Xerostomia: Clinical Aspects and Treatment

Gerodontology - Tập 20 Số 2 - Trang 64-77 - 2003
Sandra F. Cassolato1, Robert S. Turnbull1
1Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Canada M5G 1G6

Tóm tắt

AbstractXerostomia or dry mouth is a condition that is frequently encountered in dental practice. The most common cause is the use of certain systemic medications, which make the elderly at greater risk because they are usually more medicated. Other causes include high doses of radiation and certain diseases such as SjöUgren's syndrome. Xerostomia is associated with difficulties in chewing, swallowing, tasting or speaking. This results in poor diet, malnutrition and decreased social interaction. Xerostomia can cause oral discomfort, especially for denture wearers. Patients are at increased risk of developing dental caries. A thorough intra‐oral and extra‐oral clinical examination is important for diagnosis. Treatment may include the use of salivary substitutes (Biotene), salivary stimulants such as pilocarpine, ongoing dental care, caries prevention, a review of the current prescription drug regimen and possible elimination of drugs having anticholinergic effects. Because of the ageing population, and the concomitant increase in medicated individuals, dentists can expect to be presented with xerostomia in an increasing number of patients in the coming years and therefore should be familiar with its diagnosis and treatment. Therefore, the purpose of this review is to outline for clinicians the common aetiologies, clinical identification, and routine therapeutic modalities available for individuals with xerostomia.

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Tài liệu tham khảo

Rhodus N L, 1990, The association of xerostomia and inadequate intake in older adults, J Am Diet Assoc, 90, 1688, 10.1016/S0002-8223(21)01876-9

Iwamoto R R., 1996, A nursing perspective on radiation‐induced xerostomia, Oncology, 12

Provenza D V, Oral Histology, 1964

Carranza F A, 2002, Carranza's Clinical Periodontology

10.14219/jada.archive.1994.0059

10.1111/j.1741-2358.1995.tb00125.x

10.1111/j.1741-2358.1995.tb00126.x

10.1093/geronj/48.5.M219

10.1152/ajplegacy.1954.178.1.155

10.1111/j.1749-6632.1993.tb18339.x

10.1111/j.1600-0528.1997.tb00928.x

10.1111/j.1600-0528.1996.tb00868.x

Hochberg M C, 1998, Prevalence of symptoms of dry mouth and their relationship to saliva production in community dwelling elderly: the SEE project. Salisbury Eye Evaluation, J Rheumatol, 25, 486

10.1111/j.1600-0528.1993.tb01105.x

10.1111/j.1754-4505.2001.tb00225.x

10.1177/00220345940730010301

10.1111/j.1600-0528.1993.tb00744.x

10.1067/moe.2001.118478

10.1111/j.1532-5415.1995.tb05815.x

10.1111/j.1741-2358.1999.00011.x

Thomson W M, 1993, Medication and perception of dry mouth in a population of institutionalized elderly people, NZ Med J, 106, 219

10.1111/j.1601-0825.1995.tb00177.x

10.1067/moe.2001.117815

10.2337/diacare.15.7.900

10.14219/jada.archive.1998.0315

10.1111/j.1601-0825.1997.tb00362.x

10.1177/026921639500900404

10.1177/00220345840630100101

10.1177/00220345000790111001

10.1177/00220345810600070101

Ship J A, Longitudinal analysis of parotid and submandibular salivary flow rates in healthy, different aged adults, J Gerontol Med Sci, 1995, M285

Ship J A, 2003, Xerostomia and the geriatric patient, J Am Geriatr Soc, 50, 535, 10.1046/j.1532-5415.2002.50123.x

Fox P C., 1997, Management of dry mouth, Dent Clin North Am, 41, 863, 10.1016/S0011-8532(22)00048-9

10.1002/j.0022-0337.2001.65.10.tb03455.x

10.1111/j.1741-2358.1995.tb00133.x

Daniels T E, 2000, Xerostomia ‐ clinical evaluation and treatment in general practice, J Can Dent Assoc, 28, 933

10.1111/j.1532-5415.1989.tb02644.x

McDonald E, 1992, Dry mouth: Diagnosing and treating its multiple causes, Geriatrics, 46, 61

10.1111/j.1741-2358.1997.00033.x

10.1007/s005200050286

Wynn R L, 2000, Artificial saliva products and drugs to treat xerostomia, Gen Dent, 48, 630

10.14219/jada.archive.2001.0056

10.1111/j.1741-2358.2002.00053.x

10.1006/clim.2001.5128

10.1097/00002281-200009000-00007

Edgar W M, 1990, Saliva and dental health

Vivino F B, 1995, Sjögren's syndrome: clinical picture and diagnostic tests, J Musculoskel Med, 12, 40

10.14219/jada.archive.1998.0313

10.1002/art.1780330307

Venables P J, 1997, Viruses in the etiopathogenesis of Sjögren's syndrome, J Rheumatol, 24, 3

Royer B, 1997, Lymphomas in patients with Sjögren's syndrome and marginal zone B‐cell neoplasms, arise in diverse extranodal and nodal sites, and are not associated with viruses, Blood, 90, 766, 10.1182/blood.V90.2.766

10.1136/ard.60.11.1007

10.1097/00000441-200303000-00006

Greenspan B., 1996, Xerostomia: Diagnosis and Management, Oncology, 10, 7

Nagler R, 1996, Major salivary gland dysfunction in human acute and chronic graft‐versus‐host disease (GVHD), Bone Marrow Transplant, 17, 219

Tenovuo J O., 1989, Human Saliva: Clinical Chemistry and Microbiology vol 1

10.1016/S1079-2104(96)80410-0

10.1177/00220345920710070301

10.14219/jada.archive.1997.0371

10.1111/j.1741-2358.1989.tb00403.x

10.1016/S0749-0690(18)30460-9

Jacobs C, 1996, A multicenter maintenance study of oral pilocarpine tablets for radiation‐induced xerostomia, Oncology, 10, 16

10.1046/j.1365-2842.2001.00803.x

10.1111/j.1752-7325.1994.tb01211.x

10.1007/s005200000148

10.1016/S0022-3913(96)90484-9

Epstein J B, 1992, The role of saliva in oral health and causes and effects of xerostomia, J Can Dent Assoc, 58, 217

10.1016/S1368-8375(98)00109-2

Steenberghe D, 1994, Effect of a lactoperoxidase containing toothpaste in radiation‐induced xerostomia, Int Dent J, 44, 133

Banoczy J B, 1994, A clinical study with lactoperoxidase‐containing gel and toothpaste in patients with dry mouth syndrome, J Clin Dent, 5, 65

Odusola F., 1991, Chewing gum as an aid in treatment of hyposalivation, NY State Dent J, 57, 28

10.2165/00002512-199813030-00007

10.1191/026921600672294077

10.1113/jphysiol.1966.sp007870

10.1016/S0360-3016(96)00557-3

Fox P C, 1991, Pilocarpine treatment of salivary gland hypofunction and dry mouth (xerostomia), Arch Intern Med, 151, 1479

10.1590/S0100-879X2002000100015

10.1056/NEJM199308053290603

10.1001/archinte.159.2.174

Compendium of Pharmaceuticals and Specialities (CPS).36th ed. Toronto (ON): Webcom Limited;2001.P1203.

10.1016/0360-3016(94)00361-N

ZuntS L.Lecture entitled: Diagnosis and management of dry mouth/xerostomia/salivary gland hypofunction.Presented at Faculty of Dentistry University of Toronto Nov. 2002.

10.1001/archinte.162.11.1293

10.1097/00002030-199714000-00010

10.1097/00005792-200301000-00004

10.1089/107999099313497

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Gerodontology

Tập 20 Số 2

64-77

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