Diseases Causing Oral Dryness
Saliva is important for the maintenance of oral health and also plays an essential role in a number of oral and gastrointestinal functions. Consequently, patients with reduced salivary secretion and changes in their saliva composition are more susceptible
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Diseases Causing Oral Dryness Anne Marie Lynge Pedersen
Abstract
Saliva is important for the maintenance of oral health and also plays an essential role in a number of oral and gastrointestinal functions. Consequently, patients with reduced salivary secretion and changes in their saliva composition are more susceptible to dental caries, oral infections and mucosal lesions and often have symptoms of a dry and sore mouth, burning and itching oral mucosa, difficulties in chewing and swallowing dry foods, impaired sense of taste, difficulty in speaking and problems with acid reflux. These distressing consequences of salivary hypofunction also have a significant negative impact on quality of life and general health status. Several diseases and medical conditions as well as the medications used for treating them are associated with salivary gland hypofunction (objective evidence of diminished salivary output) and xerostomia (subjective sensation of dry mouth). In autoimmune diseases like Sjögren’s syndrome, salivary gland dysfunction is largely related to structural changes in the salivary glands and in endocrine and metabolic disorders mainly related to pathophysiological changes that affect the formation of saliva. Other diseases affect the autonomic outflow pathway involving the salivary gland innervation, the central nervous system and the salivation centre. This chapter reviews systemic diseases and medical conditions associated with salivary gland hypofunction and xerostomia.
A.M.L. Pedersen, PhD, DDS Section of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Noerre Allé 20, Copenhagen 2200, Denmark e-mail: [email protected] © Springer-Verlag Berlin Heidelberg 2015 G. Carpenter (ed.), Dry Mouth: A Clinical Guide on Causes, Effects and Treatments, DOI 10.1007/978-3-642-55154-3_2
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A.M.L. Pedersen
Xerostomia and Salivary Gland Hypofunction Inadequate salivary function is often associated with the sensation of dry mouth referred to as xerostomia. Xerostomia usually occurs when the unstimulated whole saliva flow rate is reduced with about 50 % of its normal value in any given individual [1]. However, xerostomia also occurs in the presence of normal salivary secretion [2] indicating that also the quality of saliva may be of importance to oral comfort. Xerostomia is a common complaint, estimated to daily and persistently affect at least 10 % of an adult population [3, 4] and about 30 % of the elderly people [4]. The increase in prevalence of xerostomia with age is primarily ascribed to a higher incidence of systemic diseases and intake of medications among the elderly [4–6]. Although age-related changes in the structure of the salivary glands might suggest hypofunction, there is no clinically significant reduction in the overall gland output with aging in healthy, non-medicated adults [7]. The term hyposalivation is based on objective measures of the salivary secretion (sialometry) and refers to the co
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