Mouth Dryness or Thick Saliva

Dry mouth, or xerostomia, happens when there is not enough saliva or saliva becomes very thick. This can be a side effect of radiation therapy to the head and neck areas, some types of chemo, certain other medicines, and dehydration. The glands that make saliva can become irritated or damaged and make less saliva, or your saliva can become very thick and sticky. The level of dryness can be mild or severe.

Having a dry mouth or thick saliva can increase your risk of cavities and mouth infection. If you smoke, chew tobacco, or drink alcohol, the dryness can be worse.

What to look for

  • Dried, flaky, whitish saliva in and around the mouth

  • Thick saliva that’s more like mucus and that sticks to lips when you open your mouth

  • Trouble swallowing foods or thick liquids

  • Mouth always open to breathe (mouth-breathing dries out the mouth and throat)

  • Burning tongue

  • Bits of food or other matter on the teeth, tongue, and gums

  • Tongue surface looks ridged or cracked

Treatment for dry mouth or thick saliva

Treatment for dry mouth and thick saliva includes increasing comfort and preventing infection or complications. Good mouth care and frequent sips of water are helpful ways to manage problems with dry mouth or thick saliva. Avoiding alcohol intake and tobacco, avoiding certain foods, and keeping caffeine and sugar (in candy, gum, or soft drinks) to a minimum can help keep a dry mouth and thick saliva from getting worse. If you are having trouble eating or are eating less, talk to your cancer care team about whether nutritional supplements may be helpful.

What the patient can do

  • Rinse your mouth every 2 hours with a solution recommended by your cancer care team.
  • Take small bites, and chew your food well.
  • Sip liquids with meals to moisten foods and help with swallowing.
  • Add liquids (such as gravy, sauce, milk, and yogurt) to solid foods.
  • Try ice chips, sugarless hard candies, and sugarless chewing gum.
  • Keep cold water nearby for frequent sips between meals and mouth rinses.
  • Rinse or spray mouth often using artificial saliva, which is sold in drugstores.
  • Use petroleum jelly, cocoa butter, or a mild lip balm to keep lips moist.
  • Suck on sugarless candy or chew sugarless gum to stimulate saliva. Citrus, cinnamon, and mint flavors often work well.
  • Use a cool mist humidifier to moisten room air, especially at night. (Be sure to keep the humidifier clean to avoid spreading bacteria or mold in the air.)
  • Avoid drinking alcohol.
  • Avoid tobacco.
  • Avoid hot, spicy, or acidic foods.
  • Avoid chewy candies, tough meats, pretzels and chips, and hard raw fruits or vegetables.
  • Avoid store-bought mouthwashes containing alcohol.

What caregivers can do

  • Offer small, soft meals with extra sauce or dressings for dipping.
  • Offer ice cream, gelatin desserts, ice chips, and frozen drinks.
  • Keep liquids nearby for frequent sipping.
  • Help the patient track their fluid intake, and encourage them to take in 2 to 3 quarts of liquid each day, if the care team approves. Ice, ice cream, sherbet, popsicles, and gelatin count as liquids.

Call the cancer care team if the patient

  • Has trouble breathing (or call 911 if necessary)
  • Can't eat or drink
  • Can’t take medicines or swallow pills
  • Has dry, cracked lips or mouth sores
  • Has a dry mouth that is a new symptom for more than 3 days

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Brown C. Mucositis. In Brown CG, ed. A guide to oncology symptom management. 2nd ed. Pittsburgh, PA: Oncology Nursing Society; 2015: 469-482.

Fall-Dickenson J, Cordes S, Berger AM.  Oral complications. In DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2019:-2094-2108.

Lalla, RV et al. Mucositis guidelines leadership group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology. (2014). MASCC/ISOO evidence based clinical practice guidelines for mucositis secondary to cancer therapy. Cancer. 2014;120:1453–1461. doi:10.1002/cncr.28592

Majithia N, Hallemeier CL, Loprinzi, CL.  Oral complications. In Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:607-620. 

National Comprehensive Cancer Network (NCCN). Adult cancer pain. Version 3.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/pain.pdf  on September 19, 2019.

Oncology Nursing Society (ONS). Symptom intervention: Mucositis. Accessed at  https://www.ons.org/pep/mucositis on January 3, 2020. 

References

Brown C. Mucositis. In Brown CG, ed. A guide to oncology symptom management. 2nd ed. Pittsburgh, PA: Oncology Nursing Society; 2015: 469-482.

Fall-Dickenson J, Cordes S, Berger AM.  Oral complications. In DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2019:-2094-2108.

Lalla, RV et al. Mucositis guidelines leadership group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology. (2014). MASCC/ISOO evidence based clinical practice guidelines for mucositis secondary to cancer therapy. Cancer. 2014;120:1453–1461. doi:10.1002/cncr.28592

Majithia N, Hallemeier CL, Loprinzi, CL.  Oral complications. In Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:607-620. 

National Comprehensive Cancer Network (NCCN). Adult cancer pain. Version 3.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/pain.pdf  on September 19, 2019.

Oncology Nursing Society (ONS). Symptom intervention: Mucositis. Accessed at  https://www.ons.org/pep/mucositis on January 3, 2020. 

Last Medical Review: February 1, 2020 Last Revised: February 1, 2020

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