Xerostomia or dry mount is caused by an insufficient production of pd saliva in the mouth. Saliva is necessary to maintain the oral health of a person. Deficiency of saliva may lead to different problems like difficulty in swallowing, speaking, chewing, sticky and dry feeling in the mouth.People of all ages are affected by xerostomia. It is more common in older people. It may be chronic or temporary and also lead to many dental problems.
Epidemiology
Xerostomia can affect about 20 % of the general population. About 40% of the individuals whose age is above 60 years may have symptoms. It affects both women and men. There is no difference in geographic location on the prevalence rate. It is linked with other medical diseases like diabetes, Sjögren’s syndrome, HIV, and AIDS. Medications like antihistamines and antidepressants may lead to xerostomia. Patients who have xerostomia may have elevated risk of dental problems and oral infections.
Anatomy
Pathophysiology
Salivary gland dysfunction:
Xerostomia is caused by the dysfunction in the salivary glands. It occurs because of different factors like drugs like diuretics, antihistamines, antidepressants, autoimmune diseases like Sjogren’s syndrome. It can lead to inflammation and damage in the salivary glands. Radiation therapy which is used on the head and neck area can damage the salivary glands and reduce the production of saliva. Infections which can affect the salivary glands are like mumps. It can lead to permanent or temporary damage to the salivary glands.
Nerve damage:
Surgery which includes the head and neck area like removal of salivary glands can damage the nerve pathways which stimulate the production of saliva. Neurological diseases like Parkinson’s disease and stroke can affect the nerve pathways which stimulate the production of the saliva.
Other factors:
Other factors like dehydration and aging can lead to xerostomia. Dehydration may reduce the production of the saliva and lead to this condition. After some age, salivary glands can not work properly, and lead to decrease production of saliva.
Etiology
Aging is a most common factor of xerostomia. Sjögren’s syndrome is an autoimmune disease which affects the lacrimal glands and salivary glands. This can lead to dry mouth and eyes. The body try to conserve the water by decreasing the production of saliva in the dehydration state. Breathing with mouth can lead to xerostomia. Nerve damage because of the surgery or injury can affect the salivary glands and lead to dry mouth. Alcohol and tobacco usage can lead to dry mouth by decreasing the production of saliva. Diabetes can cause this condition because of the high levels of sugar in the blood and dehydration. Radiation therapy, chemotherapy can damage the salivary glands and lead to this condition. Other diseases like AIDS< HIV, Alzheimer’s disease, and Parkinson’s disease can lead to xerostomia.
Genetics
Prognostic Factors
Xerostomia may be an indicator of different conditions like HIV, AIDS, diabetes, and Sjogren’s syndrome. The prognosis of xerostomia is dependent on the nature and severity of the disease. Antidepressants, antihistamines, and diuretics may lead to xerostomia. The prognosis is dependent on the duration and types of medication which is used. It is common in older people.So the prognosis is also affected by age and management of the symptoms. Poor oral hygiene can cause tooth decay and gum disease. Treatment is dependent on the cause and severity of the disease with improvement of the prognosis with the proper management.
Clinical History
Xerostomia occurs at all age, but it is more common in older people. The factors which can be linked with xerostomia:
Age groups: specifically, whose age is 65 or above
Associated comorbidity or activity: Specific medical diseases and activities can elevate the risk of xerostomia like autoimmune diseases like Sjogren’s syndrome, diabetes, nerve damage, hypertension, certain treatment like chemotherapy and radiation therapy, and medications like diuretics, antidepressants, and antihistamines.
Acuity of presentation: Xerostomia can be present with different severity. Mild cases may lead to thirst and discomfort. Severe cases may lead to difficulty in swallowing, speaking, and eating and elevated risk of dental problems and infections.
Physical Examination
The healthcare provider will inspect the oral cavity, tongue, and lips for any signs of damage or dryness. They will palpate the salivary glands to assess for any tenderness or swelling. They use the different diagnostic test to measure the amount of saliva which is produced by the mouth. They will assess the oral health of the patient like any presence of cavities, gum disease, or oral disease which lead to dry mouth. They review the medication of patient to determine any drugs that ah the side effects of dry mouth.
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Medication-induced xerostomia: Drugs like antihistamines, antidepressants, decongestants, antihypertensives, muscle relaxants, and diuretics can lead to dry mouth.
Sjögren’s syndrome: This can affect the salivary and lacrimal glands and lead to dry mouth and eyes.
Diabetes mellitus: Elevated levels of sugar in blood can lead to dry mouth and elevate the risk of oral infection.
Radiation therapy: Radiation therapy on the area of neck and head can damage the salivary gland and lead to dry mouth.
Chemotherapy: Chemotherapeutic agents can lead to dry mouth.
Dehydration: Dehydration can cause a dry mouth and other symptoms like thirst, fatigue, and dizziness.
Mouth breathing: Breathing through mouth can lead to dry mouth.
Smoking: Smoking can lead to dry mouth and elevate the risk of oral cancer.
Anxiety: Stress and anxiety can lead to dry mouth because of the elevated activity of sympathetic nervous system.
HIV infection: Patients who have HIV infection may have dry mouth because of the reduced function of salivary glands.
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Modification of environment:
Increase the intake of fluid
Use a humidifier in the dry environment
Avoid the consumption of alcohol and tobacco
Chew sugar free gum or candies to increase the production of saliva
Avoid spicy or acidic foods which can cause irritation in the mouth
Use saliva substitute to lubricate mouth
Administration of a pharmaceutical agent:
Saliva stimulating medications like pilocarpine and cevimeline, oral lubricant, and saliva substitutes like oral sprays and gels is used to treat the xerostomia. Antifungal or antibiotics are used to treat the condition if the infection is caused by fungi or bacteria.
Intervention with a procedure:
Sialagogues like vitamin C or lemon can elevate the production of saliva. Dental treatments are used to treat tooth decay and gum disease which is common in patients who have xerostomia. Surgery of salivary glands is used to remove any obstructions or tumors which can cause xerostomia.
The phase of management:
The phases of management may differ on the basis of either the treatment is used to reduce the symptoms or any causes of xerostomia. In cute cases, the main focus is to reduce the symptoms and maintain the hydration. In chronic cases, the main focus is to prevent the complications like tooth decay and gum disease. Educate the patient to maintain the proper oral hygiene and avoid the factors which can lead to this condition is necessary to manage the xerostomia.
Xerostomia or dry mount is caused by an insufficient production of pd saliva in the mouth. Saliva is necessary to maintain the oral health of a person. Deficiency of saliva may lead to different problems like difficulty in swallowing, speaking, chewing, sticky and dry feeling in the mouth.People of all ages are affected by xerostomia. It is more common in older people. It may be chronic or temporary and also lead to many dental problems.
Xerostomia can affect about 20 % of the general population. About 40% of the individuals whose age is above 60 years may have symptoms. It affects both women and men. There is no difference in geographic location on the prevalence rate. It is linked with other medical diseases like diabetes, Sjögren’s syndrome, HIV, and AIDS. Medications like antihistamines and antidepressants may lead to xerostomia. Patients who have xerostomia may have elevated risk of dental problems and oral infections.
Salivary gland dysfunction:
Xerostomia is caused by the dysfunction in the salivary glands. It occurs because of different factors like drugs like diuretics, antihistamines, antidepressants, autoimmune diseases like Sjogren’s syndrome. It can lead to inflammation and damage in the salivary glands. Radiation therapy which is used on the head and neck area can damage the salivary glands and reduce the production of saliva. Infections which can affect the salivary glands are like mumps. It can lead to permanent or temporary damage to the salivary glands.
Nerve damage:
Surgery which includes the head and neck area like removal of salivary glands can damage the nerve pathways which stimulate the production of saliva. Neurological diseases like Parkinson’s disease and stroke can affect the nerve pathways which stimulate the production of the saliva.
Other factors:
Other factors like dehydration and aging can lead to xerostomia. Dehydration may reduce the production of the saliva and lead to this condition. After some age, salivary glands can not work properly, and lead to decrease production of saliva.
Aging is a most common factor of xerostomia. Sjögren’s syndrome is an autoimmune disease which affects the lacrimal glands and salivary glands. This can lead to dry mouth and eyes. The body try to conserve the water by decreasing the production of saliva in the dehydration state. Breathing with mouth can lead to xerostomia. Nerve damage because of the surgery or injury can affect the salivary glands and lead to dry mouth. Alcohol and tobacco usage can lead to dry mouth by decreasing the production of saliva. Diabetes can cause this condition because of the high levels of sugar in the blood and dehydration. Radiation therapy, chemotherapy can damage the salivary glands and lead to this condition. Other diseases like AIDS< HIV, Alzheimer’s disease, and Parkinson’s disease can lead to xerostomia.
Xerostomia may be an indicator of different conditions like HIV, AIDS, diabetes, and Sjogren’s syndrome. The prognosis of xerostomia is dependent on the nature and severity of the disease. Antidepressants, antihistamines, and diuretics may lead to xerostomia. The prognosis is dependent on the duration and types of medication which is used. It is common in older people.So the prognosis is also affected by age and management of the symptoms. Poor oral hygiene can cause tooth decay and gum disease. Treatment is dependent on the cause and severity of the disease with improvement of the prognosis with the proper management.
Xerostomia occurs at all age, but it is more common in older people. The factors which can be linked with xerostomia:
Age groups: specifically, whose age is 65 or above
Associated comorbidity or activity: Specific medical diseases and activities can elevate the risk of xerostomia like autoimmune diseases like Sjogren’s syndrome, diabetes, nerve damage, hypertension, certain treatment like chemotherapy and radiation therapy, and medications like diuretics, antidepressants, and antihistamines.
Acuity of presentation: Xerostomia can be present with different severity. Mild cases may lead to thirst and discomfort. Severe cases may lead to difficulty in swallowing, speaking, and eating and elevated risk of dental problems and infections.
The healthcare provider will inspect the oral cavity, tongue, and lips for any signs of damage or dryness. They will palpate the salivary glands to assess for any tenderness or swelling. They use the different diagnostic test to measure the amount of saliva which is produced by the mouth. They will assess the oral health of the patient like any presence of cavities, gum disease, or oral disease which lead to dry mouth. They review the medication of patient to determine any drugs that ah the side effects of dry mouth.
Medication-induced xerostomia: Drugs like antihistamines, antidepressants, decongestants, antihypertensives, muscle relaxants, and diuretics can lead to dry mouth.
Sjögren’s syndrome: This can affect the salivary and lacrimal glands and lead to dry mouth and eyes.
Diabetes mellitus: Elevated levels of sugar in blood can lead to dry mouth and elevate the risk of oral infection.
Radiation therapy: Radiation therapy on the area of neck and head can damage the salivary gland and lead to dry mouth.
Chemotherapy: Chemotherapeutic agents can lead to dry mouth.
Dehydration: Dehydration can cause a dry mouth and other symptoms like thirst, fatigue, and dizziness.
Mouth breathing: Breathing through mouth can lead to dry mouth.
Smoking: Smoking can lead to dry mouth and elevate the risk of oral cancer.
Anxiety: Stress and anxiety can lead to dry mouth because of the elevated activity of sympathetic nervous system.
HIV infection: Patients who have HIV infection may have dry mouth because of the reduced function of salivary glands.
Modification of environment:
Increase the intake of fluid
Use a humidifier in the dry environment
Avoid the consumption of alcohol and tobacco
Chew sugar free gum or candies to increase the production of saliva
Avoid spicy or acidic foods which can cause irritation in the mouth
Use saliva substitute to lubricate mouth
Administration of a pharmaceutical agent:
Saliva stimulating medications like pilocarpine and cevimeline, oral lubricant, and saliva substitutes like oral sprays and gels is used to treat the xerostomia. Antifungal or antibiotics are used to treat the condition if the infection is caused by fungi or bacteria.
Intervention with a procedure:
Sialagogues like vitamin C or lemon can elevate the production of saliva. Dental treatments are used to treat tooth decay and gum disease which is common in patients who have xerostomia. Surgery of salivary glands is used to remove any obstructions or tumors which can cause xerostomia.
The phase of management:
The phases of management may differ on the basis of either the treatment is used to reduce the symptoms or any causes of xerostomia. In cute cases, the main focus is to reduce the symptoms and maintain the hydration. In chronic cases, the main focus is to prevent the complications like tooth decay and gum disease. Educate the patient to maintain the proper oral hygiene and avoid the factors which can lead to this condition is necessary to manage the xerostomia.
Xerostomia or dry mount is caused by an insufficient production of pd saliva in the mouth. Saliva is necessary to maintain the oral health of a person. Deficiency of saliva may lead to different problems like difficulty in swallowing, speaking, chewing, sticky and dry feeling in the mouth.People of all ages are affected by xerostomia. It is more common in older people. It may be chronic or temporary and also lead to many dental problems.
Xerostomia can affect about 20 % of the general population. About 40% of the individuals whose age is above 60 years may have symptoms. It affects both women and men. There is no difference in geographic location on the prevalence rate. It is linked with other medical diseases like diabetes, Sjögren’s syndrome, HIV, and AIDS. Medications like antihistamines and antidepressants may lead to xerostomia. Patients who have xerostomia may have elevated risk of dental problems and oral infections.
Salivary gland dysfunction:
Xerostomia is caused by the dysfunction in the salivary glands. It occurs because of different factors like drugs like diuretics, antihistamines, antidepressants, autoimmune diseases like Sjogren’s syndrome. It can lead to inflammation and damage in the salivary glands. Radiation therapy which is used on the head and neck area can damage the salivary glands and reduce the production of saliva. Infections which can affect the salivary glands are like mumps. It can lead to permanent or temporary damage to the salivary glands.
Nerve damage:
Surgery which includes the head and neck area like removal of salivary glands can damage the nerve pathways which stimulate the production of saliva. Neurological diseases like Parkinson’s disease and stroke can affect the nerve pathways which stimulate the production of the saliva.
Other factors:
Other factors like dehydration and aging can lead to xerostomia. Dehydration may reduce the production of the saliva and lead to this condition. After some age, salivary glands can not work properly, and lead to decrease production of saliva.
Aging is a most common factor of xerostomia. Sjögren’s syndrome is an autoimmune disease which affects the lacrimal glands and salivary glands. This can lead to dry mouth and eyes. The body try to conserve the water by decreasing the production of saliva in the dehydration state. Breathing with mouth can lead to xerostomia. Nerve damage because of the surgery or injury can affect the salivary glands and lead to dry mouth. Alcohol and tobacco usage can lead to dry mouth by decreasing the production of saliva. Diabetes can cause this condition because of the high levels of sugar in the blood and dehydration. Radiation therapy, chemotherapy can damage the salivary glands and lead to this condition. Other diseases like AIDS< HIV, Alzheimer’s disease, and Parkinson’s disease can lead to xerostomia.
Xerostomia may be an indicator of different conditions like HIV, AIDS, diabetes, and Sjogren’s syndrome. The prognosis of xerostomia is dependent on the nature and severity of the disease. Antidepressants, antihistamines, and diuretics may lead to xerostomia. The prognosis is dependent on the duration and types of medication which is used. It is common in older people.So the prognosis is also affected by age and management of the symptoms. Poor oral hygiene can cause tooth decay and gum disease. Treatment is dependent on the cause and severity of the disease with improvement of the prognosis with the proper management.
Xerostomia occurs at all age, but it is more common in older people. The factors which can be linked with xerostomia:
Age groups: specifically, whose age is 65 or above
Associated comorbidity or activity: Specific medical diseases and activities can elevate the risk of xerostomia like autoimmune diseases like Sjogren’s syndrome, diabetes, nerve damage, hypertension, certain treatment like chemotherapy and radiation therapy, and medications like diuretics, antidepressants, and antihistamines.
Acuity of presentation: Xerostomia can be present with different severity. Mild cases may lead to thirst and discomfort. Severe cases may lead to difficulty in swallowing, speaking, and eating and elevated risk of dental problems and infections.
The healthcare provider will inspect the oral cavity, tongue, and lips for any signs of damage or dryness. They will palpate the salivary glands to assess for any tenderness or swelling. They use the different diagnostic test to measure the amount of saliva which is produced by the mouth. They will assess the oral health of the patient like any presence of cavities, gum disease, or oral disease which lead to dry mouth. They review the medication of patient to determine any drugs that ah the side effects of dry mouth.
Medication-induced xerostomia: Drugs like antihistamines, antidepressants, decongestants, antihypertensives, muscle relaxants, and diuretics can lead to dry mouth.
Sjögren’s syndrome: This can affect the salivary and lacrimal glands and lead to dry mouth and eyes.
Diabetes mellitus: Elevated levels of sugar in blood can lead to dry mouth and elevate the risk of oral infection.
Radiation therapy: Radiation therapy on the area of neck and head can damage the salivary gland and lead to dry mouth.
Chemotherapy: Chemotherapeutic agents can lead to dry mouth.
Dehydration: Dehydration can cause a dry mouth and other symptoms like thirst, fatigue, and dizziness.
Mouth breathing: Breathing through mouth can lead to dry mouth.
Smoking: Smoking can lead to dry mouth and elevate the risk of oral cancer.
Anxiety: Stress and anxiety can lead to dry mouth because of the elevated activity of sympathetic nervous system.
HIV infection: Patients who have HIV infection may have dry mouth because of the reduced function of salivary glands.
Modification of environment:
Increase the intake of fluid
Use a humidifier in the dry environment
Avoid the consumption of alcohol and tobacco
Chew sugar free gum or candies to increase the production of saliva
Avoid spicy or acidic foods which can cause irritation in the mouth
Use saliva substitute to lubricate mouth
Administration of a pharmaceutical agent:
Saliva stimulating medications like pilocarpine and cevimeline, oral lubricant, and saliva substitutes like oral sprays and gels is used to treat the xerostomia. Antifungal or antibiotics are used to treat the condition if the infection is caused by fungi or bacteria.
Intervention with a procedure:
Sialagogues like vitamin C or lemon can elevate the production of saliva. Dental treatments are used to treat tooth decay and gum disease which is common in patients who have xerostomia. Surgery of salivary glands is used to remove any obstructions or tumors which can cause xerostomia.
The phase of management:
The phases of management may differ on the basis of either the treatment is used to reduce the symptoms or any causes of xerostomia. In cute cases, the main focus is to reduce the symptoms and maintain the hydration. In chronic cases, the main focus is to prevent the complications like tooth decay and gum disease. Educate the patient to maintain the proper oral hygiene and avoid the factors which can lead to this condition is necessary to manage the xerostomia.
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