Xerostomia

Template:DiseaseDisorder infobox Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Xerostomia is the medical term for a dry mouth due to a lack of saliva. Xerostomia is sometimes colloquially called pasties or cottonmouth.

Xerostomia can cause difficulty in speech and eating. It also leads to halitosis and a dramatic rise in the number of cavities, as the protective effect of saliva is no longer present, and can make the mucosa of the mouth more vulnerable to infection. Notably, a symptom of methamphetamine abuse usually called "meth mouth" is largely caused by xerostomia.

Causes

It may be a sign of an underlying disease, such as Sjögren's syndrome, poorly controlled diabetes, or Eaton-Lambert syndrome, but this is not always so.

Other causes of insufficient saliva include anxiety, medications, or alcohol, trauma to the salivary glands or their ducts or nerves, dehydration, excessive mouth breathing, previous radiation therapy, and also a natural result of aging. The vast majority of elderly individuals will suffer xerostomia to some degree. Playing or exercising a long time outside on a hot day will often cause your saliva glands to simply dry up as your bodily fluids are concentrated elsewhere. Drugs have also been known to cause this problem, such as cannabis, and DXM.

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic
Drug Side Effect	Apraclonidine, Benztropine, Bicalutamide, Cyproheptadine hydrochloride, Dexchlorpheniramine, Diphenhydramine, Hydroxyzine,Loratadine, Mifepristone, Nabilone, Propantheline bromide, Protirelin, Risperidone, Thiothixene, Trifluoperazine, Trimethobenzamide, Thioridazine hydrochloride, Trihexyphenidyl, Vilazodone
Ear Nose Throat	No underlying causes
Endocrine
Environmental	No underlying causes
Gastroenterologic
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic
Infectious Disease
Musculoskeletal / Ortho	No underlying causes
Neurologic
Nutritional / Metabolic
Obstetric/Gynecologic	No underlying causes
Oncologic
Opthalmologic	No underlying causes
Overdose / Toxicity
Psychiatric	No underlying causes
Pulmonary
Renal / Electrolyte
Rheum / Immune / Allergy
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

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3

Complete Differential Diagnosis for Xerostomia

In alphabetical order.

With parotid gland swelling

• Heerfordt's Disease
• Sicca Syndrome
• Sjögren's Syndrome

Without parotid gland swelling

• Advance age
• Alcoholism
• Antihistamines
• Antihypertensives
• Antiparkinsonian drugs
• Antispasmodics
• Atropine
• Bronchodilators
• Continuous vomiting
• Decongestants
• Diabetes Mellitus
• Diarrhea
• Diuretics
• Drugs- Cyclobenzaprine, Haloperidol
• Infections with high fever
• Lithium
• MAOIs
• Neuroleptics
• Psychogenic
• Radiation therapy
• Salivary gland surgery
• Tricyclic antidepressants

Treatment

Treatment involves finding any correctable causes and fixing those if possible. In many cases it is not possible to correct the xerostomia itself, and treatment focuses on relieving the symptoms and preventing cavities. Patients who have endured chemotherapy usually suffer from this post- treatment. Patients with xerostomia should avoid the use of decongestants and antihistamines, and pay careful attention to oral hygiene. Sipping sugarless fluids frequently, chewing xylitol-containing gum, and using a carboxymethyl cellulose saliva substitute as a mouthwash may help. Aquoral may be prescribed to treat xerostomia. Non-systemic relief can be found using an oxidized glycerol triesters treatment used to coat the mouth.

External links

• Oral Cancer Foundation
• University of Illinois at Chicago
• NIH
• Sjögren's Syndrome Foundation page on Dry Mouth