remaining natural saliva flow and provide oral comfort, making them useful when additional support is needed throughout the day.
When should you seek professional advice?
Speak to a GP, dentist or other appropriate healthcare professionals if dry mouth:
- Persists despite self care
- Makes speaking or eating difficult
- Causes persistent pain, redness, swelling or bleeding
- Is associated with white patches or suspected oral thrush
- Is accompanied by other unexplained symptoms
- Appears to be associated with prescribed medication
- Is causing repeated dental problems
Persistent dry mouth may have an underlying cause that requires assessment.
Frequently asked questions
What is the best treatment for dry mouth?
There is no single best treatment for everyone. Management depends on the cause and severity of dry mouth and may include addressing the underlying cause, stimulating remaining saliva, using saliva substitutes or mouth moisturisers and taking additional steps to protect oral health.
What is the best treatment for chronic dry mouth?
Chronic dry mouth usually requires ongoing management rather than occasional hydration alone. This may include identifying the underlying cause, using saliva stimulation where appropriate, using saliva substitutes or moisturising products and maintaining preventive dental care.
Is drinking water enough for dry mouth?
Water helps with hydration and temporarily moistens the mouth, but people with persistent dry mouth may require additional measures such as saliva stimulation or saliva substitutes.
What is a saliva substitute?
A saliva substitute is a product designed to provide moisture or lubrication when natural saliva is insufficient. Products are available in formats such as gels and sprays. They relieve symptoms but do not restore salivary gland function.
Is artificial saliva the same as a saliva substitute?
The terms are commonly used to describe products intended to replace some of the moisture or lubrication normally provided by natural saliva. Formulations vary, so individual products may work differently.
What can I use for a very dry mouth at night?
Measures can include addressing mouth breathing or other contributing causes, and using an appropriate dry mouth moisturising product. Persistent or severe nighttime dry mouth should be discussed with a healthcare professional.
Can medication cause dry mouth?
Yes. Dry mouth is a side effect of many medicines. Examples include some antidepressants, anticholinergic medicines and opioids. Do not stop prescribed medication without medical advice.
Can dry mouth damage my teeth?
Yes. Persistent dry mouth increases the risk of dental decay and other oral health problems because saliva plays an important protective role. Good oral hygiene, fluoride and regular dental care are therefore particularly important.