Oral health preventive measures for special needs
What is xerostomia ?
Xerostomia: (also termed dry mouth or dry mouth
syndrome) is the medical term for the
subjective symptom of dryness in the mouth, which may
be associated with a change in the composition
of saliva or reduced salivary flow (hypo salivation) or have
no identifiable cause.
This symptom is very common and is often seen as a side
effect of many types of medication.,
Acupuncture has been found useful in the prevention of
xerostomia when administered concurrently with
A technique called acupuncture-like transelectrical nerve
stimulation is currently being investigated
Surgical transfer of one sub mandibular gland to the sub
mental space facilitates shielding of the gland during
postoperative radiation therapy. Studies confirm that
there is no adverse effect on the function of the gland in
Treating the underlying cause
Drugs are a common cause of dry mouth. Reduce the dose or
change the drug if possible. Morphine is a common but often
overlooked cause of dry mouth. Other drugs that cause dry
mouth include tricycle antidepressants, antihistamines, anti
muscarinic drugs, anti-epileptic drugs, antipsychotics, betablockers and diuretics
Dehydration should be treated.
Simple measures will often relieve symptoms of dry mouth,
even if rehydration is not undertaken.
Anxiety can also cause dry mouth.
Sjögren's syndrome - check antinuclear antibody titer
PREVENTION OF XEROSTOMIA
There are several options how to prevent development of xerostomia or decrease
a) Acting on the cause of xerostomia – possible adjustment of medications and
possibly amelioration or elimination of the underlying cause
In the case of drug induced xerostomia - it is important to discuss possible
of alternative drugs with less desiccative side effects, decreasing the dose
of prescribed drug or the number of xerogenic drugs (particularly in the case of
Maintaining salivary function - Certain patients with hypo salivation may
benefit from administration of medications that stimulate
(sialagogues such as pilocarpine or cevimeline if there is
for these medications)
Simple measures should be used by all patients. Dry
mouth may be relieved in many patients by:
Frequent sips of cool drinks.
Sucking pieces of ice.
Sucking sugar-free fruit pastilles.
Eating partly frozen melon or pineapple chunks.
Sugar-free chewing gum - which stimulates salivation in
patients with residual salivary function.
Petroleum jelly - which can be applied to the lips to
prevent drying and cracking.