From Pills to Problems: Dry Mouth as a Medication Side Effect

December 9, 2023

Have you ever woken up in the middle of the night with a mouth so parched, it feels like you've been stranded in the desert for days? It's like your mouth forgot how to make saliva, leaving your tongue feeling rough and uncomfortable. It even makes it hard to speak clearly.

Everyone can have a dry mouth from time to time, especially if you are stressed, upset, or nervous. But, when dry mouth is present most of the time, it can cause a range of different problems.

That’s because saliva does more than just moisten the mouth. It helps with food digestion, regulates oral bacteria, safeguards teeth from decay, and enables proper chewing and swallowing. (1)

Many medicines can cause dry mouth. Including drugs that treat diarrhea, hypertension, obesity, and urinary incontinence. Here, you can take a closer look at the medication-induced dry mouth, why it happens, and what you can do about it.

Why do some medicines cause dry mouth?

Many medicines have what is called “anticholinergic” effects. Anticholinergic effects are a type of drug side effect that can block acetylcholine.

Acetylcholine is a neurotransmitter that influences the salivary glands and stimulates the secretion of water and ions. When the release of acetylcholine hormone decreases, people can experience drug-induced dry mouth. (2)

Another reason is the rise in protein levels in saliva. Blocking the function of the parasympathetic nerve can lead to an increase in protein concentration in saliva. This can cause a sensation of dryness. (3)

Dry mouth from medicine happens because blocking the parasympathetic nerve induces sympathetic stimulation, which results in the release of noradrenaline. Noradrenaline acts on alpha- and beta-adrenergic receptors. This reduces the production of saliva, increases protein secretion, and decreases blood flow to the salivary glands.

Which drugs cause dry mouth?

There are over 500 medications that have this side effect. Different over-the-counter and prescription drugs can affect the production of saliva in the mouth. But, they all have various mechanisms.

Take diuretics, for example. They drain the excess fluid from the body by making you urinate more often. Study shows that diuretic medication drastically decreases salivary flow rates and changes salivary composition. This can have a huge impact on your oral health and increase the odds of periodontal diseases and dental caries. (4)

Here is a list of drugs that cause dry mouth as a side effect:

Painkillers (analgesics)
Antidepressants
Cardiovascular drugs
Decongestants
Diuretics
Muscle relaxants
Proton pump inhibitors
Smoking control medicines
Antihistamines
Anti-anxiety medications
Antidiarrheals

Is dry mouth a common side effect?

Dry mouth as a side effect is a relatively common problem. Based on data from the Pharmacy Journal, there is a 20% to 30% prevalence of medication-induced dry mouth (xerostomia). This side effect is more present in older adults. (5)

A major risk factor is using multiple drugs to treat a wide range of diseases. And since the elderly often use more medications for age-related chronic ailments, they are more likely to struggle with dry mouth from medication.

Another survey shows, around 21% of individuals who visit specialized outpatient clinics for xerostomia treatment experience hyposalivation as a side effect of their medication. Hyposalivation is a condition that reduces the production of saliva in the mouth. (6)

In elderly care homes, over 95% of the population suffers from dry mouth as a side effect of their medication.

Anticholinergics often affect saliva production. These are popular medications for treating overactive bladder, Parkinson's disease, and gastrointestinal problems. This is because the secretion of saliva is typically activated by acetylcholine through muscarinic receptors.

When patients take anticholinergics, these drugs can cause dry mouth in approximately 16.9% to 53.7% of cases. In fact, dry mouth is responsible for around 40% of the instances where overactive bladder patients stop taking their anticholinergics due to adverse effects.

So, why is dry mouth such a common side effect of medicines? Most medications that cause a dry mouth have a direct impact on the sympathetic nervous system. They can hinder and thicken the flow of saliva.

When a person experiences chronic dry mouth, it can lead to dental issues and possible infection. A type of infection known as thrush, caused by candida albicans, is prevalent in patients who have dentures, use corticosteroids, smoke, or suffer from diabetes. This condition can cause tooth decay as it reduces the presence of salivary proteins and electrolytes. (7)

How long does dry mouth last after taking medication?

How long drug-induced dry mouth lasts can vary depending on the type of medicine you use, and your individual tolerance. In most patients, dry mouth can last as long as they take their medication and it goes away once they stop using it. But, it is not uncommon for dry mouth to persist even after the medication is discontinued.

For example, some medications like tricyclic antidepressants and anticholinergics can cause dry mouth that lasts for weeks or even months. On the other hand, certain medications like benzos and opioids may cause dry mouth that lasts for a shorter period of time. (8) (9)

Sometimes patients experience persistent dry mouth. This problem can occur from using a wide range of medicine, such as antidepressants or antipsychotics. Antipsychotics can trigger dryness in the mouth even at lower doses (25 mg to 200 mg). But, this side effect may be more common for people taking higher doses (600 mg to 1,000 mg).

Studies show that medications with anticholinergic properties can greatly hinder the production of saliva. They can also impede the saliva’s protective functions. This causes a decreased rate of saliva flow and can increase the occurrence of dental caries. (10)

What can I do about dry mouth caused by medication?

“Is there a solution for dry mouth?” This is a common question at any clinic. If the medication is causing mouth dryness, talk to your doctor. They can suggest you use the lowest effective dose or change your medication. But, there are also a couple of things you can try at home. The options below may help.

Take more sips of water

Drinking water can keep the mouth moist. With water, tea, or unsweetened beverages, you help the body create more saliva. Try drinking around 8 glasses of water a day. If you are drinking enough water, the urine should be plentiful, odorless, and pale.

Water can help flush out any leftover food particles and plaque from the mouth. This is something bacteria use to thrive. By hydrating regularly, you moisturize the soft tissue lining in the mouth, which can prevent discomfort and dryness.

Chew xylitol gum

Wondering how to solve dry mouth if water doesn’t work? Xylitol gum can help the mouth produce more saliva.

Research shows that chewing gum that contains xylitol can potentially prevent tooth decay by diminishing the concentration of mutans streptococci (MS) and lactobacilli in both saliva and plaque. (11) (12)

To increase salivary flow, chew xylitol gum for 3 to 5 minutes, preferably 20 minutes after a meal.

Xylitol is a non-fermentable sugar substitute that works by stimulating the salivary glands. It is considered safe for consumption by various scientific advisory bodies, including the FDA.

Xylitol is particularly useful for diabetics because it has a lower glycemic index than sugar, meaning it doesn't cause a sharp spike in blood sugar levels.

Although xylitol may not interact with any other medications you may be taking, it is best to consult with your doctor before you include xylitol-containing products.

Eat low-sugar, low-acid, moist foods

There is no miracle cure for dry mouth. But diet can help.

Some foods can keep the mouth moist. They are packed with vitamins and minerals and ca n keep the body hydrated, therefore promoting saliva production. When you experience dry mouth from medication, try to eat more:

Cucumbers
Celery sticks
Apples
Pears
Spinach
Broth

By incorporating these foods into your diet, you can alleviate the symptoms of chronic dry mouth and boost your overall health.

Additionally, some foods can make dry mouth worse. These are acidic foods, such as vinegar and lemon, and dry foods, like crackers. If you like to enjoy some dry foods, then try to soften the food by dipping the crackers in tea or milk.

Also, refrain from eating too much salt and highly spicy foods. They can irritate the lining of the mouth and make it difficult to curb dryness.

Use a saliva substitute

Saliva substitutes can be a practical treatment alternative for drug-induced dry mouth. While saliva substitutes can’t cure dry mouth, they can provide much-needed relief.

Saliva substitutes work by temporarily moistening and lubricating the mouth. Therefore, they can reduce dryness and discomfort. (13)

One such example is Essential Sprays dry mouth spray. Mouth sprays often contain xylitol, which can help stimulate saliva and curb the symptoms of dry mouth. These are products you can use on the go and may come in different flavors, like a mild mint flavor. In addition, Essential Sprays products are all natural and free of alcohol and preservatives.

The main advantage of a mouth spray for dry mouth is that the product is sugar-free and alcohol-free. You can also use it a couple of times a day.

To use a mouth spray, you would have to spray the product directly into the mouth and allow it to spread thoroughly. The relief can last for a few hours depending on the product you use.

Turn the room humidifier on

Using a room humidifier can be a great way to ease dry mouth.

Humidifiers add moisture to the air. This helps prevent irritation and dryness in the mouth and throat.

If you breathe through the mouth when you sleep, make sure the room humidifier is running at night. When you breathe through the mouth, the air bypasses the nasal passages. These passages would normally humidify and warm the air before it enters the lungs. This makes the throat and mouth become dry.

Also, mouth breathing can increase the odds of snoring, which could further exacerbate the symptoms of dry mouth. The humidifier can reduce dryness and allow the body to get that much-needed rest.

Plus, when you use a humidifier, you can maintain proper humidity levels in your home. This can alleviate symptoms of respiratory problems, allergies, and dry skin. It is particularly beneficial for improving sleep quality and reducing snoring.

To avoid the spread of bacteria, make sure to keep the humidifier clean.

See a dentist or doctor

There are many ways a doctor or a dentist can help with dry mouth.

If you have a chronic dry mouth, make sure to consult with a specialist. They can review your medical history, examine the mouth, and identify the underlying cause.

In some cases, doctors can prescribe medication to help with saliva production. Two common medications used for this purpose are pilocarpine (Salagen) and cevimeline (Evoxac). These products can stimulate the mouth to make more saliva and keep it moist.

A dentist can do a comprehensive oral examination and check for signs of dry mouth. Such as cracked lips, dry skin, or a sticky feeling in the mouth. After the dentist determines the cause, they can provide adequate treatment.

Dentists can also guide you on how to practice some useful oral hygiene practices that can decrease the risk of complications from dry mouth, like gum disease and tooth decay. Dentists often suggest using fluoride mouthwash.

Is there anything to prevent dry mouth from prescription meds?

Dry mouth when on meds is a huge problem for many patients. Unfortunately, you can’t completely prevent dry mouth from happening. But, you can reduce the risk by practicing a couple of strategies.

Try to rinse the mouth with a fluoride mouthwash, especially one that has xylitol. Consume foods that contain a lot of water. This can increase hydration and make you less susceptible to dry mouth. Cucumber is the food that contains the most water. So, try to enjoy some more cucumbers during the day.

Dry mouth sprays and xylitol gums can help lubricate the mouth even when you are taking medications. Bear in mind that if the mouth is frequently dry, you are more likely to struggle with cavities and other dental problems. Because you don’t have enough saliva, it is difficult for the mouth to wash away all the debris and organisms and neutralize acids.

So, practicing proper oral hygiene is essential. Brush the teeth at least 2 times a day with fluoride toothpaste and floss once a day. Get regular dental cleanings and check-ups to keep the dental problems at bay.

Conclusion

A dry mouth is a frequent side effect of several medications. There is a huge list of drugs that can make your mouth super dry. And most of these drugs are something that patients can’t do without.

Although it is not a serious health issue, it can be very uncomfortable and problematic to deal with. If you don’t take care of it, you may experience dental decay, trouble speaking and swallowing.

It’s crucial to discuss with a specialist if your medications are making your mouth extremely dry. They can suggest some remedies or treatments to alleviate the symptoms. There are also some at-home options for you to try, such as drinking lots of water, using xylitol-containing products, humidifiers, and making some dietary changes.

References

Back to blog

Item added to your cart