Managing xerostomia and salivary gland hypofunction: Executive summary of a report from the American Dental Association Council on Scientific Affairs
Section snippets
FUNCTIONS OF SALIVA
In addition to its role in digestion, saliva serves several protective functions, including cleansing the oral cavity, facilitating oral processing and swallowing of food, protecting oral tissues against physical and microbial insults, maintaining a neutral pH and preventing demineralization.
The antimicrobial properties of saliva are due to a wide variety of immune and nonimmune salivary proteins that inhibit the adherence and growth of viruses and bacteria.8 Salivary proteins and mucins
Systemic diseases
Box 110, 11, 12 presents medical conditions that may cause dry mouth. An estimated 4 million people in the United States have Sjögren syndrome (SS), an autoimmune disease commonly associated with hyposalivation. SS is a chronic inflammatory disease characterized by lymphocytic infiltration of the salivary and lacrimal glands, resulting in xerostomia and dry eyes.13 Approximately 90 percent of those with SS are women, and patients often experience associated symptoms such as fatigue and joint
SIGNS AND SYMPTOMS
Box 3 presents clinical signs and symptoms of hyposalivation. Patients with dry mouth often have atrophic and erythematous oral mucosa, loss of papillae on the tongue29 and lips that peel and crack. Traumatic lesions may be visible on the buccal mucosa and the lateral borders of the tongue. Dentures may become loose, causing painful ulcerations.30 Patients also may describe the need to sip fluids, especially when eating, or may need to drink water when awakened from sleep.19, 31
Cervical or root
History and examination
Appropriate evaluation and patient assessment, including a comprehensive medical and dental history, are essential for diagnosing SGH. A positive response to any of the following questions has been associated with reduced saliva, even in patients who have not expressed complaints of xerostomia34:
Does the amount of saliva in your mouth seem to be too little?
Does your mouth feel dry when eating a meal?
Do you sip liquids to aid in swallowing dry food?
Do you have difficulty swallowing?
A
MANAGEMENT
Treatment planning to alleviate dry-mouth symptoms should be tailored to the individual patient. A multidisciplinary model of care for xerostomia and SGH should include the following components:
patient education—a patient-centered process emphasizing daily oral hygiene, regular dental visits, use of topical fluoride, tobacco-use cessation counseling and other interventions;
management of systemic conditions and medication use in consultation with the patient's physician, oncologist or
CONCLUSIONS
Dentists are often challenged when diagnosing and treating patients with xerostomia and SGH, which can have potentially devastating effects on the oral cavity. Early detection, comprehensive evaluation and diagnostic testing may prevent significant oral disease and lead to multidisciplinary care that includes collaboration with physicians.
Patient education, management of systemic conditions associated with salivary dysfunction and implementation of preventive measures to reduce oral disease are
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2023, BiotribologyCitation Excerpt :It has been estimated that the overall prevalence of dry mouth is 22% of the population, which increased in elderly groups [2]. It can be attributed to certain medications, irradiation of the head or neck from cancer therapies, diseases including Sicca Syndrome (Sjögren's syndrome) and Type 1 Diabetes, psychological conditions, age and gender [3–6]. This condition can be a particular nuisance when it comes to dental hygiene, increasing the prevalence of tooth decay, dental caries, demineralisation, and tooth enamel loss in patients presenting xerostomia symptoms [6].
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Disclosure. None of the authors reported any disclosures.
- 1
Dr. Plemons is a professor, Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas.
- 2
Dr. Al-Hashimi is a professor and the director, Salivary Dysfunction Clinic and Stomatology Research Laboratory, Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas.
- 3
Dr. Marek is an associate professor, Department of Oral Pathology, Radiology and Medicine, College of Dentistry, The University of Iowa, Iowa City.