Xerostomia, the subjective complaint of dry mouth, and hyposalivation remain a significant burden for many individuals. Diagnosis of. Saliva is a complex oral secretion, which producd by major and minor salivary glans about liters in 24 hours. In the oral cavity, saliva has several important. Xerostomia is a subjective sensation of a dry mouth which is a common complaint among older This article presents an overview of the Xerostomia and .
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Xerostomia, the subjective complaint of dry mouth, and hyposalivation remain a significant burden for many individuals. Diagnosis of xerostomia and salivary gland hypofunction is dependent upon a careful and detailed history and thorough oral examination. There exist many options for treatment and symptom management: Xerostomia xerodtomia defined as the subjective complaint of dry mouth.
Chronic xerostomia remains a significant burden for many individuals. In particular, it may affect speech, chewing, swallowing, denture-wearing, and general well-being. The prevalence of xerostomia in the population ranges from 5. Studies have shown differences in the prevalence between the sexes and xerostomia appears to increase with increasing age. A possible explanation is that older individuals take xerosstomia xerogenic drugs for their chronic conditions and this may lead to an overall reduction of the unstimulated salivary flow rate.
The diagnosis of xerostomia and salivary gland hypofunction requires a thorough medical history.
Diagnosis and management of xerostomia and hyposalivation
Particular attention should be given to the reported symptoms, medication use, and past medical history. Several questionnaires have been proposed to identify patients with xerostomia and hyposalivation. Fox et al developed a questionnaire on the severity of dry mouth, which may predict true hyposalivation Table 1.
A few years later, Thomson et al created an eleven-item summated rating scale on the severity of chronic xerostomia Xerostomia Inventory. Xerostoia five items were included. One of the major risk factors for xerostomia and hyposalivation is the use of certain medications.
A careful oral examination is fundamental to identify clinical signs pathognomonic for hyposalivation. Several murnal signs have been proposed by Osailan et al: Most of the methods to measure the salivary flow are easy to perform and require little time.
Salivary flow rates are usually measured for at least 5 minutes after an overnight fast or 2 hours after a meal. Patients are asked to constantly drain saliva from the lower lip into a graduated container for 15 minutes draining method.
The saliva is then collected into a graduated cylinder for 5 minutes.
Salivary flow both stimulated and unstimulated can also be measured selectively from one major salivary gland or minor salivary gland. The parotid gland secretion is typically collected by using a suction device and placing a cup the Lashley or Carlson—Crittenden cup over the Stensen duct. Pilocarpine and cevimeline are two systemic US Food and Drug Administration-approved sialogogues for treatment of dry mouth.
Their effect depends on the presence of functional glandular tissue. Oral pilocarpine is a parasympathomimetic medication with muscarinic action.
Pilocarpine is also contraindicated in individuals with narrow-angle glaucoma and iritis, and should be used with caution in individuals with chronic pulmonary disease, asthma, or cardiovascular diseases. Anethole trithione is a cholagogue that has been shown to improve oral symptoms and xerosyomia the salivary flow in patients with xerostomia and hyposalivation. Patients who were treated with psychotropic drugs tricyclic antidepressants or neuroleptics and were suffering from xerostomia benefited from yohimbine use, an alpha 2 adrenoceptor antagonist.
Intraoral topical agents are among the xeeostomia common recommended treatments for the management of xerostomia. These include chewing gums, saliva stimulants, and substitutes. Commercially available sugar-free chewing gums and candies can also be used to simulate salivary flow. Other oral sprays, specifically oxygenated glycerol tri-ester, serve as an alternative treatment for dry mouth and have been proven to be more effective than other commercially available saliva substitutes.
Also lemon lozenge use in individuals with xerostomia did not show any increase in salivary flow when compared to baseline paraffin-stimulated mean flow rate and the gum-stimulated flow rates. The saliva substitute Saliva Orthana, a mucin-containing oral spray, was tested in a double-blind, single-phase, placebo-controlled trial for patients complaining of xeroostomia. When oral lubricants are considered, the gel formulation appears to be the most efficient and appreciated by patients.
Although the evidence available is limited, with patients on medications known to induce salivary gland hypofunction, a treatment alternative includes decreasing the dosage of the medications or potentially replacing the medications with less xerogenic drugs. Other remedies have been proposed for the management of xerostomia. Intraoral electrostimulation jurnnal also been tested to increase salivary flow.
However, additional larger studies are necessary to confirm these findings. Xerostomia and hyposalivation remain a debilitating condition for many individuals.
This review summarizes the diagnostic and therapeutic approaches to manage xerostomia and hyposalivation. Clinicians with a patient complaining of xerostomia have the opportunity to identify patients with true salivary gland hypofunction with effective diagnostic criteria and functional tests, and therefore prevent secondary effects.
Although no standard treatment guidelines are available, many treatment options exist for the management of xerostomia and hyposalivation: While systemic agents such as pilocarpine or cevimeline have been largely studied, new medical devices require large well-designed clinical trials.
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Diagnosis and management of xerostomia and hyposalivation
This article has been cited by other articles in PMC. Abstract Xerostomia, the subjective complaint of dry mouth, and hyposalivation xrostomia a significant burden for many individuals. Introduction Xerostomia is defined as the subjective complaint of dry mouth. Diagnosis of xerostomia and salivary gland hypofunction The diagnosis of xerostomia and salivary gland hypofunction requires a thorough medical history.
Dry mouth: advice and management | Learning article | Pharmaceutical Journal
Open in a separate window. Measurement of salivary flow rates Most jurnxl the methods to measure the salivary flow are easy to perform and require little time.
Systemic sialogogues Pilocarpine and cevimeline are two systemic US Food and Drug Administration-approved sialogogues for treatment of dry mouth.
Other sialogogues Anethole trithione is a cholagogue that has been shown to improve oral symptoms and increase the salivary flow in patients with xerostomia and hyposalivation. Intraoral topical agents Intraoral topical agents are among the most common recommended treatments for the management of xerostomia.
Changes in medications Although the evidence available is limited, with patients on medications known to induce salivary gland hypofunction, a treatment alternative includes decreasing the dosage of the medications or potentially replacing the medications with less xerogenic drugs.
Others Other remedies have been proposed for the management of xerostomia. Conclusion Xerostomia and hyposalivation remain a debilitating condition for many individuals. Footnotes Disclosure The authors report no conflicts of interest in this work.
Hopcraft MS, Tan C.
Dry mouth: advice and management
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