Xerostomia in Review

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Commonly known as dry mouth, xerostomia is the clinical name for salivary gland dysfunction. While these glands normally produce over a liter of saliva per day, dry mouth occurs when not enough saliva is produced for basic bodily functions. Salivary lubrication is necessary to chew and digest food, maintain a safe oral microbial environment, maintain the oral immune system and promote the healthy mineralization of teeth. It is also important for talking and other tongue functions.

Causes

Dry mouth is most commonly associated with medication side effects. It is one of the laundry list of side effects heard in advertisements and seen in magazines. While a wide variety of drugs cause this condition, usual medications include beta blockers, antidepressants, antihistamines, antipsychotics and diuretics as well as oral morphine and other pain medications. The likelihood of dry mouth increases with age because older patients are more likely to take these drugs.

Other diseases such as Sjogren’s syndrome or conditions such as hypothyroidism can cause dry mouth. Additionally, anxiety and depression are often associated with decreased saliva flow rates. Chemotherapy and radiotherapy to combat cancer often cause xerostomia as well, with over 90% of post-radiation patients reporting some level of dry mouth. This may be in part due to the dehydration caused by many types of cancer.

Symptoms

Dry mouth is generally associated with a dry mouth, which causes patients to need to drink lots of water. Other symptoms include difficulty speaking, loss of taste, and difficulty ingesting dry foods. Weight loss and lack of appetite are also common. Older patients with dental prostheses may find these more difficult to use, and burning tongue sensations are often reported, and dental caries are more common. Mouth ulcers and lip fissures may result, leading to secondary fungal infections.

Evaluation

Doctors typically examine patient histories to determine the incidence of xerostomia. Physical examination is another common tool, with salivary gland palpitation most emphasized. Indicators include the buccal mucosa being dry and sticky, a lack of pooled saliva, or the presence of a yeast infection. It may also be a sign of dry mouth if a woman’s lipstick often adheres to the front teeth.

Specialists may choose to use sialometry to help diagnose Sjogren’s syndrome, which is marked by a severe onset of dry mouth. This test collects saliva from the salivary glands and measures its response to citric acid stimulation. While this test is complex and occasionally produces inaccurate results, it allows medical specialists to image the salivary glands to see if there is something wrong with them or if the dry mouth is just a side effect of medication.

Prevention

The best way to prevent xerostomia is to stay hydrated and maintain a healthy diet. By avoiding drugs that may cause dry mouth or decreasing dosages, you may also help to prevent or treat this condition. Regular oral and dental hygiene is also important to keep dry mouth from affecting your oral health and even to help prevent its onset. Elderly patients are encouraged to remove their dentures before sleeping. People with dry mouth should avoid sugary, acidic or spicy foods. Alcohol and smoking may also cause dry mouth to be more severe, and reducing these practices is a good preventative measure.

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