What vitamin deficiency causes xerostomia (dry mouth)?

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From the Guidelines

Vitamin A deficiency is the most likely cause of xerostomia (dry mouth) among the options provided, as it can affect epithelial tissues throughout the body, including those in the mouth, leading to symptoms such as dryness and potentially xerophthalmia 1. When considering the potential causes of xerostomia, it's essential to evaluate the role of various vitamin deficiencies.

  • Vitamin A deficiency has been reported to cause symptoms such as benign intracranial hypertension, facial palsy, and xerophthalmia, which can progress to conjunctival dryness and corneal ulceration 1.
  • While other vitamin deficiencies, such as those of the B vitamins, can also contribute to dry mouth, the provided evidence suggests a stronger link between vitamin A deficiency and epithelial tissue health 1. To address vitamin A deficiency-related dry mouth, it's crucial to ensure adequate vitamin A intake, which can be achieved through supplementation or dietary changes.
  • The recommended supplementation amounts for vitamin A are dependent on serum values and supplement form, with retinol (preformed) starting low and adapting rapidly to target normal serum reference range, and beta carotene (provitamin A) prescribed at 1 mg/kg/day (maximum 50 mg/day) for 12 weeks, followed by a maintenance dose (maximum 10 mg/day) 1.
  • Additionally, maintaining good hydration, avoiding alcohol and caffeine, and using alcohol-free mouthwashes or saliva substitutes can help alleviate dry mouth symptoms.

From the Research

Vitamin Deficiency and Xerostomia

  • Xerostomia, also known as dry mouth, can be caused by various factors, including vitamin deficiencies.
  • However, the provided studies do not directly link xerostomia to a specific vitamin deficiency.
  • The studies focus on the oral manifestations of vitamin B12 deficiency, which include:
    • Glossitis
    • Stomatodynia
    • Erosions in the mouth
    • Atrophic glossitis
    • Dysgeusia
    • Lingual paresthesia
    • Burning sensations
    • Pruritus
  • These oral signs and symptoms can serve as early indicators of systemic conditions such as pernicious anemia 2, 3, 4, 5.
  • Vitamin B12 deficiency can be caused by gastrointestinal malabsorption, and its diagnosis is often delayed due to non-specific symptoms 2, 3.
  • The studies suggest that investigating vitamin B12 levels should be considered in patients presenting with oral ulcers, oral erythema, or burning sensations without an apparent origin 4.
  • High intakes of folic acid may exacerbate vitamin B12 deficiency, and public health strategies are needed to improve vitamin B12 status 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Recognition and management of vitamin B12 deficiency: Report of four cases with oral manifestations.

Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 2022

Research

Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency.

Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 1995

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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