Xerostomia

Xerostomia is not a disease, but rather a condition. Drawn from the Greek roots “xeros,” meaning dry, and “stoma,” meaning mouth, it simply denotes a circumstance in which a person has decreased saliva flow.

While it may seem only a minor inconvenience for those not affected by it, xerostomia can have very serious deleterious effects related to nutritional status, speech, and taste. More closely related to dentistry, it can affect a patient’s tolerance to dental prosthesis and also dramatically increases an individual’s susceptibility to dental caries.

Saliva serves as a lubricant in the first stage of digestion, and it also is a key cleansing agent for the mouth. Physically cleaning while continuously washing the teeth, it also helps neutralize the acidic environment created by the sugars we ingest which is so conducive to tooth decay. Without the positive effects of saliva, a patient’s decay rate can sky rocket.

Other signs and symptoms include gingivitis, a burning sensation in the mouth, yeast infections, inability to wear dentures or eat certain foods, diminished sense of taste, and increased susceptibility to infection. Halitosis (bad breath) is a sign of xerostomia. After the flow of saliva decreases, particles that ordinarily would be removed by saliva remain, causing an odor.

Among the causes of xerostomia are several hundred medications currently available, both in over-the-counter and prescription drugs. These include blood pressure medications, antidepressants, analgesics, tranquilizers, diuretics, and antihistamines. Chemotherapy drugs and radiation treatments (used to treat cancer) can also affect the quantity and composition of the salivary flow. Sjogren’s syndrome, which is an autoimmune disease, can decrease secretions from the tear ducts in the eyes, as well as the salivary glands. The aging process in general also causes a lessening of the volume of the saliva.

Unfortunately, for many patients little can be done to alter the underlying causes of xerostomia. Symptomatic treatment may include the use of prescription and over-the-counter saliva substitutes, which can be recommended by a dentist or pharmacist. It is very important to control the caries which inevitably increases in these patients. Extensive use of fluoride products is helpful in these circumstances. Fluoride toothpastes, while readily available, are hardly strong enough to be useful. Prescription strength fluoride pastes and professional fluoride treatments are more effective. Your dentist can help you select products which are appropriate. Chewing gum and lozenges which contain the sugar xylitol can be helpful in two ways. Firstly, these products increase the flow of saliva. Secondly, xylitol has been shown to decrease caries rates in clinical studies.

While xerostomia is mainly an inconvenience, the secondary effects can be rather devastating. If you suspect you suffer from this condition, consult your dentist or physician to see how it can best be managed.

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