Xerostomia: Clinical Aspects and Treatment

Abstract

Xerostomia or dry mouth is a condition that is frequently encountered in dental practice. The most common cause is the use of certain systemic medications, which make the elderly at greater risk because they are usually more medicated. Other causes include high doses of radiation and certain diseases such as Sjogren's syndrome. Xerostomia is associated with difficulties in chewing, swallowing, tasting or speaking. This results in poor diet, malnutrition and decreased social interaction. Xerostomia can cause oral discomfort, especially for denture wearers. Patients are at increased risk of developing dental caries. A thorough intraoral and extra-oral clinical examination is important for diagnosis. Treatment may include the use of salivary substitutes (Biotene), salivary stimulants such as pilocarpine, ongoing dental care, caries prevention, a review of the current prescription drug regimen and possible elimination of drugs having anticholinergic effects. Because of the ageing population, and the concomitant increase in medicated individuals, dentists can expect to be presented with xerostomia in an increasing number of patients in the coming years and therefore should be familiar with its diagnosis and treatment. Therefore, the purpose of this review is to outline for clinicians the common aetiologies, clinical identification, and routine therapeutic modalities available for individuals with xerostomia.

Taste of a Pill

“…In some cases, medications can produce prolonged taste disturbance that cannot be quickly reversed by drug cessation (1). Taste-related adverse effects can significantly impact a patient's quality of life, dietary choices, emotional state, and compliance with medication regimens, especially in pediatric and geriatric populations (1)(2)(3). As taste receptors are located in taste buds on the tongue, the physical presence of a drug substance in saliva is a prerequisite for taste disturbance caused by many medications.…”

Development of Poly(Ethylene Glycol) Hydrogels for Salivary Gland Tissue Engineering Applications

“…However, no current treatment can fully restore or emulate the myriad functions of the salivary gland, leading to oral health deficiencies. 1,2 The salivary gland is composed of two major cell types: acinar cells that initiate salivary secretion and duct cells that propel and modify the ionic components of the secretions. 3 Although the salivary gland does not regenerate after radiation damage, it exhibits regenerative potential after mild insults.…”

The Effect of a Combination Saliva Substitute for the Management of Xerostomia and Hyposalivation

“…The published research does provide similar, although not significant, prevalence rates ranging between 20 and 30 %, with a higher incidence in older women and in polymedicated individuals [7,[9][10][11][12]. Interestingly, there is some indication that there is an upward trend in younger adults, although the etiology is unknown [12].…”

“…Functionally, there can be impairment in speaking, chewing, swallowing and taste perception [1][2][3][4][5][9][10][11][12][13][14][15][16][17][18]. Dentally, there is a demineralization of the teeth, progressive periodontal disease, and mucositis [1-4, 9-11, 16, 18].…”

“…Dentally, there is a demineralization of the teeth, progressive periodontal disease, and mucositis [1-4, 9-11, 16, 18]. As the disease progresses, other than dry oral mucosa and saliva thickening, there have been reports of mouth burning, pain, depression, irritability and sleep alterations [1,4,5,9,11,12,[14][15][16][17].…”