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Dry MouthAka: Xerostomia, Salivary Hypofunction, Decreased Saliva Secretion

Definition
1. Decreased Saliva production
Physiology: Saliva plays vital role in Dental Health
1. Re-mineralizes enamel
2. Buffers cariogenic acids
3. Removes food residue
4. Inhibits bacterial growth
Causes
1. Medications (anticholinergic affect)
  1. Tricyclic Antidepressants
  2. Antispasmodics
  3. Neuroleptics
  4. MAO inhibitors
  5. Antiparkinsonian agents
  6. Lithium
  7. Central Adrenergic Agonists (antihypertensives)
  8. Diuretics
  9. Decongestants
  10. Antihistamines
  11. Bronchodilators
2. Other causes:
  1. Radiation therapy to head and neck
  2. Salivary Gland surgery
  3. Sjogren's Syndrome
  4. Amyloidosis
  5. Human Immunodeficiency Virus (HIV Infection)
  6. Diabetes Mellitus
  7. Major Depression
  8. Granulomatous Disease
Management
1. Consider stopping offending medication
2. Commercial Saliva substitute
3. Fluoride Supplementation
  1. Use 1.1% Fluoride gel daily
  2. Fluoride toothpaste
4. Scrupulous dental care is essential
References
1. Daniels in Goldman (2000) Cecil Medicine, p. 2245

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This page was written by Scott Moses, MD, and was last revised 1/26/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.