Xerostomia is the medical term for the subjective complaint of dry mouth due to a lack of saliva.
EPIDEMIOLOGY:
Studies epidemiologists" have demonstrated like, in general terms, the women are more subject to the xerostomia regarding the men . Also the possibility that is taken in consideration the menopause is xerostomia cause . The xerostomia is on the other hand a common symptom in the old subjects, where usually it is associated to a reduced flow to salivare. Complicating the other oral problems and dentale legacies to the age, it can determine deficit of the feeding and involuntary loss of weight in the more fragile old subjects and to be cause of mortality. A natural decline of the function to salivare can contribute, but the xerostomia of the old commonly is associated to the medicine use . Various autoimmune pathologies, between which the sarcoidosi and the syndrome of Sjögren", they can be associate to xerostomia. In particular, the syndrome of Sjögren is an autoimmune chronic esocrinopathy that hits with clean prediletion feminine sex (80-90% of the cases) and rebels mainly after the 40 years of age. It is a enough frequent disease, with a medium prevalence of 0.2%. One is since 40% of the patients that resorts to the specialist for a xerostomia are affection from such pathology .
SYMPTOMS:
Xerostomia have many symptoms and is a symptom that acts like a disease.
-A sticky, dry feeling in your mouth and tongue
-Cracked lips
-Difficulty in chewing, swallowing, tasting, or talking.
-Mouth sores
-Frequent bad breath
-Dentures that do not fit comfortably.
-Sore throat.
DIAGNOSIS
the xerostomia diagnosis is simple when the anamnesis, the symptomatology and the objective examination agree with the appearance of the symptom. Very more complex is, instead, to quantify it, that is to establish the degree of compromissione of the woven one to ghiandolare for being able to set up an adequate therapy. The methodical ones commonly used (2) for their validity, simple of execution and low cost, are the scintigraphy" to salivare sequenziale with “99Tc” and the Saxon test" The first examination affords to record the phases of secretion of the gland also when the xerostomia degree is light. Second the methodical one consists in making to chew to the patient for 2 refolded sterile bandage minutes spugnetta (dimensions 5×5 cm), which comes then weighed in tubes standard of which the tare is known.
CAUSE OF XEROSTOMIA:
There are several reasons that might cause a consistent dry mouth problem.
-Smoking is one of the top causes of dry mouth. Many heavy smokers experience dry mouth symptoms.
-Dry mouth can be a side effect of prescription drugs and medicines, that reduces the flow of saliva. . Drugs used to control high blood pressure, parkinson disease , anti-anxiety agents, anti-depressants, antihistamines, decongestants and pain killers are some of the drugs causing xerostomia.
-Conditions that lead to dehydration, such as fever, excessive sweating, vomiting, diarrhea can cause temporary dry mouth.
-Some systemic diseases and conditions that affect the salivary glands cause dry mouth syndrome. (diabetes, Hodgkin's, Parkinson's disease, HIV/AIDS" who are increase disease in the women and Sjogren's syndrome are usual causes of xerostomia symptoms)
-Cancer treatment with Radiation therapy and chemotherapy can damage the salivary glands reducing or even stopping the saliva flow.
PATHOGENESIS:
The salivary glands are innervate by likeable the independent or parasympathetic nervous system or sympathetic . The vasomotor fibers of the two sections control the blood flow to glands and the motor fibers make to contract the epithelial cells. The fibers, at last, give beginning to the formation of went up primary in the acinus" influence on the absorption and the secretion of some Ionian ones in the scholars and stimulate esocito of containing grains the macromolecules like the amylase, in the acinar cells and the kallikrein, in the scholars.
The xerostomia however very often is caused by drugs and is brought back that more than 600 drugs than common use they can cause Cracked of the associate mouth or less to reduced function of the salivari glands. Mechanisms"of the xerostomie from drugs.It wend up has a pH optima of 7.4. Ace-inibitor" one of the drugs that cause xerostomia.
PATIENTS RISK FACTORS :
Age and medication are significant risk factors for xerostomia, attending general dental practice such as smoking, mouth-breathing and intake of caffeine-containing beverages, increase the risk of xerostomia. Decreasing or ceasing these practices, if possible, should have some impact on dry mouth.
Mutations in the gene encoding fibroblast growth factor 10 are associated with aplasia of lacrimal and salivary glands
Decrease in salivary secretion by radiation mediated by nitric oxide and prostaglandins"
TISSUE SPECIFIC RISK FACTORS:
The nictric oxide" and prostaglandins" are subtance who destruct the epitelial cells and are cause of many dru mouth pathology.
COMPLICATIONS:
Complications of xerostomia include:
- Dental caries
- Gingivitis
- Periodontal disease
- Glossitis"
CONCLUSION:
Xerostomia is an increasing problem; however, the dental care professional plays an important role in facilitating effective xerostomia management, which greatly improves the health and quality of life of the dry mouth patient. In addition, this ties in with the new concept 'Minimal Intervention Dentistry' and its emphasis on promotion of healthy saliva.
