The word xerostomia reflects its Greek origins from "xeros" (dry) + "stoma" (mouth).

The condition of not having enough saliva to keep the mouth wet due to inadequate function of the salivary glands. Everyone has a dry mouth once in a while when they are nervous, upset or under stress. But if someone has a dry mouth all or most of the time, it can be uncomfortable and can lead to serious health problems. Dry mouth can cause difficulties in tasting, chewing, swallowing, and speaking. If it goes untreated, severe dry mouth can also lead to increased levels of tooth decay and infections of the mouth such as thrush.

Signs and symptoms
Aside from the sensation of dryness in your mouth, xerostomia may result in:

• Saliva that seems thick, stringy
• Sores or split skin at the corners of your mouth
• Bad breath
• Difficulty speaking, swallowing
• A burning or tingling sensation of your tongue
• An altered sense of taste
• Increased plaque, tooth decay and gum disease

• Medications - Several hundred current medications can cause xerostomia. These include antihypertensives, antidepressants, analgesics, tranquilizers, diuretics and antihistamines c.

• Cancer Therapy - Chemotherapeutic drugs can change the flow and composition of the saliva. Radiation treatment that is focused on or near the salivary gland can temporarily or permanently damage the salivary glands.

• Sjogren's syndrome - An autoimmune disease, causes xerostomia and dry eyes.

• Other conditions -such as bone marrow transplants, endocrine disorders, stress, anxiety, depression, and nutritional deficiencies may cause xerostomia.

• Nerve Damage - Trauma to the head and neck area from surgery or wounds can damage the nerves that supply sensation to the mouth. While the salivary glands may be left intact, they cannot function normally without the nerves that signal them to produce saliva.

Screening and diagnosis
To determine if you have dry mouth, your doctor or dentist likely will examine your mouth and review your medical history. Sometimes you'll need blood tests and imaging scans of your salivary glands to identify the cause.

Treatment
Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping sugarless fluids frequently, chewing xylitol-containing gum, and using a carboxymethyl cellulose saliva substitute as a mouthwash may help.

Palliative treatment can be used but does not cure the condition:

• Pilocarpine (Salagen) 5mg, qid, prescription required.

• Special food preparation - blended and moist foods are easier to swallow artificial saliva (available over-the-counter).

• Sipping plain water is usually preferred over artificial saliva by most patients.

• Biotene brand, over-the-counter, dry mouth products (toothpaste, alcohol- free mouth rinse and Oralbalance lubricating gel).

• Avoidance of alcohol-based mouth rinses
• Use of water and glycerin mixed in a small aerosol spray bottle.

Self-care
When the cause of the problem either can't be determined or can't be resolved, you may be able to improve your saliva flow by sucking on sugar-free hard candy or chewing sugar-free gum. Avoid lemon-flavored hard candy - it makes saliva acidic, increasing the possibility of tooth decay.

To protect your teeth, brush with a fluoride toothpaste and visit your dentist regularly. Your doctor may suggest using prescription fluoride toothpaste. Using a fluoride rinse or brush-on fluoride gel before bedtime also may offer protection.