Dry mouth in children

Overview

Dry mouth (also called xerostomia) means your child's mouth does not make enough saliva. Saliva is the liquid that keeps the mouth moist, helps with swallowing, and protects teeth from cavities.

Dry mouth is fairly common in children, especially when they take certain medicines (like for allergies or ADHD) or when they are dehydrated from fever or not drinking enough.

It can affect children of any age, but it is more common in those who breathe through their mouth (often due to allergies or a stuffy nose), take certain medications, or have health conditions that affect saliva production.

Symptoms

Common symptoms

• Dry feeling in the mouth
• Sticky or thick saliva
• Cracked lips or corners of the mouth
• Bad breath
• Difficulty swallowing or chewing
• Trouble speaking or dry tongue

Symptoms in children

• Fussiness or crying during feeding
• Trouble eating dry foods like crackers
• Complaints of a 'cotton mouth' feeling
• Increased cavities or tooth decay
• Difficulty paying attention because of mouth discomfort

Symptoms in older adults

• Dry mouth in older adults is usually due to medications or aging. This article focuses on children, but similar symptoms apply—dryness, difficulty swallowing, and increased cavities.

Causes

Main causes

• Medicines (such as some for ADHD, allergies, or colds)
• Dehydration (not drinking enough water, fever, vomiting, or diarrhea)
• Mouth breathing (often from a stuffy nose or enlarged tonsils)
• Anxiety or stress
• Medical conditions that affect saliva glands (e.g., Sjögren's syndrome, diabetes, or HIV)
• Radiation therapy (rare in children)

Risk factors

• Taking certain medicines
• Being a mouth breather
• Having a fever or being dehydrated
• Having a medical condition that affects saliva production

When to see a doctor

See a doctor urgently if:

• Call your local emergency number if your child has trouble breathing or swallowing, or if their mouth, tongue, or throat swells suddenly.

Book a routine appointment if:

• If dry mouth lasts more than a few days despite drinking more water
• If your child has trouble eating or speaking because of the dryness
• If your child has mouth sores or signs of infection (redness, pus)
• If you notice increased cavities or tooth discoloration

Diagnosis

The doctor will ask about your child's symptoms, medicines, and drinking habits. They will look inside your child's mouth to check for dryness, cavities, or other problems.

Tests that may be done

• Blood tests to check for dehydration or underlying conditions
• Saliva tests to measure how much saliva your child produces
• Sometimes a small biopsy of lip gland (rare)

What to expect at your appointment

The doctor may ask your child to open wide, stick out their tongue, or sip water. They may review any medicines your child takes. The visit is usually quick and comfortable.

Treatment

Treatment focuses on the cause. For example, if a medicine is causing it, the doctor may adjust the dose or switch medicines. If dehydration is the cause, increasing fluids will help.

Self-care at home

• Encourage your child to drink small sips of water throughout the day
• Use a cool-mist humidifier in the bedroom at night
• Offer sugar-free gum or sugar-free hard candies for older children who can chew safely (age 4+ under supervision)
• Avoid sugary drinks, caffeine, and salty snacks
• Practice good oral care: brush with fluoride toothpaste twice a day, and consider fluoride rinse or varnish from the dentist
• Use plain water mist spray for quick relief

Medical treatments

If home care is not enough, a doctor may recommend saliva substitutes (like special mouthwashes or sprays) or medicines that help the body make more saliva. These are prescribed based on your child's specific needs. Always talk to your doctor before trying any new product.

When is surgery considered?

Surgery is rarely needed for dry mouth. It may be considered if a blockage in the saliva gland is causing the problem.

Living with this condition

Dry mouth is a manageable condition. The key is to keep your child's mouth moist and protect their teeth. Offer frequent small drinks, avoid sticky or sugary foods, and keep up with regular dental check-ups.

Lifestyle tips

• Encourage nose breathing by treating stuffy noses or allergies
• Avoid giving your child foods or drinks that dry the mouth, like caffeine or very dry crackers
• If mouth breathing at night, consider a humidifier or saline spray

Diet and exercise

Soft, moist foods are easier to eat. Offer soups, yogurts, smoothies, and applesauce. Avoid dry, hard, or salty foods. Staying hydrated is also important during exercise. Make sure water is always available.

Mental health and emotional wellbeing

Mild dry mouth is not harmful, but it can be annoying or make your child feel self-conscious about their breath. Reassure your child that it is common and usually temporary. Good oral hygiene and sugar-free gum can help with bad breath.

Prevention

Many cases can be prevented by making sure your child drinks enough water, especially when they are sick or active. Treating mouth breathing from allergies or a stuffy nose can also help. If your child takes medicines that cause dry mouth, talk to the doctor about alternatives.

Complications

If left untreated

• Increased risk of tooth decay and cavities
• Oral infections, like thrush (yeast infection)
• Difficulty eating, leading to poor weight gain
• Mouth sores and cracked lips that can get infected

Long-term outlook

With proper care, dry mouth in children is usually temporary and easy to manage. Treating the cause and practicing good oral hygiene can prevent most problems. Most children return to normal quickly.

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