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What is the most common cause of xerostomia?
There are numerous causes of xerostomia; the most common cause is medication side effects, followed by Sjogren syndrome (SS) and radiotherapy and other autoimmune diseases in no particular order.
What is xerostomia and what causes it?
Dry mouth, or xerostomia (zeer-o-STOE-me-uh), refers to a condition in which the salivary glands in your mouth don't make enough saliva to keep your mouth wet. Dry mouth is often due to the side effect of certain medications or aging issues or as a result of radiation therapy for cancer.
What is the difference between dry mouth and xerostomia?
Dry mouth is also called "xerostomia." It happens when the body's salivary glands do not make enough saliva, or spit, to keep the mouth moist. Saliva is needed for chewing, swallowing, tasting, and talking. A dry mouth can make these activities difficult or uncomfortable.
What is the best treatment for xerostomia?
Sip water regularly. Try over-the-counter saliva substitutes — look for products containing xylitol, such as Mouth Kote or Oasis Moisturizing Mouth Spray, or ones containing carboxymethylcellulose (kahr-bok-see-meth-ul-SEL-u-lohs) or hydroxyethyl cellulose (hi-drok-see-ETH-ul SEL-u-lohs), such as Biotene Oral Balance.
What are the side effects of xerostomia?
a sticky, dry, or burning feeling in the mouth.trouble chewing, swallowing, tasting, or speaking.altered taste or intolerance for spicy, salty, or sour foods or drinks.a dry or sore throat.cracked, peeling, or atrophic lips.a dry, rough tongue.mouth sores.an infection in the mouth.More items...•
Is xerostomia serious?
It's normal to occasionally have a dry mouth if you're dehydrated or feeling nervous, but a persistently dry mouth can be a sign of an underlying problem. You should see your dentist or GP if you have an unusually dry mouth (known as xerostomia) so they can try to determine the cause.
What diseases causes dry mouth?
Dry mouth can be a side effect of medical conditions, including Sjögren's syndrome, HIV/AIDS, Alzheimer's disease, diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension, Parkinson's disease, stroke, and mumps.
Is xerostomia curable?
Dry mouth is usually a temporary and treatable condition. In most cases, you can prevent and relieve symptoms of dry mouth at home by doing one or more of the following: sipping water throughout the day. sucking on ice cubes.
What does xerostomia look like?
In women, the “lipstick sign,” where lipstick adheres to the front teeth, may be a useful indicator of xerostomia. The oral mucosa may be dry and sticky, or it may appear erythematous due to an overgrowth of Candida albicans. The red patches often affect the hard or soft palate and dorsal surface of the tongue.
What foods increase saliva?
To increase saliva, try tart foods and drinks, such as lemonade or cranberry juice. Very sweet foods and drinks may also help. Avoid acidic foods and drinks if you have a sore or tender mouth. Enjoy soothing frozen fruits, such as frozen whole grapes, banana pieces, melon balls, peach slices, or mandarin orange slices.
What vitamins help produce saliva?
Vitamin A. Vitamin A is not only good for your eyes and skin—but it's also great for your mouth, particularly your saliva production. Saliva helps break down food and also cleans bacteria from in between your teeth.
Is milk good for dry mouth?
Because of the nutritional, anticariogenic, and moisturizing properties of milk, patients with xerostomia may find milk of value as a saliva substitute to help reduce the oral health problems associated with hyposalivation.
How do you know if you have xerostomia?
Dry mouth, or xerostomia, happens when you don't make enough saliva (spit). Saliva is important for mouth health. A lack of saliva can lead to tooth decay. Dry mouth symptoms include discomfort, sore throat and swallowing problems....More severe symptoms include:Tooth decay.Dry eyes and skin.Skin rash.Joint pain.
Can xerostomia be reversed?
Xerostomia is a symptom, not a disease entity, and can be temporary, reversible, or permanent. Once considered an inevitable part of the aging process, xerostomia is now associated with hundreds of medications and numerous nonpharmacologic conditions, including some cancer treatment regimens.
Is xerostomia curable?
Dry mouth is usually a temporary and treatable condition. In most cases, you can prevent and relieve symptoms of dry mouth at home by doing one or more of the following: sipping water throughout the day. sucking on ice cubes.
What vitamin deficiency causes dry mouth?
Deficiencies in Vitamin A or riboflavin can also cause dry mouth. While both these conditions are rare, they are real and serious, and a medical professional should treat them.
What is Xerostomia?
You may not be familiar with the medical term xerostomia, yet you probably know what it is - dry mouth! Many people have personally experienced dry mouth for one reason or another - are you one of them? Basically, xerostomia occurs because the salivary glands aren't producing enough saliva to keep the mouth wet. Short-term xerostomia may occur due to illness, nervousness, or stress, but long-term xerostomia can lead to dental problems like tooth decay and may make eating, drinking, and talking difficult. Xerostomia is usually a side effect of another condition, rather than a medical condition in and of itself.
How to get rid of dry mouth?
If drinking water doesn't help, then what does one do to get rid of dry mouth?! Because the most common cause is medication, switching medications can eliminate the symptoms. If you suspect your medication is to blame, you can speak with your doctor about other alternatives. If there are no alternatives, you may be able to get a prescription for a drug that stimulates the production of saliva (it seems counter-intuitive, but sometimes it's necessary). There are also over-the-counter medications that can help treat dry mouth. Finally, if long-term dry mouth occurs, there may be dental devices one can wear to help prevent tooth decay. When a specific disease is the cause, managing that disease can help lessen the side effects that include dry mouth.
What does it mean when you feel dry mouth?
You may not recognize the term xerostomia, but you may have experienced it before - it is the medical term for dry mouth, that uncomfortable cottony feeling you get in your mouth when you aren't producing enough saliva.
Why does my mouth dry out?
Other causes of dry mouth include age (instances increase with age), tobacco use, and drug use (especially methamphetamines).
What does it mean to enroll in a course?
Enrolling in a course lets you earn progress by passing quizzes and exams.
What causes dry mouth?
The differential of hyposalivation significantly overlaps with that of xerostomia. A reduction in saliva production to about 50% of the normal unstimulated level will usually result in the sensation of dry mouth. Altered saliva composition may also be responsible for xerostomia.
What is xerostomia in salivary gland?
Salivary gland dysfunction is an umbrella term for the presence of xerostomia, salivary gland hyposalivation, and hypersalivation.
How to diagnose hyposalivation?
A diagnosis of hyposalivation is based predominantly on the clinical signs and symptoms. The Challacombe scale maybe used to classify the extent of dryness. The rate of the salivary flow in an individual's mouth can also be measured. There is little correlation between symptoms and objective tests of salivary flow, such as sialometry. This test is simple and noninvasive, and involves measurement of all the saliva a patient can produce during a certain time, achieved by dribbling into a container. Sialometery can yield measures of stimulated salivary flow or unstimulated salivary flow. Stimulated salivary flow rate is calculated using a stimulant such as 10% citric acid dropped onto the tongue, and collection of all the saliva that flows from one of the parotid papillae over five or ten minutes. Unstimulated whole saliva flow rate more closely correlates with symptoms of xerostomia than stimulated salivary flow rate. Sialography involves introduction of radio-opaque dye such as iodine into the duct of a salivary gland. It may show blockage of a duct due to a calculus. Salivary scintiscanning using technetium is rarely used. Other medical imaging that may be involved in the investigation include chest x-ray (to exclude sarcoidosis), ultrasonography and magnetic resonance imaging (to exclude Sjögren's syndrome or neoplasia). A minor salivary gland biopsy, usually taken from the lip, may be carried out if there is a suspicion of organic disease of the salivary glands. Blood tests and urinalysis may be involved to exclude a number of possible causes. To investigate xerophthalmia, the Schirmer test of lacrimal flow may be indicated. Slit-lamp examination may also be carried out.
What is the subjective sensation of dry mouth?
Xerostomia is the subjective sensation of dry mouth, which is often (but not always) associated with hypofunction of the salivary glands. The term is derived from the Greek words ξηρός ( xeros) meaning "dry" and στόμα ( stoma) meaning "mouth". A drug or substance that increases the rate of salivary flow is termed a sialogogue .
What causes xerostomia in the eyes?
Xerostomia may be caused by autoimmune conditions which damage saliva-producing cells. Sjögren's syndrome is one such disease, and it is associated with symptoms including fatigue, myalgia and arthralgia. The disease is characterised by inflammatory changes in the moisture-producing glands throughout the body, leading to reduced secretions from glands that produce saliva, tears and other secretions throughout the body. Primary Sjögren's syndrome is the combination of dry eyes and xerostomia. Secondary Sjögren's syndrome is identical to primary form but with the addition of a combination of other connective tissue disorders such as systemic lupus erythematosus or rheumatoid arthritis.
What is dry mouth syndrome?
Other names. Dry mouth, dry mouth syndrome. 3D medical animation still showing decreased or insufficient functioning of salivary glands. Xerostomia, also known as dry mouth, is dryness in the mouth, which may be associated with a change in the composition of saliva, or reduced salivary flow, or have no identifiable cause .
How common is xerostomia?
Xerostomia is a very common symptom. A conservative estimate of prevalence is about 20% in the general population, with increased prevalences in females (up to 30%) and the elderly (up to 50%). Estimates of the prevalence of persistent dry mouth vary between 10 and 50%.
What is dry mouth?
Dryness of the mouth, having a varied etiology, resulting from diminished or arrested salivary secretion, or asialism.
Why does my mouth feel dry?
dryness of the mouth from salivary gland dysfunction.
Why does my mouth dry out?
Causes of dry mouth can include toxicity from chemotherapy, head and neck radiotherapy, adverse effects of medications, autoimmune disease, or other conditions (e.g., uncontrolled diabetes, infections, hormonal changes). Xerostomia occurs commonly in those with Sjögren disease or who are receiving radiation therapy for head and neck cancer.
What happens when salivary flow is reduced?
Reduced salivary flow can cause difficulties in tasting, chewing, swallowing, and speaking; it can also increase the chance of developing dental decay, demineralization of teeth, tooth sensitivity, and/or oral infections.
What are the goals of xerostomia?
The goals of treating xerostomia include identifying the possible cause (s), relieving discomfort, and preventing complications (e.g., dental caries and periodontal infections).
What does the ADA seal of acceptance mean?
The ADA Seal of Acceptance category for products for temporary relief of dry mouth means that the product is safe and has shown efficacy in temporarily relieving dry mouth symptoms, when used as directed.
Is Chiappelli effective for dry mouth?
Chiappelli F. No strong evidence that any topical treatment is effective for relieving the sensation of dry mouth. Evid-based Dent 2012;13 (1):16-17.
Does chewing gum help dry mouth?
A 2011 Cochrane Review 25, 26 found “no strong evidence” that any specific topical therapy (e.g., sprays, lozenges, mouth rinses, gels, oils, chewing gum, or toothpastes) was effective for relieving the symptoms of dry mouth. Although chewing gum was shown to increase saliva production, there was no strong evidence that dry mouth symptoms were improved. The authors noted that “patient preference is an important consideration, together with consideration of the potential adverse effects.” The review concluded that, “Well designed, adequately powered randomised controlled trials of topical interventions for dry mouth, which are designed and reported according to CONSORT guidelines, are required to provide evidence to guide clinical care.”
What is xerostomia in the elderly?
Xerostomia is defined as dry mouth resulting from reduced or absent saliva flow. Xerostomia is not a disease, but it may be a symptom of various medical conditions, a side effect of a radiation to the head and neck, or a side effect of a wide variety of medications. It may or may not be associated with decreased salivary gland function. Xerostomia is a common complaint found often among older adults, affecting approximately 20 percent of the elderly. However, xerotomia does not appear to be related to age itself as much as to the potential for elderly to be taking medications that cause xerostomia as a side effect.
What is pilocarpine used for?
The tablets are indicated for the treatment of symptoms of dry mouth from salivary gland hypofunction caused by Sjögren’s syndrome or by radiotherapy for cancer of the head and neck. The time to reach peak concentrations following oral administration is approximately 1.25 hours. The duration of sialogogic effect is about two to three hours. In clinical studies, pilocarpine at dosages of 5 mg to 30 mg, divided into one to four oral daily doses, was shown to significantly decrease dryness of the mouth and eyes when compared to artificial saliva or placebo in patients with Sjögren’s syndrome and those who developed xerostomia following radiation therapy.
What happens when salivary glands are stimulated?
When the oral mucosal surface is stimulated, afferent nerve signals travel to the salivatory nuclei in the medulla. The medullary signal may also be affected by cortical inputs resulting from stimuli such as taste, smell, anxiety or depression.
What are the health problems associated with xerostomia?
Some common problems associated with xerostomia include a constant sore throat, burning sensation, difficulty speaking and swallowing, hoarseness and/or dry nasal passages.1 Xerostomia is an original hidden cause of gum disease and tooth loss in three out of every 10 adults.11 If left untreated, xerostomia decreases the oral pH and significantly increases the development of plaque and dental caries.Oral candidiasis is one of the most common oral infections seen in association with xerostomia.
How to diagnose xerostomia?
Diagnosis of xerostomia may be based on evidence obtained from the patient’s history, an examination of the oral cavity and/or sialometry, a simple office procedure that measures the flow rate of saliva. Xerostomia should be considered if the patient complains of dry mouth, particularly at night, or of difficulty eating dry foods such as crackers. When the mouth is examined, a tongue depressor may stick to the buccal mucosa. In women, the “lipstick sign,” where lipstick adheres to the front teeth, may be a useful indicator of xerostomia.
What is the function of saliva?
Saliva possesses many important functions including antimicrobial activity, mechanical cleansing action, control of pH, removal of food debris from the oral cavity, lubrication of the oral cavity, remineralization and maintaining the integrity of the oral mucosa.
How long after fluoride can you eat?
No food or beverage should be consumed for at least 30 minutes after fluoride application. Chlorhexidine rinses also may be useful in preventing caries by reducing lactobacillus counts in the mouth. Dentures should not be worn during sleep and should be kept clean by overnight soaking.
What is the best treatment for xerostomia?
Either agent is tried for up to 3 months to ascertain efficacy. These medications do require some residual salivary gland function as it stimulates the patent gland to secrete saliva. The application of topical physostigmine has also been a therapy option in the treatment of xerostomia. Physostigmine is a cholinesterase inhibitor, thus increasing the amount of acetylcholine available to stimulate salivary glands. It increases the production of saliva by stimulating mucin-producing glands.[15] A gel containing 1.8 mg of physostigmine may provide relief for about 120 minutes.[15] Additionally, malic acid has demonstrated some benefit if xerostomia is drug-induced.[10] Anethole trithionate (cholagogue-bile secretion stimulant) is another drug that has proven to be beneficial for xerostomia. [16]
Why is Xerostomia delayed?
Xerostomia has many causes, including medications and radiation. Despite being a common disorder, its diagnosis usually gets delayed, and the treatment is not satisfactory. For this reason, an interprofessional team is the best management strategy.
What is Xerostomia in medical terms?
Xerostomia is defined as "a subjective feeling of oral dryness." These symptoms might present as dry mouth, difficulty swallowing, or dry oral mucosa/skin. There are numerous causes of xerostomia; the most common cause is medication side effects, followed by Sjogren syndrome (SS) and radiotherapy and other autoimmune diseases in no particular order. Irrespective of a specific etiology, the patient's primary complaint is dry mouth. Because it is such a debilitating condition without any particular treatment, there are major psychosocial factors that come into play, ranging from mild anxiety to major depressive disorder. This activity outlines the evaluation, pathophysiology, and treatment of xerostomia and highlights the role of the interprofessional team to aid in managing patients with xerostomia.
What is the interprofessional approach to xerostomia?
Because it can have both benign and pathological etiologies, xerostomia requires an interprofessional team approach, including physicians, specialists, dentists, specialty-trained nurses, and pharmacists, all collaborating across disciplines to achieve optimal patient results. [Level V]
What are the three major salivary glands?
The three major salivary glands responsible for saliva production are the parotid gland, submandibular gland, and sublingual gland . The anatomy of all three glands is quite similar, consisting of a duct that opens into the oral cavity.[2] Hyposalivation due to radiation shows fibrosis while hyposalivation due to an autoimmune disease could show an infiltrate of B and T-cells, leading to gland destruction.
What is the most important thing to know about xerostomia?
The most important thing is the recognition of the symptoms of xerostomia and taking action. A simple history and physical exam can help with the diagnosis.[18] It is crucial that healthcare professional reviews the patient's medication list. Anti-hypertensives, Parkinson drugs, diuretics, and many others have implications as a cause of xerostomia. If a medication is the suspected cause and alteration of regimen is straightforward, it should merit consideration and a mutual decision made regarding ongoing therapy. A pharmacy consult is often necessary to discuss alternative regimens and to avoid drug-drug interactions.
Why is xerostomia increasing?
The prevalence of xerostomia is increasing due to the increasing aging population. [6] Age by itself is not a cause of xerostomia, but older patients tend to be on multiple medications and have a higher incidence of comorbid conditions.
What is Xerostomia in saliva?
What is Xerostomia? What is Xerostomia? Xerostomia is a symptom of unusual mouth dryness. This is usually related to changes in the chemical composition of the saliva, dehydration or hyposalivation due to some form of underlying mechanism in the salivary glands themselves.
Why does diabetes cause salivation to decrease?
Diabetes causes an increase in blood serum osmolality due to the high load of sugar in the blood, this causes your body to urinate more in an attempt to get rid of the excess sugar, doing so makes the body lose a lot of plasma which in turn causes the salivary glands to decrease salivation in an attempt to conserve water.
What causes xerostomia?
Causes. The major causes of xerostomia are conditions that stem from low plasma volume (in the case of dehydration), hyposalivation, and radiation therapy to the salivary glands or blunt trauma that causes a blockage in the secretion of saliva. Numerous other glands are also present in the mouth that are responsible for producing saliva, ...
What causes dry mouth?
In xerostomia, alteration in the structures causes the dry mouth sensation and need to be identified so that proper xerostomia management can be initiated. The saliva is also composed of a lot of antimicrobial agents such as lysozymes, oxidase and immunoglobulins that help keep the normal flora of the mouth in control, without these agents, ...
How do anticholinergic drugs affect the body?
Anticholinergic drugs exert their effects by promoting sympathetic effects, stimulating receptors that suppress the parasympathetic response such as salivation in anticipation of a meal. Fight or flight responses take over and the body switches of anabolic processes in favor over rest and digest .
Why is saliva excreted?
Saliva is also excreted when there is something in the mouth such as a mouthful of food or a foreign object in an attempt to digest said object. These and all the above mentioned factors are necessary to promote good oral health along with a good helping of oral hygiene during tooth brushing.
Why is saliva important in the oral cavity?
Knowledge of the oral cavity and its internal milieu are necessary to guide interventions that will prevent further episodes of xerostomia. Saliva is essential to oral health. Without saliva, impairments can be seen in the form of tooth decay, bacterial or fungal overgrowth, speech impairment and more.
How common is dry mouth?
Dry mouth is common, especially among older adults. It affects about one in five older adults. Older people are more likely to take medications that can cause dry mouth.
What can I do at home to treat dry mouth?
Oral hygiene is essential if you have a dry mouth. Brush your teeth twice a day, and use mouthwash. Doing so will help prevent tooth decay. Cavities and decay are more common for people with dry mouth.
Why is saliva important for the body?
Saliva keeps the mouth and teeth healthy. It cleans your mouth, keeps it moist and removes food. Lack of saliva can cause problems including:
What does it mean when you don't have enough saliva?
Dry mouth, or xerostomia, is the sensation you may feel when you don’t have enough saliva (spit). Saliva is the fluid produced by the salivary glands in your mouth. Dry mouth is a symptom of a condition, not a condition itself. Most often, it’s a side effect of certain medications, such as antihistamines or decongestants ...
Why does my mouth get dry?
Dry mouth happens when something causes the salivary glands to produce less saliva. The most common causes of dry mouth are: Medications. Radiation therapy, especially for head and neck cancer. Hundreds of medications (prescription and over-the-counter) can reduce your body’s saliva production.
Why is it important to have saliva?
Cavities and decay are more common for people with dry mouth. It’s also important to promote saliva production. Saliva protects your mouth and teeth from decay and disease. Some dry mouth remedies can help you produce more saliva and improve symptoms. Chewing and sucking help stimulate saliva flow.
How to prevent dry mouth at night?
Use a humidifier, especially in your bedroom, to prevent dry mouth at night. Breathe through your nose, not your mouth. Avoid: Over-the-counter medications that can cause dry mouth, such as antihistamines and decongestants. Ask your healthcare provider about a different treatment or medication.
What is xerostomia in the mouth?
Xerostomia is defined as the subjective complaint of dry mouth. 1Interestingly, patients complaining of xerostomia frequently do not show any objective sign of hyposalivation and their symptoms may be secondary to qualitative and/or quantitative changes in the composition of saliva.2,3The normal stimulated salivary flow rate averages 1.5–2.0 mL/min while the unstimulated salivary flow rate is approximately 0.3–0.4 mL/min.4,5A diagnosis of hyposalivation is made when the stimulated salivary flow rate is ≤0.5–0.7 mL/min and the unstimulated salivary flow rate is ≤0.1 mL/min.5–7Xerostomia in patients with objective hyposalivation is diagnosed when the rate of saliva flow is less than the rate of fluid absorption across the oral mucosa plus the rate of fluid evaporation from the mouth.8
How prevalent is xerostomia?
The prevalence of xerostomia in the population ranges from 5.5% to 46%. 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 several xerogenic drugs for their chronic conditions and this may lead to an overall reduction of the unstimulated salivary flow rate.1,10,12,14–18Xerostomia remains an unresolved common complaint especially among the geriatric population, despite seeking medical or dental consultation.19The aim of this review is to explore the current state of knowledge on management and treatment of patients affected by xerostomia and hyposalivation.
What is the subjective complaint of dry mouth?
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: salivary stimulants, ...
What are the effects of xerostomia?
In particular, it may affect speech, chewing, swallowing, denture-wearing, and general well-being .9Xerostomia secondary to hyposalivation may also result in rampant dental caries, oral fungal infections (eg, candidiasis), taste changes, halitosis, or burning mouth .5,10,11The most frequent cause of hyposalivation is the use of certain medications (such as anticoagulants, antidepressants, antihypertensives, antiretrovirals, hypoglycemics, levothyroxine, multivitamins and supplements, non-steroidal anti-inflammatory drugs, and steroid inhalers) (Villa et al, unpublished data, 2014), followed by radiotherapy to the head and neck, and Sjögren’s syndrome.12Other factors include depression, anxiety and stress, or malnutrition.13
What is subjective grade 3?
Subjective grade 3= dryness causing dietary alterations or interference with sleep, speaking, or other activities
Is Anethole trithione a cholagogue?
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.47More studies are necessary to prove the efficacy of this medication.
Can salivary glands cause dry mouth?
Patients with salivary gland hypofunction typically complain of dry mouth, difficulty swallowing and/or speaking; they hardly tolerate spicy, acidic, and crunchy food and often times report taste changes or difficulty wearing dentures.20
