Xerostomia results from the loss of saliva that may develop as a side effect from the use of medications, as a manifestation of sjogrens syndrome secondary to a number of connective tissue diseases or as a complication of radiation therapy. After exclusion of treatable causes, treatment is symptomatic to prevent the consequences of salivary hypofunction, such as tooth decay and infection of the oral mucosa. Risk factors and symptoms associated with xerostomia. Xerostomia in the older adult population, from diagnosis to. Additional topics included the physiology of salivary function and the management of xerostomia and its complications. Causes of xerostomia in the geriatric population have been attributed to the use of medications, chronic disorders, and radiation therapy to the head and neck region. Xerorstomia or dry mouth is common among older adults and may be caused by systemic diseases, medications and head and neck radiotherapy. Other druginduced pericarditides can occur with the use of such agents as pro. Smoking, including vaping and use of ecigarettes, has a strong association with dry mouth and should be minimized or discontinued altogether.
Herve sroussi, dmd, phd abstract saliva is a key element in oral homeostasis, oral function and maintenance of oral health. This helps in stimulating the salivary glands to secrete more saliva. Xerostomia can make it difficult to speak, eat, and digest food and can lead to malnutrition. Acupuncture and electrostimulation are being studied as a treatment for xerostomia. Xerostomia is the subjective complaint of oral dryness which may lead to the development of angular cheilitis, mucosal ulceration and leukoplakia. Oct 01, 2008 older persons are at risk of chronic diseases of the mouth, including dental infections e. Physiological factors affecting salivary flow rate oral sugar clearance, and the sensation of dry mouth in man. Remedies for xerostomia usually are palliative but may offer some protection from the. A dryness of the mouth from salivary gland dysfunction, often seen in patients with sjogren syndrome. Although dry mouth is most frequently associated with altered salivary gland function, there are other etiologies for this oral issue. The size, texture and tenderness of salivary glands should be assessed. Dentists should be able to diagnose this condition and administer appropriate treatment to provide acceptable level of comfort and function of denture wearers. Maintaining optimal oral health during and after treatment will facilitate adequate hydration and nutrition, reduce severity of xerostomia and preventminimize oral complications ensure dentures and other appliances fit well prior to treatment.
Pdf xerostomia commonly called as dry mouth, is the sub jective feeling of oral dryness. Salivary secretory disorders, inducing drugs, and clinical. For druginduced xerostomia, using the lowest effective dose or switching to an alternative medication may help. She was initially started on nicotinic acid as it is the most effective treatment for elevated lipoprotein a however as it caused her adverse side effects it was stopped and she was subsequently commenced on 20 mg. It causes several signs and symptoms, and compromise oral functions and healthrelated qualityoflife. Xerostomia also is a frequent complication of radiation therapy. It is a condition that primarily affects older adults and can have a significant negative effect on ones quality of life. Dh are often the first to observe dry mouth during the intraoral exam and the first to hear the complaints of the patients of the discomforts caused early diagnosis and early treatment of sjogrens syndrome or other cause of xerostomia can provide a major contribution to the general and oral health as well as comfort of the patient.
If dry mouth is associated with correctable causes and correction of underlying causes doesnt improve the condition, several additional steps are critical. Treatment of dry mouth is aimed at both minimizing its symptoms and preventing oral complications with the employment of sialogogues and topical acting substances. A 55yearold asian lady, nonsmoker, and a teetotal with bilateral xanthelasma was commenced on simvastatin in august 2011 due to hypercholesterolemia and elevated lipoprotein a. Managing xerostomia and salivary gland hypofunction american. It is important to recognize that xerostomia is not a diagnosis, but a symptom with multiple possible causes. When xerostomia is the result of a reduction in salivary flow, significant oral complications can occur. Additional topics included the physiology of salivary function and the management of xerostomia.
Use of a humidifier is useful for those who snore andor breathe through their mouth. Clinicians may encounter symptoms of xerostomia, commonly called dry mouth, among patients who take medications, have certain connective tissue or immunological disorders or have been treated with radiation therapy. Xerostomia or dry mouth is a condition that is frequently encountered in dental practice. Taking multiple medications the risk is increased 2,3up to 50% in patients taking 35 medications having diabetes due to medications or high blood sugar levels4. The underlying etiology of xerostomia includes a variety of systemic diseases and local factors. It may be recommended to remove dentures for part or all of treatment. Xerostomia, or dry mouth, is common among elderly people and is typically associated with decreased salivary gland function.
Xerostomia is the medical term for the subjective complaint of dry mouth which may or may not be associated with a lack of saliva. Pdf diagnosis and treatment of xerostomia dry mouth. The term is derived from the greek words xeros meaning dry and stoma meaning mouth. Xerostomia, dry mouth, treatment, adverse effect, psychiatric. Various studies reveal an association of xerostomia with increasing age and female gender. A systematic approach should be employed to determine the etiology of this condition, with. The nonsurgical treatment of patients with periodontal disease. Xerostomia, also known as dry mouth, is a common but frequently overlooked condition that is typically associated with salivary gland hypofunction, which is the objective measurement of. Mar 14, 2015 the subjects had xerostomia over 3 months and a measured hyposalivation.
Xerostomia is defined as the complaint of oral dryness. To view the figures for this article, please download the pdf. The clinician needs to identify the possible causes and provide the patient with appropriate treatment. It is also caused by irradiation of the head and neck region or by damage to or disease of the salivary glands. Xerostomia, commonly known as dry mouth, is a reported side effect of 1,800 drugs from 80 classes. It also causes significant problems in denture retention.
Xerostomia, saliva, dental implications, management. At the end of each treatment phase, subjects returned for a follow up evaluation. Xerostomia is a debilitating side effect of statins. The following list of medications are in some way related to, or used in the treatment of this condition. Extreme dry mouth and salivary gland dysfunction can produce significant anxiety, permanent mouth and throat disorders, and can impair a persons quality of life. Hyposalivation in elderly patients anurag gupta, bds. Treatment options for xerostomia also include artificial saliva spray. Additionally, xerostomia often is associated with sjogrens syndrome, a condition that involves dry mouth and dry eyes and that may be accompanied by rheumatoid arthritis or a related connective tissue disease.
Xerostomia is a subjective complaint of dry mouth 1 that affects at least 1 in 10 adults. Dental hygienists play an important role in increasing awareness regarding the causes of xerostomia, its impact on the oral cavity, and management strategies. Trials have found acupuncture improves symptoms of xerostomia, 33,34 and 1 study found electrostimulation improved xerostomia in patients with sjogrens syndrome. A dry mouth can causes difficulty in speaking and swallowing, a burning or cracking tongue, cracked lips, mouth sores, reduction in the taste of flavors in food and drink, and pain. Xerostomia dry mouth is the subjective feeling of oral dryness. As such, dentists can identify early symptoms to improve patient oral comfort and function. Diagnosis and management of xerostomia and hyposalivation. Xerostomia can lead to dysphagia, dysgeusia, oral pain, dental caries, oral infection, periodontal disease, and finally can affect the healthrelated qualityoflife. A drug or substance that increases the rate of salivary flow is termed a sialogogue. The study was 3 weeks in duration, with 2 treatment phases of 1 week and a 7 day wash out period in between. Dec 23, 2015 xerostomia dry mouth may be a sideeffect of medication.
Xerostomia is a common complaint of nearly half of the elderly population and about onefifth of younger adults. More studies are required to investigate whether patients discontinue this vital medication due to oral. Managing xerostomia and salivary gland hypofunction. Xerostomia an overview italian journal of dental medicine. In those over 65 years of age, prevalence approaches 25%, while rates in institutionalised elderly people. Xerostomia is an uncomfortable condition and a common oral complaint for which patients may seek relief from dental practitioners. Xerostomia dry mouth is a common complaint with widespread implications such as impaired quality of life, oral pain, and numerous oral complications. Xerostomia pronounced zerosto meah is the medical word for the sensation of dry mouth often due to decreased or absent saliva.
Xerostomia is a subjective complaint of dry mouth that affects at least 1 in 10 adults. The subjects had xerostomia over 3 months and a measured hyposalivation. There are a variety of salivary and nonsalivary causes of xerostomia, the most frequent being medication side effects and systemic disorders. Complications of xerostomia include dental caries, candidiasis or difficulty with the use of dentures. Xerostomia is defined as dry mouth resulting from reduced or absent salivary flow. Individuals with xerostomia complain of problems with. Xerostomia, or dry mouth, is a very common symptom amongst the terminally ill and can have profound. Common side effects include excessive sweating, nausea, rhinitis, and diarrhea. The etiology of xerostomia dimensions of dental hygiene. All healthcare professionals are encouraged to investigate dry mouth. Association between salivary flow rates oral symptoms and oral mucosal status. Xerostomia can also be a consequence of systemic disease and its recognition is a valuable aid in the treatment. Saliva plays a critical role in the preservation of oropharyngeal.
Medicationinduced xerostomia and hyposalivation will increasingly become oral health issues for older and geriatric patients because of the likely high prevalence of medication intake and polypharmacy, with a complex negative impact on other symptoms such as dysphagia, caries incidence, malnutrition, and quality of life. Xerostomia, or dry mouth syndrome, can be caused by medication, systemic diseases such as sjogrens syndrome, glandular pathologies, and radiotherapy of the head and neck. The aim of this study was to investigate the perception of dry mouth among dental patients and explore the possible risk factors and symptoms associated with this condition. Sometimes patients will need prescription strength medication. Common oral conditions in older persons american family. X erostomia, or the subjective feeling of a dry mouth, is a common complaint. The objective of this study was to evaluate the difference between the combination agent of xylitol, beatine and olive oil in a chewable capsule versus the control agent of a sorbitol tablet in subjects with hyposalivation and xerostomia. Xerostomia represents a serious problem with medical and oral consequences. Remedies for xerostomia usually are palliative but may offer some protection from the conditions more significant complications.
In cases of alzheimers disease or stroke, patients may complain of dry mouth in the presence of. It is a potentially debilitating condition that can affect up to 1 in 5 oncology patients, with higher prevalence in women and the elderly. The most common cause is the use of certain systemic medications, which make the elderly at greater risk because they are usually more medicated. By sharing your expertise and discussing treatment options early, you can help patients control their xerostomia before permanent damage occurs. Out of these patients 1723 showed improvements following the discontinuation of statin treatment for a period of two weeks. Medications and dry mouth medications are the most common cause of dry mouth, and 80% of the most commonly prescribed. Xerostomia is the subjective sensation of dry mouth, which is often but not always associated with hypofunction of the salivary glands. Patients with dry mouth exhibit symptoms of variable severity that are commonly attributed to. Managing dry mouth how to comfort and care for this condition also known as xerostomia. Xerostomia is a common oral concern for many patients.
Understanding the diagnosis and the treatment of dry. Jul 29, 2009 xerostomia dry mouth is a common complaint with widespread implications such as impaired quality of life, oral pain, and numerous oral complications. Discuss early recognition dh are often the first to observe dry mouth during the intraoral exam and the first to hear the complaints of the patients of the discomforts caused early diagnosis and early treatment of sjogrens syndrome or other cause of xerostomia can provide a major contribution to the general and oral health as well as. The effect of a combination saliva substitute for the. Patients with a persistently dry mouth may develop a burning or scalded sensation and have poor oral hygiene. Treatment is primarily palliative, with emphasis on the use of saliva substitutes.
Cevimeline is an oral cholinergic agent approved for symptomatic treatment of dry mouth in patients with sjogrens syndrome. Mar 24, 2018 xerostomia dry mouth xerostomia is a disorder in salivary secretion etiology sjogrens syndrome ss clinical features management treatment summarized slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Treatment methods for xerostomia vary and can be local or systemic. Xerostomia, also known as dry mouth, is a common but frequently overlooked condition that is typically associated with salivary gland hypofunction, which is the objective measurement of reduced salivary flow. The condition is also informally known as xerostomia, pasties, cottonmouth, drooth, doughmouth, or des. Xerostomia perspectives on swallowing and swallowing. Multiple reasons are proposed to describe the etiology of xerostomia such as local factors, psychogenic factors, and systemic. Xerostomia may also be a consequence of systemic disease, and early recognition may aid in treatment. Dry mouth is also a common complaint in patients with diabetes mellitus. Xerostomia, or dry mouth, is a common complaint that may be caused by several conditions, which include side effects of a wide variety of drugs, such as antidepressants, therapeutic radiation to the head and neck, dehydration, diabetes, and diseases involving salivary glands, such as sjgrens syndrome. Patients with xerostomia often do not have objective signs of hyposalivation. You should avoid smoking or chewing tobacco, if that is the etiology in your case.
Adequate and wellcontrolled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy. Xerostomia is the subjective sensation of oral dryness, which can be influenced by etiological factors including the use of several types of medications, sjogrens and metabolic syndromes, head and neck irradiation, among others. Saliva is important for hydration, lubrication and cleansing in the oral cavity. Xerostomia often develops when the amount of saliva that bathes the oral mucous membranes is reduced. Dry mouth has multiple oral health consequences and affects quality of life. Xerostomia is a subjective sensation of dry mouth which is a common complaint among older patients during periods of anxiety, radiation therapy and immunological disorders, which lead to increased frequency of caries, candida infection, dysarthria and dysphagia. Xerostomia is defined as a subjective complaint of dry mouth that may result from a decrease in the production of saliva. The literature pertaining to xerostomia represented the disciplines of oral medicine, pathology, pharmacology, epidemiology, gerodontology, dental oncology, immunology and rheumatology. Mar 01, 2012 xerostomia, dry mouth, is a common and chronic problem that not only impacts a patients comfort but can adversely affect swallowing and vocal abilities.
This article will look at the causes, symptoms, diagnosis, and treatment. The efficacy of cevimeline hydrochloride in the treatment of xerostomia in sjogrens syndrome in southern chinese patients. Xerostomia, dry mouth, is a common and chronic problem that not only impacts a patients comfort but can adversely affect swallowing and vocal abilities. The study was 3 weeks in duration, with 2 treatment phases of 1 week and a. Individuals with xerostomia complain of problems with mastication, phonetics, deglutition and wearing dentures. Etiology, evaluation, and management of xerostomia. Dry mouth is a condition that results from a decreased volume of saliva in the mouth. Medicationinduced xerostomia and hyposalivation in the. Past medical history should inquire about conditions associated with xerostomia, including sjogren syndrome, history of radiation treatment, head and neck trauma, and a diagnosis of or risk factors for hiv infection. Aug 28, 2011 xerostomia represents a serious problem with medical and oral consequences. This video explains what xerostomia or dry mouth is, analyzes its causes, describes how it is diagnosed and presents treatment options.