Differential Diagnosis for Dry Mouth

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 dry mouth 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.
  • Aging: Older adults often experience a decrease in saliva production, contributing to dry mouth.
  • Sjögren's syndrome: An autoimmune disorder that can affect the glands that produce tears and saliva, leading to dry mouth and dry eyes.
  • Diabetes: Uncontrolled diabetes can lead to dry mouth due to increased glucose levels in the saliva and decreased saliva production.
  • Anxiety and stress: Can lead to mouth breathing and decreased saliva production, resulting in dry mouth.

• Do Not Miss Diagnoses:

  • Sarcoidosis: A condition that can affect various parts of the body, including the salivary glands, leading to dry mouth.
  • HIV/AIDS: Can cause 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 of stem cell or bone marrow transplants that can affect 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 can lead to iron overload, potentially affecting the salivary glands and causing dry mouth.
  • Ectodermal dysplasias: A group of genetic disorders that can affect the development of teeth, hair, nails, and salivary glands, leading to dry mouth.
  • Radiation therapy: Head and neck radiation can damage the salivary glands, resulting in dry mouth.