What does this mean?
Tears and saliva are made in separate glands, but those glands are built alike and work in similar ways. Both falling off at the same time brings to mind a shared cause affecting all of them rather than two separate coincidences. The immune system turning on these glands is one of the known reasons; some medicines, and radiotherapy given to the head and neck, can produce the same pairing.
What sets this apart from a dry mouth on its own is the pairing itself and how long it lasts. In the eyes it is described not as burning but as a gritty soreness, as though sand had got in; lids that stick together in the morning; discomfort that grows while looking at a screen. In the mouth what stands out is not being able to swallow dry bread without water, and needing a pause when you talk for any length of time. Dryness in both places that has lasted more than three months and happens almost every day is looked into differently from a few weeks of passing dryness. Dryness caused by a medicine usually falls in the same period as starting a new one; where the glands themselves are affected, it comes on quietly and swelling in the glands may be added from time to time.
This pairing is not diagnosed in dentistry. Blood tests, tests of the surface of the eye and, where needed, a small sample of gland tissue taken from inside the lip belong to the assessment carried out by rheumatology and by eye specialists. The dentist's part is long-term monitoring: when the flow drops, decay can multiply quickly in unusual places on the tooth, on root surfaces and along biting edges, oral thrush can keep coming back and dentures can become harder to wear.
Two groups of glands drying up at the same time points to a shared cause. The headings below are the possibilities looked into behind this pairing; which one applies is decided by examination and tests.
Likely causes
What helps at home?
- Write down separately when each of the two started; which came first, and which change of medicine it coincided with, shortens the assessment.
- Do not stop your prescribed medicines on your own and do not start supplements you have read about; a change made before the cause is known upsets the treatment you actually need and muddies the picture.
- Do not keep wetting your mouth with acidic drinks and do not suck sugary lozenges or sweets; when saliva is scarce, that habit produces decay within a short time.
- When you see the dentist, mention the dryness in your first sentence; how often you are seen and the preventive care you are given are planned around it.
- If both kinds of dryness have lasted more than three months and happen almost every day
- If the glands under your jaw or in front of your ear swell up again and again
- If the dryness comes with painful, swollen joints, long-lasting tiredness or a skin rash
- If you have developed pain in the eye, difficulty tolerating light, or blurred vision
- If you have noticed several new cavities or broken teeth within a few months
Frequently asked questions
- Is this Sjögren's syndrome?
- Having these two symptoms together brings Sjögren's syndrome to mind, but on its own it does not make the diagnosis. Medicines, a history of radiotherapy, some hormonal conditions and other connective tissue diseases can produce the same pairing. Telling them apart is done with blood tests, tests of the surface of the eye and, where needed, a small tissue sample. That assessment is led by rheumatology.
- Who should I see first?
- The place that will assess the whole picture is rheumatology; eye specialists come in for the state of the surface of the eye, and the dentist for what is happening in the mouth. If you already see a dentist, it helps to mention the dryness, because signs in the mouth are often the first to be noticed. The order can change depending on which of the two bothers you more.
- Why have my teeth suddenly started breaking down?
- When saliva flow drops, the three things that protect a tooth weaken at once: acid is not buffered, debris is not cleared away and less mineral is supplied. Under those conditions decay can start in unusual places, at the gum margin and along the biting edges, and it can move quickly. That is why people with dryness are seen for check-ups more often and preventive care is brought forward.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.