Dry Mouth (Xerostomia)
What is Xerostomia?
Xerostomia is the medical term for dry mouth. While drooling is a common symptom in Parkinson’s Disease, nearly 80% of people with Parkinson’s Disease have xerostomia. Those with Parkinson’s Disease can have BOTH xerostomia and drooling at the same time.
What Does Saliva Do?
Saliva lubricates the mouth and throat, helps you chew and swallow, helps you taste food, and protects your teeth and gums from decay and infection. Persistent dry mouth increases the risk of dental cavities, gum disease, mouth infections, trouble swallowing, and changes in taste.
Why Does Dry Mouth Happen in Parkinson’s Disease?
Dry mouth in Parkinson’s Disease usually comes from two sources:
1) Nerve changes from Parkinson’s Disease: The autonomic (automatic) nerves that control the salivary glands may be affected which reduced how much saliva is created.
2) Medications: Many medications cause dry the mouth as a side effect, particularly a class of medications called the anticholinergic drugs. Some of these anticholinergic drugs are the very same medications used to reduce drooling, so treating one symptom can sometimes tip you toward the other.
Treatment Strategies
Non-Medication Strategies
– Sip water frequently throughout the day to keep the mouth moist. Sucking on ice chips may be helpful.
– Using lip balm to prevent cracked lips.
– Using a humidifier in the bedroom at nighttime to prevent dry skin, lips, and mouth.
– Reducing caffeine and alcohol intake. Avoiding mouthwash that contains alcohol.
– Keep up regular dental checkups and daily dental hygiene (including fluoride) since dry mouth raises the risk of cavities and gum problems. You may consider using a regular fluoride toothpaste prescribed by your dentist.
Medication Options
Medication review is one of the most useful steps. Your care team can look for drugs that worsen dry mouth and adjust them where possible.
Over-the-counter saliva substitutes (sprays, gels, or rinses) for symptom relief.
Mouth moisturizers (saliva substitutes): these coat and lubricate the mouth.
Gels tend to last longest, especially overnight.
– Biotène (spray, gel, rinse, or lozenges)
– OralBalance gel
– BioXtra gel or spray
– XyliMelts (small discs that stick to the gum and dissolve slowly — good for nighttime!)
• Things to chew or suck (stimulates saliva production): most useful if your mouth still makes some saliva. Always choose sugar-free.
– Sugar-free chewing gum (look for xylitol)
– Sugar-free lozenges, mints, or hard candies
– Sour/lemon sugar-free drops can help, but limit them if your teeth are sensitive as the acid can wear enamel
– Prescription “sialogogues” may be considered in certain situations to stimulate saliva production.
Author Mick Reedy, MD, is a Movement Disorders Specialist with
Inova Parkinson’s and Movement Disorders Center (IPMDC)