2. Saliva plays an important role in oral health. It functions
in protection against bacteria and fungi, transportation
of nutrients and digestive enzymes, lubrication of the
oral cavity, remineralization of teeth, as well as aiding
in chewing, swallowing, and speech..
Importance of Saliva:
3. Xerostomia is the perception of dry mouth and
can be associated with diminution of salivary
flow. A reduction of salivary flow by *40%–50% *
makes the patient symptomatic and prone to develop
xerostomia. Oral dryness (OD) can profoundly
affect the quality of life and interfere with basic daily
functions.
Xerostomia:
4. Pale and thin oral mucosa, which has lost
its glistening appearance
Mouth mirrors or tongue blades tend to
attach this type of mucosa easily, and thick
whitish threads of saliva are often seen on
the mucosal surfaces
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Headline
Pleas your text
Symptoms:
5. 3
4
Existing saliva is viscous and appears
foamy.
lack of saliva decreases swallowing
frequency
Symptoms:
6. 1
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primary or direct cause which affect
salivary gland and cause decreased salivary
production (Sjögren syndrome)
secondary or indirect cause (radiotherapy)
and medication
Causes:
7. Forms of Sjögren Syndrome:
Primary:
In the primary Sjögren syndrome the inflammatory
process is limited to exocrine glands;
Secondary:
In secondary Sjögren syndrome the exocrine involved is
associated with other autoimmune diseases or
connective tissue diseases
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8. What’s is Sjögren syndrome?
•It is the most common autoimmune disease that
involves the exocrine glands especially lacrimal and
salivary gland. It's chronic slowly progressive
multiexocrionpathy disease which is characterized by dry
mouth resulting in xerostomia and dry eye as it attacks
the glands that make saliva and tears.
Studies have suggested that the under lying cause of
approximately 40% xerostomia is Sjögren syndrome and its
duration is in positive correlation with severity of xerostomia.
The progressive lymphatic infiltration gradually destroy the
secretory acini of the major and minor salivary glands which
result in hypo salivation and finally in xerostomia.
How does it cause xerostomia?
9. What’s the use of Radiotherapy?
Right head and neck is a therapy that is used to treat the
cancer by killing cancer cell and can be used by its own
but it is often used in combination with chemotherapy.
How does it cause Xerostomia?
Their is a recovery if the dose is less than 25 gy on the other
hand if dose increase it will lead to atrophy of the gland
After 1 week from radiation, Salvation decrease from 60 to 90%.
Causing acute or late xerostomia because degree of salivary
gland damage depend on number of salivary gland exposed to
radiation and dose of radiation.
10. How does medication causes Xerostomia?
It was recorded that about 80% of drugs cause xerostomia .
For example , All drugs that are used to treat : depression ,
anxiety, hypertension, Parkinson's disease, pain and allergy
cause xerostomia.
11. Complications:
decrease the defense mechanism of the oral cavity and
makes it more susceptible to microbial growth ex:
Candida infections that appear as pseudo membranous
Development of Dental caries The carious lesions
develop fast and the appear on surfaces not
normally at risk for caries (ex: incisal edges)
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12. Treatment:
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Use a humidifier: The dry ambient air of most modern
homes contributes to one’s sensation of dryness.
The use of a humidifier, particularly at night, helps address
this concern.
Frequently sip fluids: Frequent sips of small amounts of fluids,
especially water, can be quite helpful in diminishing the effects
of oral dryness. Letting chips of ice dissolve in the mouth may
also be useful.
Alcohol free mouth rinses: There are numerous
marketed mouthwashes that either sooth the mouth
or help with re-mineralizing teeth.
13. Treatment:
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Protect dry lips: Dry cracked lips contribute to the
annoyance of oral dryness. The regular use of topically
applied oil-based balms or lipsticks may provide
soothing relief
Use sugar-free salivary stimulants: To the extent that
functional salivary tissue remains, the regular use of
gums, mints, and candies can help stimulate salivary
flow.
Saliva substitutes / moisturizing sprays / gels: There are
many products that may aid in moisturizing and
lubricating the oral tissues .
14. Treatment 7
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Avoid caffeine: Caffeine is as a mild diuretic which
promotes fluid loss and may worsen dry mouth. one
should avoid or limit items which contain significant
amounts of caffeine such as coffee or tea
Avoid sugary food and drinks: Decrease your fermentable
carbohydrate intake, especially for sticky foods such as
cookies, bread, potato chips, gums, candies. Avoid the
frequent intake of acidic beverages (such as lemon)
Perform oral hygiene : Your dentist should reinforce the
importance of regular brushing and flossing and may
also recommend a prescription strength fluoride to be
used in addition to your regular toothpaste.
15. Refrences
1-Bhandare, N. and W. Mendenhall, A literature review of late complications of radiation therapy for head and
neck cancers: incidence and dose response. J .Nucl Med Radiat Ther S, 2012. 2: p. 2.
2-Manheimer, E., et al., Acupuncture for treatment of irritable bowel syndrome.The Cochrane Library, 2012.
3-Sreebny LM, Vissink A, editors. Dry mouth, the malevolent symptom: a clinical guide. Singapore: Wiley-
Blackwell. 2010; 268 pp.
4-Borgnakke WS, Taylor GW, Anderson PF, Shannon MC. Oral and General Health - Exploring the Connection.
Dry Mouth (Xerostomia): Diagnosis, Causes, Complications and Treatment Research Review. DDPA. 2011:1-35.
