Xerostomia

Xerostomia Oral health preventive measures for special needs

patient (Xerostomia)

What is xerostomia ?Xerostomia: (also termed dry mouth or dry mouth syndrome) is the medical term for the subjective symptom of dryness in the mouth, which may be associated with a change in the composition of saliva or reduced salivary flow (hypo salivation) or have no identifiable cause.

This symptom is very common and is often seen as a side effect of many types of medication,.

Physical treatments

Acupuncture has been found useful in the prevention of xerostomia when administered concurrently with radiotherapy

A technique called acupuncture-like transelectrical nerve stimulation is currently being investigated

Prevention

Surgical transfer of one sub mandibular gland to the sub mental space facilitates shielding of the gland during postoperative radiation therapy. Studies confirm that there is no adverse effect on the function of the gland in this position

Treating the underlying cause

Drugs are a common cause of dry mouth. Reduce the dose or change the drug if possible. Morphine is a common but often overlooked cause of dry mouth. Other drugs that cause dry mouth include tricycle antidepressants, antihistamines, anti muscarinic drugs, anti-epileptic drugs, antipsychotics, beta-blockers and diuretics

Dehydration should be treated.Simple measures will often relieve symptoms of dry mouth, even if

rehydration is not undertaken.Anxiety can also cause dry mouth.Sjögren's syndrome - check antinuclear antibody titer

PREVENTION OF XEROSTOMIA There are several options how to prevent development of xerostomia or

decrease its severity: a) Acting on the cause of xerostomia – possible adjustment of medications

and possibly amelioration or elimination of the underlying cause In the case of drug induced xerostomia - it is important to discuss possible

prescription of alternative drugs with less desiccative side effects, decreasing the dose of prescribed drug or the number of xerogenic drugs (particularly in the case

of poypharmacy). Maintaining salivary function - Certain patients with hypo salivation may

benefit from administration of medications that stimulate salivary output

(sialagogues such as pilocarpine or cevimeline if there is no contraindications

for these medications)

General measures

Simple measures should be used by all patients. Dry mouth may be relieved in many patients by:

Frequent sips of cool drinks.Sucking pieces of ice.Sucking sugar-free fruit pastilles.Eating partly frozen melon or pineapple chunks.Sugar-free chewing gum - which stimulates salivation in

patients with residual salivary function.Petroleum jelly - which can be applied to the lips to

prevent drying and cracking.