Dry mouth and medications after 60

Reviewed by Dr. Samar Fadavi, DDS

Short answer: Dry mouth after 60 is most often a side effect of medicines, especially when several are taken together. Less saliva means faster decay along the gum line, gum problems, sore spots under dentures and trouble swallowing. Sip water often, use sugarless gum or lozenges, ask about high-fluoride toothpaste and tell your dentist and pharmacist about every medicine. Never stop a medicine without talking to your doctor.

Why dry mouth matters more as we age

Saliva does far more than keep the mouth comfortable. It rinses away food, neutralizes acids, carries minerals that repair early decay, helps you taste, chew and swallow, protects the gums and helps dentures stay in place. When saliva drops, the mouth loses much of its natural protection.

Ageing on its own does not dry the mouth much in healthy people. The main reason older adults have dry mouth is medicine. Many adults over 60 take several prescription and over-the-counter medicines every day, and a large number of common medicines reduce saliva. The effect adds up when they are combined.

This guide explains which medicines commonly cause dry mouth, how it affects teeth, gums and dentures, what helps at home and what the dentist can do. It is general information for older adults and caregivers in Scarborough, the Danforth and East Toronto. Our seniors’ dental care page explains how we care for older patients at our clinic.

Signs of dry mouth

• A sticky, dry or burning feeling in the mouth.
• Thick or stringy saliva.
• Waking at night needing a drink of water.
• Trouble chewing, swallowing or speaking, especially with dry foods like crackers or bread.
• Cracked lips or sores at the corners of the mouth.
• A dry, rough or red tongue.
• Changes in taste or a metallic taste.
• Bad breath.
• Dentures that feel loose, rub or cause sore spots.
• New cavities, especially near the gum line or around old fillings and crowns.

The medical term for the feeling of dry mouth is xerostomia. Our guide on salivary glands and saliva explains how saliva is made and what it does.

Medicines that commonly cause dry mouth

Hundreds of medicines list dry mouth as a side effect. Common groups include:

• Blood pressure medicines, including some diuretics (water pills) and beta blockers.
• Antidepressants and anti-anxiety medicines.
• Bladder control medicines for overactive bladder.
• Antihistamines and decongestants for allergies, colds and sleep.
• Pain medicines, especially opioids.
• Medicines for Parkinson’s disease.
• Some medicines for COPD and asthma taken by inhaler.
• Sleep aids and muscle relaxants.
• Some medicines for psychosis, nausea and vertigo.

Taking several medicines together, called polypharmacy, increases the effect. A person who takes five or more daily medicines is much more likely to notice dry mouth than someone taking one.

Other causes

• Diabetes, especially when blood sugar runs high.
• Sjögren’s syndrome and other autoimmune conditions.
• Radiation treatment to the head and neck, and some cancer medicines.
• Breathing through the mouth, snoring or using a CPAP machine without a humidifier.
• Not drinking enough fluids, especially in hot weather or with illness.
• Smoking, alcohol and a lot of caffeine.

How dry mouth affects teeth, gums and dentures

Root cavities

Many older adults have some gum recession, which exposes the roots of the teeth. Roots are softer than enamel and decay much faster, especially without saliva. Decay at the gum line and around old crowns can spread quickly and quietly. Our guide on gum recession explains why roots become exposed.

Gum problems

Without saliva’s rinsing and protection, plaque builds up more easily, and gums can become inflamed and bleed.

Denture problems

Dentures rely on a thin film of saliva for suction and comfort. With dry mouth, dentures can feel loose, rub and cause sore spots. Our guide on dentures: types, fit and daily care explains how to look after them.

Thrush and mouth infections

A dry mouth is more prone to yeast infections, called thrush, which can cause white or red patches, burning and sore corners of the mouth.

Eating, swallowing and nutrition

When chewing and swallowing are hard, people often switch to soft, sweet or processed foods, which can feed decay and reduce nutrition. Trouble swallowing can also make taking pills harder.

What helps at home

1. Sip water often through the day and keep a glass or bottle within reach, including at night.
2. Use sugarless gum or lozenges, ideally with xylitol, to stimulate saliva. Avoid regular candy, mints or cough drops with sugar, which feed decay.
3. Try a saliva substitute gel, spray or rinse from the pharmacy, especially at night.
4. Use a humidifier in the bedroom, and ask about a humidifier for a CPAP machine.
5. Choose a mouthwash without alcohol. Alcohol-based rinses dry the mouth further.
6. Brush twice a day with fluoride toothpaste and clean between the teeth daily. Ask the dentist about a high-fluoride toothpaste for extra protection. Our guide on fluoride in toothpaste explains how fluoride works.
7. Limit sugary and acidic drinks and snacks, especially sipping or snacking through the day.
8. Cut back on caffeine and alcohol, which can dry the mouth.
9. Moisten foods with sauces, gravies, broth or yogurt, and take small bites with sips of water.
10. Breathe through your nose when you can, and keep lips moist with a lip balm.
11. Take dentures out at night and clean them every day, unless your dentist advises otherwise.

What to avoid

• Do not stop or change any prescribed medicine on your own because of dry mouth. Talk to your doctor or pharmacist first.
• Avoid sucking on hard candy or sugary mints for relief.
• Avoid mouthwashes that contain alcohol.
• Avoid tobacco, which worsens dry mouth and raises the risk of gum disease and oral cancer.
• Avoid sipping juice, pop, sweet tea or sweetened coffee throughout the day.
• Avoid going a long time between dental visits.

Talk to your doctor and pharmacist

Dry mouth is a known side effect that your health team can often help with. Bring a complete list of your medicines, including over-the-counter products, vitamins and supplements, to your doctor or pharmacist and mention dry mouth. They may be able to:

• Change the time of day you take a medicine.
• Adjust a dose.
• Suggest a different medicine with less drying effect.
• Review whether every medicine is still needed.
• Recommend a saliva substitute or a medicine that stimulates saliva, when appropriate.

A yearly medication review with a pharmacist is a good habit for anyone taking several medicines.

What the dentist can do

• Check saliva and the mouth. The dentist can see signs of dry mouth, check the soft tissues and look for early root decay.
• Prescribe high-fluoride toothpaste or apply fluoride varnish at visits to protect the roots.
• Suggest more frequent check-ups and cleanings, often every three to four months, to catch decay early. Our guide on how often to see a dentist explains why intervals differ.
• Treat small cavities early with tooth-coloured fillings.
• Adjust or reline dentures that have become loose or sore.
• Treat thrush and other mouth infections.
• Screen for oral cancer at every exam. Our guide on oral cancer explains what is checked.
• Work with your doctor when a medical cause of dry mouth is suspected.

A daily routine for a dry mouth

Morning

• Drink a glass of water.
• Brush for two minutes with fluoride toothpaste. Spit, do not rinse.
• Clean dentures and soak them as directed.

During the day

• Keep water nearby and sip often.
• Chew sugarless gum or use a lozenge after meals.
• Choose water or milk over sweet drinks.

Evening

• Clean between the teeth with floss or interdental brushes.
• Brush with fluoride toothpaste, or high-fluoride toothpaste if prescribed. Spit, do not rinse.
• Apply a saliva substitute gel if you wake with a dry mouth.
• Run a humidifier in the bedroom.

For caregivers

If you help an older parent or partner with daily care, watch for signs that dry mouth is affecting eating, speaking or denture comfort. Offer water often, keep sugary snacks to mealtimes and help with brushing if hands are stiff or weak. Electric toothbrushes and toothbrushes with large handles can make brushing easier. Keep a current medicine list in the wallet or on the phone for every appointment.

Foods that are easier with a dry mouth

• Soups, stews and casseroles with plenty of broth or sauce.
• Cooked cereals such as oatmeal, made a little thinner than usual.
• Soft fish, eggs and tofu with a sauce.
• Well-cooked vegetables and soft fruit such as melon, ripe pears and berries.
• Yogurt and cottage cheese, which are also gentle on the teeth.
• Bread dipped in soup or softened with spreads, instead of dry toast or crackers.

Foods that are harder to manage include dry crackers, chips, tough meats, very spicy dishes and sticky sweets. Salty and acidic foods can also sting a dry mouth.

Keeping a medicine and mouth diary

If you are not sure which medicine is drying your mouth, keep a simple diary for two weeks. Note each medicine and the time you take it, when your mouth feels driest, what you ate and drank and how you slept. Bring the diary to your doctor, pharmacist and dentist. Patterns, such as dryness that starts an hour after a certain pill, can help your health team decide whether a change in timing or a different medicine might help.

Myths about dry mouth

• “Lemon drops help.” Sour candy does make saliva flow, but sugary and acidic sweets harm the teeth. Choose sugarless lozenges instead.
• “Dentures mean you no longer need the dentist.” Gums, fit and oral cancer screening still need a yearly check.
• “A strong mouthwash will fix dry mouth.” Many strong mouthwashes contain alcohol, which dries the mouth further.

When to see a dentist

Book a visit if:

• Your mouth feels dry most of the time.
• You notice new cavities, brown spots near the gum line or sensitive roots.
• Your dentures have become loose or sore.
• You have white or red patches, burning or sores at the corners of the mouth.
• You have a sore or lump that does not heal within two weeks.
• You started a new medicine and your mouth has felt drier since.

Our seniors’ dental care page explains care for older patients, and the clinic accepts Canadian Dental Care Plan patients; our CDCP dentist page explains how coverage works.

Questions about dry mouth and medications

Is dry mouth a normal part of ageing?

Not usually. Healthy older adults still make enough saliva. Most dry mouth in older adults comes from medicines or health conditions.

Should I stop the medicine that dries my mouth?

No. Never stop or change a medicine without talking to your doctor. Ask your doctor or pharmacist whether there are options.

Does drinking more water fix dry mouth?

Sipping water helps comfort and rinses the mouth, but it does not replace saliva’s protective minerals. Fluoride and regular dental visits are still important.

What is the most helpful thing I can do for my teeth?

Use fluoride every day, keep sugar to mealtimes and see the dentist regularly so root decay is caught early.

Why do my dentures hurt more than before?

Less saliva means less cushion and suction. The denture may also need a reline. Book a visit to have it checked.

Can dry mouth affect my sense of taste?

Yes. Saliva carries flavours to the taste buds, so dry mouth can dull or change taste.

Will a CPAP machine make my mouth drier?

It can, especially if air leaks through the mouth. A heated humidifier, a chin strap or a full face mask may help. Ask the clinic that set up your machine.

How often should I see the dentist if my mouth is dry?

Many people with dry mouth do well with visits every three to four months, so early root decay is found and fluoride can be applied. Your dentist will suggest the right interval for you.

Is xylitol safe to use every day?

Sugarless gum and lozenges with xylitol are fine for most adults in normal amounts, though large amounts can upset the stomach. Keep xylitol products away from dogs, because it is toxic to them.