Xerostomia: Etiology and Clinical Management


  • Reprint requests to Kathleen M. Stack, RDH, MPH, Tufts University School of Dental Medicine, 1 Kneeland Street, Room 413, Boston, MA 02111. E-mail: kathleen.stack@tufts.edu


Xerostomia, or dry mouth, is a serious oral health problem that, when left untreated, leads to deterioration and disease in the oral cavity. Patients with dry mouth include those on xerogenic medications (including many elderly patients), those undergoing chemotherapy and radiation, and individuals with Sjögren syndrome, an autoimmune disease. Common complaints with dry mouth include difficulty in speaking, chewing, and tasting and swallowing foods. Patients with dry mouth will also complain of food sticking to the teeth, taste alterations, foods burning the oral tissues, and a burning tongue. The lack of saliva may lead to such complications as fungal infections (eg, candidiasis), atrophy of the filiform papillae of the tongue, mucosal ulcerations, salivary gland enlargement, an increase in the number of cariogenic, aerobic organisms Streptococcus and Lactobacillus, and rapidly progressing caries. Recommended therapy for patients with xerostomia includes regular dental visits, fluoride therapy, nutritional counseling, and patient education regarding oral home care to manage the high risk for dental decay. Some patients may also benefit from the use of artificial salivas or Pilocarpine, which is effective in increasing salivary flow in patients with functional salivary glands. Salivary stimulants and increased water intake are also recommended.