Dry Mouth Differential Diagnosis

The differential diagnosis for dry mouth, also known as xerostomia, can be categorized into several groups based on likelihood and potential impact on patient health.

• Single Most Likely Diagnosis:

  • Medication side effect: Many medications, including anticholinergics, antidepressants, antihistamines, and decongestants, can cause dry mouth as a side effect. This is often the most common reason for xerostomia due to the widespread use of these medications.

• Other Likely Diagnoses:

  • Dehydration: Inadequate fluid intake or excessive fluid loss can lead to dehydration, which may cause dry mouth.
  • Sjögren's syndrome: An autoimmune disorder that primarily affects the glands that produce tears and saliva, leading to dry eyes and mouth.
  • Aging: Older adults may experience a decrease in saliva production, contributing to dry mouth.
  • Mouth breathing: Breathing through the mouth instead of the nose can dry out the mouth.
  • Diabetes: Uncontrolled diabetes can lead to dry mouth due to increased glucose levels in the saliva and decreased saliva production.

• Do Not Miss Diagnoses:

  • Sarcoidosis: A condition in which inflammatory cells form lumps known as granulomas in various parts of the body, including the salivary glands, which can lead to dry mouth.
  • HIV/AIDS: Individuals with HIV/AIDS may experience dry mouth due to the disease itself or as a side effect of antiretroviral therapy.
  • Lymphoma: Certain types of lymphoma can affect the salivary glands, leading to dry mouth.
  • Graft-versus-host disease (GVHD): A complication that can occur after a stem cell or bone marrow transplant, where the donated stem cells attack the recipient's body, potentially affecting the salivary glands.

• Rare Diagnoses:

  • Amyloidosis: A condition characterized by the deposition of abnormal proteins (amyloid) in various tissues, including the salivary glands, which can lead to dry mouth.
  • Hemochromatosis: A genetic disorder that leads to excessive iron accumulation in the body, potentially affecting the salivary glands.
  • Ectodermal dysplasias: A group of disorders that affect the skin, hair, nails, teeth, and salivary glands, which can result in dry mouth.
  • Irradiation of the head and neck: Radiation therapy in this area can damage the salivary glands, leading to xerostomia.