Dry Eyes and Mouth
Welcome to our decision guide on persistent and long standing dryness of the eyes and/or mouth, a condition often called "SICCA syndrome." The name comes from the Latin word, "siccus" which means "dry."
Brief symptoms of eye dryness may be due to air blowing near your eyes, an environment with dry air (as with indoor heating), smoke or dust exposure. Dryness can complicate other eye conditions, such as eyelid disorders and bulging of the eyes (as may occur with an overactive thyroid). Temporary dryness of the mouth may accompany nervousness, anxiety and breathing through the mouth (as many people do when they sleep). Also many medications can make the mouth dry.
This guide will cover the most common reason for dry eyes and dry mouth. While these symptoms are more common among persons who are older, they are not inevitable; while tear production may decline with advancing age, symptoms are often not solely related to aging. In fact, plenty of elderly people have perfectly normal tear and saliva production.
Please keep in mind that this information cannot replace a face-to-face evaluation with your own health care provider. It is meant to provide helpful information while you are awaiting further evaluation, or to supplement what you may have already learned after evaluation with your doctors.
Click here to start with some general information.
If you have dry eyes and dry mouth, a disease called Sjogren's syndrome could be to blame; it's an autoimmune condition in which the body's immune system is thought to attack certain tissues in the body, including the glands that make tears and saliva. The next question asks about features of this disease that could make it more likely in your case.
Besides dry eyes and dry mouth, other findings are common in people with Sjogren's syndrome.
In addition to the dry eyes and dry mouth, do you have one or more of the following?
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swelling in the parotid gland(s) -- these are salivary glands located on the sides of the face, just below and in front of the ears.
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abnormalities on specialized tests of tear or saliva production performed by your doctor, usually an eye doctor or ear-nose-and-throat doctor. These tests include the Schirmer's test, Rose-Bengal staining, basal and stimulated salivary flow, or lip biopsy.
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a positive (abnormal) ANA (anti-nuclear antibody) blood test, in the blood, especially with one type of ANA called anti-Ro.
If you aren't sure if you've had any of these checked, you can get the information from your doctor's office.
Yes, I have one or more of those.
No, I don't have any of those.
Good. That makes Sjogren's syndrome less likely. It's a rheumatic disease that affects the entire body; in addition to commonly causing dry eyes and mouth, it may also cause arthritis, rash, fever, and other symptoms.
Now, on to some questions about some other possible causes of dryness of the eyes and mouth.
Have you ever been told you have blepharitis, an inflammation of the eyelids?
Common symptoms of blepharitis include awakening with mucous in the corners of the eye, a greasy appearance to the lids, a crusty, scaly material on the lashes near the lids, a grainy feeling when blinking, and redness and swelling of the lids.
Yes, I think I may have blepharitis.
No, I don't think I have blepharitis.
Okay. If you do have one or more of these, it's possible you have Sjogren's syndrome, a rheumatic disease that is related to rheumatoid arthritis. In addition to the dryness symptoms, joint pain, rash, and lung inflammation may occur.
Now, on to some questions about some other possible causes of dryness of the eyes and mouth.
Have you ever been told you have blepharitis, an inflammation of the eyelids?
Common symptoms include awakening with mucous in the corners of the eye, a greasy appearance to the lids, a crusty, scaly material on the lashes near the lids, a grainy feeling when blinking, and redness and swelling of the lids.
Yes, I think I may have blepharitis.
No, I don't think I have blepharitis.
Okay -- that's helpful information; blepharitis is one cause of eyes feeling dry, but from your answer, this does not seem likely.
Do you wear contact lenses?
Yes, I wear contact lenses.
No, I don't wear contact lenses.
Okay -- that's helpful information; blepharitis is one cause of eyes feeling dry, so, from your answer, it's possible that blepharitis is the cause of your eyes feeling dry. Treatment usually begins with warm compresses to the eyelids and a scrub with a mild soap (like baby shampoo). See your regular doctor or ophthalmologist about these and other treatment options.
Just a few more questions.
Do you wear contact lenses?
Yes, I wear contact lenses.
No, I don't wear contact lenses.
Okay, just checking, because medicines are a common cause of dry mouth. Over-the-counter drugs count, too; certain cold remedies, for example, have a tendency to dry up congested sinuses, but they also commonly cause mouth dryness.
Now, on to a question about another medical problem that may be associated with dry mouth.
Do you have diabetes?
Yes, I do have diabetes.
No, I don't have diabetes.
Well, many medicines can cause dryness of the mouth as a side effect. Check the side effect profile of your medications to see if dry mouth is a common side effect. Don't stop taking medications you were prescribed, even if you think your medication could be causing your symptoms. Check with your doctor and talk about whether an alternative medicine (or even no medicine) is a reasonable option. And keep in mind that over-the-counter medicines, such as cold remedies, can cause dryness of the mouth as well.
Do you have diabetes?
Yes, I do have diabetes.
No, I don't have diabetes.
Good. It's important to know because, among the many problems associated with diabetes, high blood sugar can lead to increased urination and excessive urination may lead to dehydration and dry mouth.
Speaking of which, other causes of dehydration are: diarrhea, vomiting, prolonged fever, taking diuretics (water pills) or poorly controlled diabetes (as above). Exercise in hot, humid weather is another common cause. Symptoms include thirst, a dizzy feeling when arising, headache and fatigue.
Do you think you may be dehydrated?
Yes, I think I may be dehydrated.
No, I don't think I'm dehydrated.
Okay. One relatively common cause of mouth dryness is poorly controlled diabetes, probably related to the frequent urination and mild dehydration that can develop if the blood sugar is high. Closer control of your blood sugars could improve the oral dryness you describe. Talk with your doctor about whether tighter blood sugar control would make sense for you.
Speaking of dehydration, now comes a related question.
Dehydration is a term that means "too little water" and is common among persons with diarrhea, vomiting, fever, those who take diuretics (water pills) or poorly controlled diabetes. Exercise in hot, humid weather is another common cause. Symptoms include thirst, a dizzy feeling when arising, headache and fatigue, and mouth dryness.
Based on this information, do you think you may be dehydrated?
Yes, I think I may be dehydrated.
No, I don't think I'm dehydrated.
Okay. This is an important question because dehydration is a relatively common cause of dry mouth.
One more question, this one is about the parotid gland, which is located just below the ear, in front of the jaw, and is one of the major salivary glands.
Have you ever had enlargement of the parotid gland?
It may have been called parotitis, or inflammation of the parotid gland.
Yes, but only on one side.
Yes, both salivary glands have been enlarged.
Nope, never had an enlarged salivary gland.
Okay. As a cause of mouth dryness, dehydration is among the most reversible; that is, it's often easy to fix: drink more fluids (unless you were instructed not to do so by your doctors). If you have an underlying medical condition that makes you prone to repeated or chronic dehydration -- such as diabetes or colitis with chronic diarrhea -- treatment of the underlying condition, rather than specific treatment of dry mouth, tends to help the most. Talk to your doctor about how you might better avoid dehydration.
One more question, this one is about the parotid gland, which is located just below the ear, in front of the jaw, and is one of the major salivary glands.
Have you ever had enlargement of the parotid gland?
It may have been called parotitis, or inflammation of the parotid gland.
Yes, but only on one side.
Yes, both salivary glands have been enlarged.
Nope, never had an enlarged salivary gland.
Good! That makes infection, obstruction or other body-wide conditions that can enlarge the parotid less likely.
If none of the conditions mentioned here seem likely to explain your symptoms, try the simple, conservative treatments and see if your symptoms resolve over time. Follow-up with your physician regularly, especially if symptoms continue or worsen. And contact your doctor right away if you have fever, swelling or significant pain in the parotid gland.
Okay. Causes of dry mouth with parotid swelling on both sides include:
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viral infections, such as mumps
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Sjogren's syndrome, an autoimmune condition marked by dry eyes, dry mouth, arthritis, lung problems and abnormal antibodies in the blood
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sarcoidosis, a condition most commonly causing enlarged lymph nodes in the chest easily seen on a chest x-ray but sometimes causing parotid enlargement
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amyloidosis, in which an abnormal protein deposits in tissues throughout the body
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high blood triglyceride levels (one of the blood lipids, often checked with cholesterol)
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alcohol abuse
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anorexia nervosa , recurrent vomiting can lead to parotid enlargement, though dry mouth is not a common symptom in this situation.
Okay.
When a person has dry mouth and swelling on one side, an obstructed salivary gland is a real possibility. The most common cause of obstruction is a stone (much like a kidney stone or gallstone), but there are other possibilities. An infection -- usually bacterial -- can also cause swelling on one side, and bacteria can complicate an obstruction.
Swelling in one parotid gland is a reason to see your doctor sooner than later. Understanding the cause is critical so that you can get prompt, appropriate treatment.
