Xerostomia

Xerostomia :

Xerostomia (pronounced /ˌzɪəroʊˈstoʊmɪə/) is the medical term for the subjective complaint of dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties, cottonmouth, doughmouth or des (like a desert). Xerostomia is also common in smokers.
Xerostomia can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva's remineralizing the enamel is no longer present, and can make the mucosa and periodontal tissue of the mouth more vulnerable to infection. Notably, a symptom of heavy methamphetamine use usually called "meth mouth" is largely caused by xerostomia which is worsened by the fact that methamphetamine at recreational doses can cause tight clenching of the jaw, bruxism (compulsive grinding of the teeth), or a repetitive 'chewing' movement like the user is chewing without food in the mouth.


- Causes :
It may be a sign of an underlying disease, such as Sjögren's syndrome, poorly controlled diabetes, or Lambert-Eaton syndrome, but this is not always the case.
Other causes of insufficient saliva include anxiety, medications, or the consumption of alcoholic beverages, physical trauma to the salivary glands or their ducts or nerves, dehydration caused by lack of sufficient fluids, excessive breathing through the mouth, previous radiation therapy, and also a natural result of aging, other conditions or factors not mentioned also can have the ability to cause dry mouth. The vast majority of elderly individuals will suffer xerostomia to some degree, although the most common cause is the use of medications. Output from the major salivary glands does not undergo clinically significant decrements in healthy older people and clinicians should not attribute complaints of a dry mouth and findings of salivary hypofunction in an older person to his or her age[1]. The results of one study suggested that, in general, objective and subjective measurements of major salivary gland flow rates are independent of age, gender, and race. Furthermore, signs and symptoms of dry mouth in the elderly regardless of race or gender should not be considered a normal sequela of aging[2]. Playing or exercising a long time outside on a hot day can cause the salivary glands to become dry as the bodily fluids are concentrated elsewhere. Xerostomia is a common side-effect of various drugs such as cannabis, amphetamines, antihistamines, and some antidepressants.

-Treatment :
Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients who have endured chemotherapy usually suffer from this post- treatment. Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping sugarless fluids frequently, chewing xylitol-containing gum[3], and using a carboxymethyl cellulose saliva substitute as a mouthwash may help. Aquoral may be prescribed to treat xerostomia. Non-systemic relief can be found using an oxidized glycerol triesters treatment used to coat the mouth. Drinking water when there is another cause of the xerostomia besides dehydration may bring little to no relief and can even make the dry mouth more uncomfortable.


References
1. Ship JA, Pillemer SR, Baum BJ. Xerostomia and the geriatric patient. J Am Geriatr Soc 2002;50(3):535–43.[Medline]
2. Fox PC. Autoimmune diseases and Sjögren’s syndrome: an autoimmune exocrinopathy. Ann N Y Acad Sci 2007;1098:15–21.[Medline]
3. Shiboski CH, Hodgson TA, Ship JA, Schiodt M. Management of salivary hypofunction during and after radiotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(supplement 1):S66–S73.[Medline]
4. Bergdahl M. Salivary flow and oral complaints in adult dental patients. Community Dent Oral Epidemiol 2000;28(1):59–66.[Medline]
5. von Bultzingslowen I, Sollecito TP, Fox PC, et al. Salivary dysfunction associated with systemic diseases: systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(supplement 1):S57–S65.[Medline]