The subjective feeling of oral dryness is
termed as xerostomia.
Xerostomia is a symptom not diagnosis or
It is basically termed as clinical
manifestation of salivary gland
• This includes anxiety & depression.
• These causes decrease in salivary flow rate.
• Blockage of minor salivary glands.
• Commonly submandibular gland is blocked.
• Can produce dryness, along with pain and
swelling in the gland.
• If untreated may cause permanent xerostomia.
• Inflammation of the salivary gland can reduce
• Acute infections such as mumps & post operative
• Chronic infections include swelling of gland.
• Sympathomimetic agents.
• Produces diureses dehydration xerostomia.
SALIVARY GLAND APLASIA-
• Congenital absence of one or more major salivary
• Rare condition.
• Unknown etiology.
• Combination of dry mouth, dry eyes & rheumatoid
• Females commonly affected.
• Age = 40-50 years.
• Swelling of salivary glands may also develop.
• Therapeutic radiography of head & neck tumors.
• Saliva: thickened, altered electrolytes, pH↓,
secretion of immunoglobulins↓.
• Glandular atrophy fibrosis or replaced by fatty
• Atrophy due to ↓ vascularity of gland.
OTHER SYSTEMIC DISORDERS-
• Diabetes mellitus as a result of polyurea.
• Vitamin A, riboflavin, nicotinic acid deficiency.
• Brain tumors
• Diarrhoea etc.
There is lack of saliva.
Duct calculi may lead to unilateral dryness
with pain& swelling on the affected gland.
Sjogren’s syndrome produce bilateral swelling
accompanied by lymph node enlargement in
Dry or burning sensation.
The mucosa appears dry, sometimes inflamed,
On tongue there is atropy of papillae,
inflammation, fissuring & crackling.
In severe cases areas of denudation are seen.
Soreness of mucous membrane.
Caries due to decrease salivary flow rate.
Abnormaily in taste.
Eliminate etiological factors such as drug,
Promote salivary secretion by using sugar
free chewing gums.
Patient must drink plenty of water.
Artificial saliva is avaliable these day.
• Potassium Chloride.
• Sodium Chloride.
• Calcium Chloride.
• Dipotassium hydrogen phosphate.
• Sicca syndrome.
• Gougera sjogren syndrome.
Described by Hernik Sjogren in year 1933.
It’s a chronic autoimmune disorder.
In sjogren’s syndrome the body’s defense system
turns against itself & attacks glands that produce
Sjogren’s syndrome is described as a triad
• Keratoconjunctivitis sicca (dry eye sundrome).
• Xerostomia (dry mouth).
• Rheumatoid arthritis.
PRIMARY SJOGREN’S SYNDROME-
• Comprises of dry mouth & dry eyes.
• Not associated with any connective tissue
SECONDARY SJOGREN’S SYNDROME-
• Comprises dry mouth and dry eyes.
• Associated with disease such as rheumatoid
arthritis & other disorders such as
polymyositis(inflammation of muscles),
The causes of sjogren’s syndrome are known.
In many cases sera antisalivary duct antibody
Associated with HLA(human leukocyte
HLA-DR3 & HLA-B8 are associated only with
primary form of disease.
HLA-DRw52 is assosiated with both the
Predominates in females.
F:M = 10:1.
Children, young adults & older age people
Dryness of moth and eyes due to
hypofunction of salivary & lacrimal glands.
Painful & burning sensation of oral mucosa.
Secretor glands of nose, larynx, pharynx &
tracheobroncial tree are involved with
Parotid gland enlargement.
Schirmer's test - more than 10 mm of moisture
on the filter paper
in 5 minutes is normal.
ESR (Erythrocyte Sedimentation Rate)-
increased in sjogren’s syndrome.
AntiSalivary duct antibodies- elevated.
Sialography- radiographic examination of
the salivary glands.
It usually involves the injection of a small
amount of contrast medium into the salivary
duct of a single gland, followed by routine X-
Demonstrate the formation of puncture,cavity
defects filled with radiopaque contrast media.
These filling defects produce ‘cherry blossom’
or ‘branchless fruit laden tree’ appearance.
No satisfactory treatment.
Keratoconjunctivitis – treated by ocular
lubricants like artificial saliva.
Xerostomia – treated by oral lubricants.
For dental caries oral hygiene & fluoride
application is indicated.
No specific treatment for enlargement of
Sometimes surgery is done in patients with