Xerostomia
Xerostomia is the sensation of dry mouth due to decreased salivary flow, and is common in the elderly. Saliva acts as a lubricant for the oral cavity, promotes remineralization of teeth to prevent decay, and protects against fungal and bacterial infection. Saliva is also the most important protection against caries. Xerostomia significantly increases the risk of caries and periodontal disease.
Etiology
- Medications are the typical cause.
- Other causes include rheumatic disease and radiation therapy.
- Sjögren's syndrome typically presents with xerostomia and xerophthalmia.
Symptoms
- Dry mouth
- Burning sensation
- Changes in taste
- Difficulty with swallowing and speech
A positive response to any of the following questions indicates xerostomia:
- Does your mouth feel dry?
- Does your mouth feel dry when eating?
- Do you have difficulty swallowing dry foods?
- Do you sip liquids to aid swallowing?
- Is the amount of saliva in your mouth too little most of the time?
Examination
- Mucosa is dry and friable in appearance.
- No pooling of saliva in floor of mouth.
Dry Mucosa
References
Visvanathan V, Nix P. Managing the patient presenting with xerostomia: a review. Int J Clin Pract 2010; 64(3): 404–407.
Filshie J, Rubens CN. Complementary and Alternative Medicine, Anesthesiology Clinics of North America 2006; 24(1):81-111.
Guggenheimer J, Moore PA. Xerostomia: etiology, recognition and treatment. Journal of the American Dental Association 2003; 134(1):61-9; quiz 118-9.
Papas AS, Singh M, Harrington D. Stimulation of salivary flow with a powered toothbrush in a xerostomic population. Special Care in Dentistry 2006; 26(6): 241-246.
Papas AS, Singh M, et al. Reduction in caries rate among patients with xerostomia using a power toothbrush. Special Care Dentistry 2007; 27(2):46-51.
Turner MD, Ship JA. Dry mouth and its effects on the oral health of Elderly People. Journal of the American Dental Association 2007; 138(1)15s-20s.