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Christabel E. Fowler, David Urquhart
Introduction:
Xerostomia can be defined as the subjective sensation of dry
mouth, and can result in profound negative effects on the quality
of life.1 Dietary habits, nutritional status, speech, and taste can
all be affected, as well as tolerance to dental prostheses and susceptibility
to dental caries and yeast infections (in particular,
candidiasis), along with a tendency toward increased tooth wear.2
One hypothesis is that xerostomia occurs when the salivary flow
rate is lower than the rate of water loss due to evaporation from
the mouth and adsorption by the oral mucosa.3 This leads to a
thinning of the salivary film and the subsequent complaint of
xerostomia. A common cause of xerostomia is the use of medications
with anticholinergic side-effects, such as certain antihypertensives,
antidepressants, analgesics, tranquilizers, diuretics,
and antihistamines. Over 400 medications can produce the
side effect of xerostomia.4 Indeed, of the 200 most prescribed
drugs in the United States in 1992, 63% had the potential to cause
xerostomia.5 Other less common causes include Sjögren's syndrome,
radiation therapy, nerve damage caused by head and
neck trauma, endocrine disorders, stress, anxiety, depression,
and bone marrow transplantation.
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References:
- Cooke C, Ahmedzai S, Mayberry J: Xerostomia: A Review. Palliative Med 10:284Ð292, 1996.
- Young W, Khan F, Brandt R, Savage N, Razek AA, Huang Q: Syndromes with salivary dysfunction predispose to tooth wear: Case reports of congenital dysfunction of major salivary glands, Prader-willi, congenital rubella, and Sjögren's syndromes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 92:38Ð48, 2001.
- Dawes C: How much saliva is enough for avoidance of xerostomia? Caries Res 38:236Ð240, 2004.
- Kroll B: Dry mouth. The pharmacist's role in managing radiation-induced xerostomia. Pharm Pract 14:72Ð82, 1998.
- Smith RG, Burtner AP: Oral side-effects of the most frequently prescribed drugs. Spec Care Dent 14:96Ð102, 1994.
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