medigraphic.com

2008, Number 1

<< Back

Rev Med Inst Mex Seguro Soc 2008; 46 (1)

Xerostomia: Etiology, Diagnosis and Treatment

Gallardo JM

Language: Spanish
References: 70
Page: 109-116
PDF size: 167.72 Kb.


ABSTRACT

Salivary hypofunction caused by salivary gland disease, medication, or radiation may predispose for secondary oral mucosal disease. In these patients the protective coating of saliva is reduced or absent, leaving the oral mucosa more vulnerable. Candidiasis, burning mouth syndrome, and white lesions of oral mucosa are increased in frequency. The aim of management is to prevent oral pathological changes. The management procedure may include proper oral hygiene, saliva-stimulating agents, or saliva substitutes, depending on the severity of the salivary dysfunction. Treatment includes antifungal therapy if fungal infection appears. In severely distressed patients, local or systemic corticosteroids may be indicated. Precautions like refraining from smoking and avoid agents with detergents. Some antiinflammatory agents could be help.


REFERENCES

  1. Sreebny LM, Broich G. Xerostomia. En: Sreebny LM, editor. The salivary system. Miami, USA: CRC Press; 1987. p. 179-197.

  2. Fox PhC, Weiffwnbach JM, Van der Ven PF, Baum BJ, Sonies BC. Xerostomia: evaluation of a symptom with increasing significance. J Am Dent Ass 1985;110:519-525.

  3. Shafer WG, Levy BM. Tratado de patología oral. México: Interamericana; 1987. p. 34-35.

  4. Seifert G, Miehlke A, Haubrich J, Chilla R. Disorders of secretion. En: Seifert G, editor. Diseases of the salivary glands. Pathology-diagnosis-treatment. Stuttgart, Germany: Theme Vertag Theem; 1986. p. 71-76.

  5. Grad H, Grushka M, Yanover L. Drug induced xerostomia. The effects and treatment. J Can Dent Assoc 1985;4:296-299.

  6. Ship J, Grushka M, Lipton J, Mott A, Sessle B, Dionne R. Burning mouth syndrome: an update. J Am Dent Assoc 1995;126:842-853.

  7. Rhodus NL, Brown J. The association of xerostomia and inadequate intake in older adults. J Am Dietetic Assoc 1990;90:1688-1692.

  8. Sreebny LM, Schwartz SS. A reference guide to drugs and dry mouth. Gerodontology 1986;5: 75-99.

  9. Ship J, Baum B. Is reduced salivary flow normal in old people? Lancet 1990;336:1507.

  10. Loesche WJ, Bromberg J, Terpenning MS, Bretz WA, Dominguez BL, Grossman NS. Xerostomia, xerogenic medications and food avoidances in selected geriatric groups. J Am Geriatr Soc 1995; 43:401-407.

  11. Geigy. Tablas científicas. Sexta edición. Suiza: Documenta Geigy; 1965. p. 531-533.

  12. Mason DK, Chisholm DM. Salivary glands in health and disease. London, United Kingdom: Saunders; 1975. p. 37-135.

  13. McDonald E, Marino C. Dry mouth: diagnosis and treating its multiple causes. Geriatrics 1991; 46: 61-63.

  14. Carmona L. Terapia local del síndrome de Sjögren. Una revisión práctica. Rev Esp Reumatol 1994; 21:259-262.

  15. Douglas H. Protective and maintenance functions of human saliva. Quintessence Int 1993;24: 813-816.

  16. Courtois P, Van Beers D, de Foor M, Mandelbaum IM, Pourtois M. Abolition of herpes simplex cytopathic effect after treatment with peroxidase generated hypothiocyanite. J Biol Buccale 1990; 18:71-74.

  17. Pourtois M, Binet C, Van Tieghem N, Courtois P, Vandenabbeele A, Thiry L. Inhibition of HIV infectivity by lactoperoxidase produced hypo-thiocyanite. J Biol Buccale 1990;18:251-253.

  18. Roberts BJ. Help for the dry mouth patient. J Dent 1982;10:226-234.

  19. Mandel I. The role of saliva in maintaining oral homeostasis. JAMA 1989;119:298-304.

  20. Ship JA, Fox PC, Baum BJ. How much saliva is enough? “Normal” function defined. J Am Dent Assoc 1991;122:63-69.

  21. Glick D, Ben-Aryeh H, Gutman D, Szangel R. Relation between idiopathic glossodynia and salivary flow rate and content. Int J Oral Surg 1976; 5:161-165.

  22. Dubner B, Senle BJ, Stoney AT. The neural basis of oral and facial function. London, United Kingdom: Plenun Press; 1978. p. 390-409.

  23. Steckfus C. Salivary function and hypertension: a review of the literature and a case report. J Am Dent Assoc 1995;126:1012-1017.

  24. Fox RI. Fifth International Symposium on Sjögren’s Syndrome. Arthritis Rheum 1996;9:195-196.

  25. Eli I, Baht R, Littner MM, Kleinhauz M. Detection of psychopathologic trends in glossodynia patients. Psychosom Med 1994;56:389-394.

  26. Grinspan D. Enfermedades de la boca. Buenos Aires, Argentina: Mundi; 1977. p. 2457.

  27. Grinspan S. The mouth and perioral tissue. New York, USA: Crispian; 1980. p. 402.

  28. Preda EG, Pasetti P, Caggiula S. Oral pathology of psychosomatic origin of emotional stress. Review of the literature. Dent Cadmos 1990;58: 66-72.

  29. Andrews VH, Hall HR. The effects of relaxation imagery training on recurrent aphthous stomatitis. Psychosom Med 1990;52:526-534.

  30. Theorell T, Orth G. Slow-reacting immunoglobulin in relation to social support and changes in job strain. Psychosom Med 1990;52:511-516.

  31. Kiecolt JK. Psychoneuroimmunology: can psychological intervention modulate immunology? J Cons Clin Psych 1992;60:569-575.

  32. Brosschot JF. Effect of experimental psychological stress on distribution functional of peripheral blood cell. Psychosom Med 1992;54:394-406.

  33. Toth BB, Martin JW, Fleming TJ. Oral complication associated with cancer therapy. J Clin Period 1990;17:508-515.

  34. Ritchie JR. Dental care for the irradiated cancer patients. Quintessence Int 1985;12:837-843.

  35. Jacob R, Weber R, King G. Whole salivary flow rates following submandibular gland resection. Head Neck 1996;5-6:242-247.

  36. Bergdahl J, Anneroth G, Anneroth I. Clinical study of patients with burning mouth. Scand J Dent Res 1994;102:299-305.

  37. Cauli A, Yanni G, Pitzalis C, Challacombe S, Panayi G. Cytokine and adhesion molecule expression in the minor salivary glands of patients with Sjögren’s syndrome and chronic sialoadenitis. Ann Rheum Dis 1995;54:209-215.

  38. Rhodus N, Brown J. The association of xerostomia and inadequate intake in older adults. J Am Diet Assoc 1990;90:1688-1692.

  39. Epstein J, Freilich M, Le N. Risk factors for oropharyngeal candidiasis in patients who receive radiation therapy for malignant conditions of the head and neck. Oral Surg Oral Med Oral Pathol 1993;76:169-174.

  40. Widdop F. Caring for dental elderly. Int Dent J 1989;39:85-94.

  41. Vitali C. On focal lymphocytic sialoadenitis as a gold standard for diagnosis of Sjögren’s syndrome. Arthritis Rheum 1995;38:869-876.

  42. Tenouve J. Human saliva clinical, chemistry and microbiology. Miami, USA: CRC Press; 1989. p. 26-32.

  43. Chatelut E, Rispail Y, Berlan M. Yohimbine increases human salivary secretion. Br J Clin Pharmacol 1989;28:366-368.

  44. Rhodus NL. Xerostomia and the geriatric patients. Dentistry 1988;12:12-16.

  45. Neil G. Fisiología y bioquímica bucal. México: Limusa; 1983.

  46. Bagan S. Medicina oral. Barcelona, España: Mason; 1995. p. 284.

  47. Fox P, Van der Ven P, Sonies B, Weiffenbach J, Baum B. Xerostomia: evaluation of a symptom with increasing significance. JADA 1985;110:519-525.

  48. Aguilera S, Lobo G, Ladrón de Guevara D, Zerboni A. Utilidad de la escintigrafía de glándulas salivales en el síndrome de Sjögren y su relación con el resultado de la biopsia de labio. Estudio comparativo con una población control. Rev Med Chil 2000;128:877-886

  49. Oliva AH, Aguilera TB, Segura PG, Rivas MC. Patología de la glándula salival labial en el síndrome por aceite tóxico adulterado en España: una forma de síndrome de Sjögren secundario. Rev Clin Esp 1988;182:71-78.

  50. González E, López A, Granados M, Hernández G. Hiperplasias gingivales farmacoinducidas. Aten Primaria 1995;16:367-372.

  51. Wiseman L. Oral pilocarpine: a review of its pharmacological properties and clinical potential in xerostomia. Drugs 1995:49:143-155.

  52. Carr DS, Noble TA. Oral pilocarpine for xerostomia. Drug Int Clin Pharm 1988;22:794-795.

  53. Fox PH, Ven P, Baum B, Mandel I. Pilocarpine for the treatment of xerostomia associated with salivary gland dysfunction. Oral Surg Oral Med Oral Pathol 1986;61:243-245.

  54. Fox PH, Atkinson J, Macynski A, Wolff A, Kung D, Valdez I, et al. Pilocarpine treatment of salivary gland hypofunction and dry mouth (xerostomia). Arch Intern Med 1991;151:1149-1152.

  55. Johnson J, Ferretti G, Nethery J, Valdez I, Fox Ph, David NG, et al. Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer. N Engl J Med 1993;329:390-395.

  56. Le Veque F, Montgomery M, Potter D, Zimmer M, Ricke J, Steiger B, et al. A multicenter, randomized, double-blind, placebo-controlled, dosetitration study of oral pilocarpine for treatment of radiation induced xerostomia in head and neck cancer patients. J Clin Oncol 1993;11:1124-1131.

  57. Foster HE, Gilroy JJ, Kelly CA, Howe J, Griffiths ID. The treatment of sicca features in Sjögrens’s syndrome: a clinical review. Br J Rheum 1994;33: 278-282.

  58. Joensuu H. Treatment for post-irradiation xerostomia. N Engl J Med 1994;220:141-142.

  59. Wiesenfeld D, Stewart AM, Mason DK. A critical assessment of oral lubricants in patients with xerostomia. Br Dent J 1983;155:155.

  60. Reijden W, Kwaak H, Vissink A, Veerman E, Nieuw A. Treatment of xerostomia with polymer- based saliva substitute in patients with Sjögren’s syndrome. Arthritis Rheum 1996;39:57-62.

  61. Lynch A. Oral medicine Burket’s. Diagnostic and treatment. Philadelphia, USA: Lippincott; 1984.

  62. Jansma J, Vissink A, Spijkervet FKL, Roodenburg JLN, Panders AK, Vermey A, et al. Protocol for the prevention and treatment of oral sequelae resulting from had and neck radiation therapy. Cancer 1992;70:2171-2179.

  63. George CF. British National Formulary. London, United Kingdom: BMJ Books; 1996. p. 450.

  64. Spielman A. Xerostomia: diagnosis and treatment. Oral Surg 1981;51:144-147.

  65. Sullivan DH. Impact of nutritional status on health outcomes of nursing home residents. J Am Geriatr Soc 1995;43:195-196.

  66. Shay K, Ship JA. The importance of oral health in the older patient. J Am Geriatr Soc 1995;43:1414-1422.

  67. Sweeney MP, Bagg J, Fell GS, Yip B. The relationship between micronutrient depletion and oral health in geriatrics. J Oral Pathol Med 1994;23:168-171.

  68. Johnson DA, Alvarez OF. Zinc deficiency-induced changes in rat parotid salivary proteins. J Nutr 1984;114:1955-1964.

  69. Johansson I, Tedehag P, Lundberg V, Hallmans G. Dental status, diet and cardiovascular risk factors in middle-aged people in northern Sweden. Community Dent Oral Epidemiol 1994;22:431-436.

  70. Sullivan DH, Walls RC. Impact of nutritional status on morbidity in a population of geriatric rehabilitation patients. J Am Geriatr Soc 1994;42:471-477.




2020     |     www.medigraphic.com