Dry mouth (xerostomia) is a result of a salivary hypofunction where the salivary glands produce less or decreased amount of saliva as it used to.
Mentioned in the article were the causes that lead to dry mouth, i.e, a number of salivary gland disorders and as side effects to non-prescriptive and prescriptive medications, and chemotherapeutic and radiation treatments to cancers. This study focuses on the elderly people, as this population is more likely to take medications compared to the rest of the human population. In addition, “xerostomia often accompanies the normal aging process; between 25% and 50% of people over 65 complain of increasing dryness of mouth” (Swartout-Corbell & Frey, 2006).Medications like anticholinergics were found to cause dry mouth. Aside from this, antihistamines, antidepressants and antihypertensives, anti-Parkinsonism, antiseizure and even over-the counter medications also attribute to cause a decrease in salivary output leading to dry mouth. This drug-induced dry mouth is the most common cause, thus increasing the incidence of xerostomia in the elderly people since the majority of the elderly population is taking the above aforementioned medications.
Chemotherapeutic medications and radiation therapies for head and neck cancers are also associated with salivary disorders. These therapies are known to damage the salivary tissues and cause extreme and permanent salivary hypofunction resulting to xerostomia. Further doses of chemotherapeutic and radiation will ultimately lead to severe decline of salivary output with no recovery causing a number of oropharyngeal side effects.Sjorgen’s syndrome was also mentioned in this article to cause xerostomia especially with the older people. Sjorgen’s syndrome is a systemic autoimmune connective tissue disorder that is associated with dry mouth and failure of the salivary glands to function well. Hormonal factors play a role in this syndrome as this occurs predominantly in women. This syndrome is genetically inherited as incidence of higher Sjorgen’s syndrome antibodies were found in people with this disorder running in their families.Production of normal amount of saliva necessary to maintain a good oropharyngeal health is important.
Saliva plays a vital role in swallowing, ingestion of food, creating healthy oral environment, speech and breaking down of food ingested. Decrease in saliva production and xerostomia due to altered salivary glands as a result to side effects of medication, chemotherapeutic agents, radiation therapies and autoimmune disorder such as Sjorgen’s syndrome will give rise to a number of oral disorders.Plaque and calculus growth in teeth of individuals with xerostomia and decreased salivary function are common. Problems pertaining to swallowing will also be encountered as saliva helps out in easy ingestion of food particles especially the dry ones. Fungal growth on the tongue of these patients also arise as saliva’s function in providing a healthy oral environment is altered.
Fungus may also grow in the corners of the dry mouth. Patients using dentures will experience denture sores, eating difficulties and even speech problems. Dental caries are also common, as deficient amount of saliva in the mouth will increase bacterial growth since saliva helps out maintaining the oral pH of the mouth. Infection of the salivary and parotid glands will cause an enlargement of these glands. These glands may be palpable and visible and could sometimes distort the patient’s appearance like displacing the earlobe.The article also mentioned steps in treating xerostomia. Treatment of xerostomia in the elderly adults will involve a multidisciplinary team of health care professionals because this population is concurrently facing a number of medical issues and are taking a lot of medications.
If the patient is diagnosed with xerostomia, referral to his/her dentist is very important. Regular dental visits are essential to prevent the development of other oral disorders like dental caries, fungal and bacterial growth in the mouth as well as difficulty swallowing. Clinicians should educate and instruct patients about how low-sugar diets, regular use of topical fluorides, antimicrobial mouthrinses, oral moisturizers and lubricants, drinking of fluids when eating and even bedside humidifiers when sleeping could help in the prevention of acquiring these oral disorders. Stimulation of the salivary glands like sugar-free chewing gums and candies are instructed to patients with some intact salivary gland functions. Treatment regimen of pilocarpine and cevimeline was included, effective in increasing salivary production thereby decreasing dry mouth problem.
Xerostomia (dry mouth), in general is marked by a significant reduction in the secretion of saliva. Xerostomia is manifested by dryness of mouth, cracked lips, cuts, or cracks at the corners of the mouth, taste changes, burning sensation of the tongue and difficulty swallowing fluids accompanied by an increase in thirst. Development of gum diseases and cavities is increased in xerostomia because it makes the mouth less able to neutralize acid, clean the teeth and gums, and protect itself from infection (Swartout-Corbell & Frey, 2006).I totally agree with this article.
The elderly people is very susceptible to xerostomia and salivary hypofunction since they are the population facing concomitant medical issues and taking the most numbers of medications. As mentioned earlier, drug-induced xerostomia is most common as xerostomia is a side effect of numerous medications or drugs, may it be a prescription or non-prescription one. Early diagnosis of xerostomia to an elderly individual is very beneficial for the clinician to give preventative measures and treatment interventions, thus inhibiting the deleterious effects of dry mouth thereby improving the elderly individual’s quality of life.