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Xerostomia

Xerostomia refers to dry mouth which results when there is a decrease in salivary secretion or an alteration in the quality of saliva due to the impairment of salivary gland function. It is a common condition and is different from the mouth dryness which occurs during fear and stress.

Symptoms

The following symptoms may be evident in patients with xerostomia:

  • Inflammation and fissures on lips
  • Sticky saliva
  • Bad breath
  • Difficulty in swallowing food without any liquids
  • Difficulty with speech
  • Alterations in the taste
  • Burning sensation in the mouth
  • Excessive thirst especially during night

Causes

There are multiple causes for the dry mouth of which the most common causes include:

  • Dehydration due to inadequate fluid intake
  • Sleeping with the mouth open
  • Underlying diseases such as diabetes, hypertension, hypothyroidism, and depression
  • Side effects of several medicines
  • Head and neck irradiation which damages the salivary glands
  • Surgery which causes damage to the nerves in the head and neck
  • Exercising or playing in hot climates

Risk factors

Xerostomia is more common in older individuals as they tend to use multiple medicines. However, dry mouth is not linked with ageing. Smoking and use of removable dentures are the factors which make a person more prone to develop dry mouth.

Complications

Xerostomia can lead to the following complications if a timely treatment is not provided:

  • Dental cavities
  • Gingivitis
  • Tooth decay
  • Fungal infections of the mouth such as thrush
  • Poor nutrition due to the difficulty with swallowing

Diagnosis

Diagnosis begins after taking a complete medical history of the patient along with the symptoms. Dry mouth is usually diagnosed clinically. Physical examination mainly includes checking for the insufficient pooling of saliva around or under the tongue, presence of cavities near the necks of the teeth at the gumline and parched or fissured tongue. Some of the tests which may be performed include:

  • Blood tests
  • Imaging tests such as CT scans, MRI, x-rays of the salivary glands
  • Sialometry to measure the flow rate of the saliva
  • Sialography (radiographic examination) of the salivary glands and ducts to identify any unusual masses

Sometimes a biopsy or tissue sample of the salivary gland is performed if a cancer is suspected. The doctor will take a sample of the suspected tissue and examine it under the microscope to check for abnormalities.

Treatment

Treatment of xerostomia is based on the cause and may include the below approaches:

  • If use of medicines has resulted in dry mouth, the doctor will either adjust the dose of such medicine or may prescribe altogether a new drug.
  • An oral rinse may be prescribed to restore the moisture in the mouth and provide a symptomatic relief. If this is not helpful, then medications may be prescribed to stimulate the secretion of saliva.
  • Use of fluoride trays may be suggested to prevent cavities. These trays should be filled with fluoride and worn over the teeth during night times.

Self-care

Some of the self-care measures which can help to prevent xerostomia are as follows:

  • Chewing sugar-free gums which can stimulate the secretion of saliva
  • Drinking plenty of water or other fluids to prevent dehydration
  • Avoiding the use of dentures during sleep
  • Moderating the consumption of alcohol and caffeine
  • Brushing and flossing the teeth and gums everyday
  • Visiting the doctor regularly for dental check-ups.
  • Using a vaporizer to improve the moisture levels of the room.
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