DRY MOUTH AND ASSOCIATED COMPLICATIONS
Saliva is critical for maintenance of good oral health. Key actions of saliva include: buffering to prevent an acidic oral environment which predisposes to dental demineralization and supply of calcium and phosphate, key substrates for dental remineralization, and protein secretion that enhances the local defenses against infection.
Dry mouth can develop due to salivary gland hypofunction or due to pathological dysfunction of the glands. In the general population there are about 10% of individuals with dry mouth. In individuals over 65 years of age, about 20-25% complain of dry mouth. In nursing homes up to 50% of individuals can have dry mouth.
Saliva is important for communication and nutrition and hyposalivation can significantly alter quality of life. In this presentation we will discuss causes that may lead to dry mouth and associated complications to oral and general health. Common conditions include diabetes and hormonal changes, depression and anxiety, radiation therapy of the head and neck that includes salivary glands in the radiation fields, and some autoimmune diseases like Sjögren’s Syndrome.
For instance, hyposalivation develops shortly after initiation of radiation therapy and persists long term when doses to the salivary glands exceeds 3000 cGy. Patients with chronic hyposalivation are at risk for oral cavity infections and dental caries. Depending on the extent of hyposalivation and the oral environment, a severe form of rapidly developing decay can lead to loss of dentition. Current concepts regarding the management of patients with dry mouth will complete the discussion.