Xerostomia: Part 2. investigations and management

In the first part of this two-part series on xerostomia, or dry mouth, the aetiology and oral manifestations were explored, with particular attention being paid to the impact dry mouth can have on both a patient's oral health and their oral health-related quality of life. In Part 2, its diagnosis and symptom management are discussed.

When diagnosing xerostomia a thorough history should be obtained from the patient in order to establish the duration and severity of their symptoms, as well as the impact on the patient's quality of life. The history should then be focused to try and identify any potential underlying causes, such as associated systemic diseases including diabetes mellitus and rheumatological conditions that may raise the suspicion of Sjögren's syndrome. A comprehensive drug history should then follow to identify whether the patient is taking any medications that are implicated in inducing xerostomia. A social history including smoking status, alcohol consumption and illicit drug use should also be taken.