XEROSTOMIA

Dr Yoseph Eyob DDM,MD

Lecture for DDM students
Oral pathlogy II
 X erostomia
• Xerostomia refers to a subjective sensation of a dry
mouth; it is frequently, but not always, associated with
salivary gland hypofunction.
• A number of factors may playa role in the cause of
xerostomia
• Any reduction s in salivary function associated with age
are modest and probably are not
associated with any significant reduction in salivary
function.
• Xerostomia in older adults is more likely to be the result
of other factors, especially medications
Medications that May Produce Xerostomia
 Clinical Features
• Examination of the patient typically
demonstrates a reduction in salivary
secretions, and the residual saliva appears
either foamy or thick and "ropey."
• The mucosa appears dry and the clinician may
notice that the examining gloves stick to the
mucosal surfaces.
• The dorsal tongue often is fissured with atroph
y of the filiform papillae
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• The patient may complain of difficulty with mastication and
swallowing and may even
indicate that food adheres to the oral membranes during eating.
• The clinical findings, however, do not always correspond to the
patient 's symptoms
• There is an increased prevalence of oral candidiasis
in patients with xerostomia because of the reduction in
the cleansing and antimicrobial activity normally provided by
saliva.
• In addition, the se patients are more pr one
to dental decay, especially cervical and root caries
 Treatment and Prognosis
• The treatment of xerostomia is difficult and
often unsatisfactory.
• Artificial salivas are available and may help
make the patient mo re comfortable, as ma y
continuo us sips of water throughout the day.
• In addition, sugarless candy can be used in an
effort to stimulate salivary flow.
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• One of the better patient -accepted management
approaches includes the use of oral hygiene products
that contain lactoperoxidase, lysozym e, and lactoferrin
(Blctene toothpaste and mouth rinse; Oral balance gel).
• If the dryness is secondary to the patient's medicat ion,
discontinuation or dose modification in consultation
with the patient's physician may be considered; a
substitute drug can also be tried.
• Systemic pilocarpine is a parasympathomimetic agonist
that has shown great promise as a sialogogue.
• At doses of 5 to 10 mg. three to four times daily