Dry mouth/xerostomia

Dry mouth occurs when the amount of saliva in the mouth becomes reduced. Saliva, with its proteins and enzymes is essential for keeping the mouth lubricated and healthy. Dry mouth is a very common condition and affects more than 1 out of every 4 adults1,2.

Impact of xerostomia

Dry mouth can lead to ongoing bad breath, cavities, mouth infections and a number of other physical, social and emotional issues. The dental professional is in a position to help patients recognize dry mouth symptoms and help sufferers proactively manage their dry mouth condition.

Symptoms of xerostomia

Patients suffering from dry mouth may complain of the following:

  • Oral dryness
  • Thirst- frequent fluid intake, night waking
  • Cracked lips
  • Difficulty swallowing
  • Difficulty eating dry foods
  • Altered sense of taste
  • Increased plaque, tooth decay or gum disease
  • Soreness or split skin at the corners of the mouth
  • Sore throat
  • Difficulty speaking

Causes of xerostomia

a. Medication

Medications are the leading cause of dry mouth. Over 400 different medications have been associated with xerostomia1,3,4 and additionally taking more than one medication significantly increases the chance of having dry mouth.

Common medications associated with dry mouth include:

  • Tricyclic antidepressants
  • Antipsychotics
  • Atropinics
  • Beta blockers
  • Antihistamines

b. Cancer treatment

Cancer treatment often requires procedures such as surgery, radiotherapy and chemotherapy, all of which can damage salivary tissue and may have a dramatic effect on salivary flow. In the most severe case, this can result in a total loss of salivary output.

c. Systemic disease

Dry mouth can also occur as a result of a number of systemic diseases, the main autoimmune inflammatory disease being Sjögren's syndrome.

Diagnosing xerostomia

Proactive screening for dry mouth can be simply incorporated into routine clinical practice by identification of those at risk or with symptoms through:

  • Medical History
  • Drug history
  • Subjective questioning on dry mouth symptoms
  • Clinical examination for oral signs

Typical signs of xerostomia the dental professional may identify include:

  • Dental mirror sticks to the tongue or buccal mucosa
  • No saliva pooling
  • Cervical caries
  • Frothy saliva
  • Altered gingival architecture (not only related to dry mouth)

Management of xerostomia

The dental professional is key in proactively identifying those patients at risk before more serious and irreversible oral consequences occur.

The symptoms of dry mouth can have a profound effect on patients. Advice should include how to manage and improve symptoms, thereby improving patients' quality of life.

References:
  1. Hupp WS. Xerostomia. Woman Dentist Jnl Feb. 8, 2008.
  2. Guggenheimer J, Moore PA. Etiology, recognition and treatment. JADA 2003; 134:61-69.
  3. Wind DA. Management of Xerostomia. An overview. Jnl Prac Hygiene Sept/Oct 1996:23-27.
  4. ADA Guide to Dental Therapeutics, 4th Ed 2006.
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