Dry Mouth (Xerostomia): Strong Link to Sjögren’s Syndrome

Xerostomia is the subjective sensation of dry mouth. The most characteristic systemic cause is Sjögren’s syndrome, an autoimmune exocrinopathy targeting lacrimal and salivary glands.

Sjögren’s Hallmarks

• Dry eyes (keratoconjunctivitis sicca) + dry mouth
• Autoantibodies: anti‑Ro/SSA, anti‑La/SSB, RF, ANA
• Focus score ≥1 on minor salivary gland biopsy
• Can be primary or secondary (with RA, SLE, scleroderma)

Other Xerostomia Causes

• Medications (anticholinergics, diuretics, antidepressants – hundreds of drugs)
• Head/neck radiation
• Uncontrolled diabetes, HIV, HCV
• Dehydration, mouth breathing

Management

• Sialogogues (pilocarpine, cevimeline)
• Saliva substitutes, frequent sips, humidifier
• Rigorous oral hygiene, fluoride to prevent caries
• Treat underlying disease.