XEROSTOMIA; How to mange the dryness of the mouth.

Xerostomia (dry mouth)

 

Xerostomia is defined as the dryness of the mouth resulting from reduced or absent saliva flow. It is not a disease pathology, but it may be a symptom of various medical conditions, a side effect of a radiation to the head and neck, or a side effect of a wide variety of medications.

It is about 20% prevalent, with about 50%of cases found more in Elderly Individuals. It occurs more in female than in male.

 

Causes

  • Dehydration
  • Radiotherapy and chemotherapy.
  • Generalized Anxiety Disorder.
  • Medications such as Bronchodilators, piriton, diuretics, omeprazole , cancer drugs etc
  • Disease conditions like sicca syndrome, sjogren’s syndrome, upper respiratory tract Infection, Diarrhea etc
  • Surgical removal of salivary gland.
  • Lifestyle such as smoking or chewing tobacco.

SIGNS AND SYMPTOMS

Saliva is regarded as a catalyst which moistens our food thereby aiding in mastication and digestion of food. It also prevents infection in the mouth.

When there is deficit production of saliva, It leads to:

  • Fatigue
  • Discomfort
  • Insomnia/ lack of sleep
  • Oral Candidiasis or thrush.
  • Dental caries.
  • Dysphagia or difficulty in swallowing especially when eating dry food.
  • Sticking of tongue into the palate.
  • Cracked Lip.

MANAGEMENT

  • Offer frequent sips of water or artificial saliva.
  • Encourage the person to breath through the nose and desists from breathing through the mouth.
  • Lubricate with gravies, butter, margarine, milk, cream ,or bouillon ,Sugarless hard candy, chewing gum, or popsiclesso as to stimulate saliva production.
  • . Products such as fluoride toothpaste, moisturizing gel, or mouthwash can be used to promote good oral hygiene and decrease dryness
  • . If the patient is allowed occasional ice chips, they can be made from normal saline to prevent depletion of electrolytes.
  • . Adequate post-prandial(oral hygiene) oral hygiene and prompt treatment of oral candidiasis are essential.
  • Encourage frequent mouth care.
  • Saliva substitute is available over the counter and is helpful, especially at night when patients complain of a choking sensation from extreme dryness.
  • .
  • A dry mouth is uncomfortable and can cause increased bacterial accumulation and mucous membrane breakdown
  • . Alcohol-containing mouthwashes increase dryness and should be avoided. Lemon glycerin swabs may also increase dryness .so therefore should be avoided.
  • ,Artificial saliva and oral gels can be tried for xerostomia but are often not effective.
  • Stimulation of saliva flow by sugar-free chewing gum or lozenges may be helpful.

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