xerostomia (asialism, aptyalism, dry mouth, hyposalivation)
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Introduction
A dryness of the mouth, having varied etiology, resulting from diminished or arrested salivary secretion (asialism).
Etiology
- Sjogren's syndrome
- unlikely to cause xerostomia[5]
- pharmaceutical agents[6]
- therapeutic irradiation of the head for head & neck cancer[8]
- diabetes mellitus type1 in poor control
- obstructive sleep apnea[5]
- mucocutaneous vesiculobullous dermatitis
- salivary stones generally do not cause xerostomia[5]
Pathology
- inhibition of normal functions of saliva
- antibacterial activity
- inhibition of demineralization
- lubrication
- secretions facilitating taste sensors
Clinical manifestations
- intra-oral dryness or burning
- alterations in tongue surface
- dysphagia
- cheilosis
- dysgeusia
- dysarthria
- development of root caries
Complications
- cervical or incisal caries
- oral candidiasis
- overgrowth of anaerobic bacteria
Management
- swishing water in the mouth frequently[6]
- oral hygiene with soft toothbrush[5]
- fluoride mouth rinses
- saliva substitutes
- salivary stimulation with sugarless candies
- avoidance of sugar-containing drinks or food
- limit caffeine, tobacco, alcohol[6]
- pilocarpine[4]
- Salagen tablets
- 4-5 drops of 2% pilocarpine ophthalmic in 4 oz H2O QID
- cevimeline (Evoxac)[4]
- use a humidifier at night
More general terms
Additional terms
- pilocarpine (Pilocar, Isopto Carpine, Salagen, Ocusert Pilo)
- salivation
- sialorrhea; hypersalivation; ptyalism
- Sjogren's syndrome (autoimmune epitheliitis)
References
- ↑ Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 186
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 4.0 4.1 4.2 Prescriber's Letter 8(7):40 2001
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ 6.0 6.1 6.2 6.3 Holt PR, Annals of Long-Term Care suppl, Feb 2004
- ↑ Prescriber's Letter 17(10): 2010 Treatment of Dry Mouth Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=261006&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 8.0 8.1 Jensen SB, Pedersen AM, Vissink A et al A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact. Support Care Cancer. 2010 Aug;18(8):1061-79. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20333412
- ↑ Gibson B, Periyakaruppiah K, Thornhill M et al. Measuring the symptomatic, physical, emotional and social impacts of dry mouth: a qualitative study. Gerodontology. 2020;37(2):132-142 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31347735 https://onlinelibrary.wiley.com/doi/10.1111/ger.12433
- ↑ Marcott S, Dewan K, Kwan M et al. Where dysphagia begins: polypharmacy and xerostomia. Fed Pract. 2020;37(5):234-241 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32454578 PMCID: PMC7241606 Free PMC article
- ↑ Millsop JW, Wang EA, Fazel N. Etiology, evaluation, and management of xerostomia. Clin Dermatol. 2017;35(5):468-476 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28916028 https://www.sciencedirect.com/science/article/abs/pii/S0738081X17301062
- ↑ Dry Mouth http://www.nohic.nidcr.nih.gov/pubs/drymouth/dmouth.htm