Xerostomia

:Introduction

Radiotherapy of tumours of the naso- and oropharynx is liable to damage the salivary glands. Therefore, the saliva becomes thick and tenacious with a high viscosity and a lower PH, consequently Xerostomia predisposes to infections, especially: caries, oral candidosis, and acute ascending sialadenitis

:Main causes
A. Drugs: such as: anticholinergics, anti histamines (H1 receptor blockers), tricyclic antidepressants, and sympathomimics.
B.Sjogren syndrome.
C.Diabetes -Type 1.
D.Radiation therapy.
E.Mechanical obstruction.

:Management

With edentulous patients, lemon drops (Glycerin + lemon, mixture 1:1) is useful-

By frequent sips of water or drinks to moisten the mouth continuously-

With dentition patients, in order to prevent caries as the PH is become low, we can use saliva substitutes such as Glandosan, Saliva Orthana, but these seldom relief symptoms for more than an hour or two, and the derived benefit is not greater than that of obtained by frequent sips of water

Pharmacogical stimulation of the salivary glands can be achieved by cholinergic agonists -parasympathomimics- such as Pilocarpine, but they are only used for a short time since they have effects on the gastrointestinal tract and the cardiovascular system and more

If there are some residual salivary functions, diabetes sweets, sugar free chewing gum, and citric and malic acids may enhance the secretion

:The accompanied diseases should be treated, for example
A.Angular chelitis should be treated with an antifungal agent -Nystatin or Metronidazole
B.Dental caries should be managed by a frequent fluoride application

:Please keep in mind that saliva functions are
It keeps the mouth moist-
Facilitates speech-
Lubricates food-
Helps with taste -as it is a food solvent-
Contains a digestive enzyme (Amylase-
Dilutes noxious materials-
Cleanses the mouth-
Contains antibodies-
Acts a buffer by maintaining the PH of the mouth-
:Prepared by

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