BMJ 2007;334:534 (10 March), doi:10.1136/bmj.39036.433542.68
Practice
10-minute consultation
Dry mouth
Mark Taubert, specialist registrar in palliative medicine1, Eleanor M R Davies, general practitioner2, Ian Back, consultant in palliative medicine1
1 Holme Tower Marie Curie Centre, Penarth CF64 3YR, 2 Fairwater Health Centre, Cardiff CF5 3JT
Correspondence to: M Taubert mtaubert@hotmail.com
| The first 150 words of the full text of this article appear below. |
A 67 year old man presents with a six week history of dry mouth (xerostomia). He has prostate cancer, which has spread to his spine, and he takes opiates for pain relief. Recently, he started taking an antidepressant. He finds having a dry mouth frustrating as it interferes with his speech and chewing and he can no longer taste his food.
What issues you should cover
Dry mouth has many causes and is commonly encountered in patients with cancer.
History
Consider what the patient is experiencing and what he is finding most distressing. Dry mouth can affect quality of life by causing dysphagia, loss of taste, or prolonged chewing.
Establish the underlying cause(s)—for example, nasal obstruction can cause mouth breathing, with resulting dryness of lips, mouth, and throat. Assess hydration status and fluid intake. Ascertain his mental state and determine his ability to take care of himself. Anxiety can be a cause of dry mouth as
Examination
Medications with antimuscarinic properties
What you should do
Treat reversible causes
Symptomatic management
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