Xerostomia

XEROSTOMIA

XEROSTOMIA PRESENTED BY Satyki Verma

CONTENTSIntroductionEtiologyClinical FeaturesOral ManifestationsManagementSummaryConclusionBibliography

INTRODUCTION It is subjective clinical condition of less than normal amount of saliva. It is dryness of mouth, which is a clinical manifestation of salivary gland dysfunction.It is also known as Cottonmouth Drough mouth Des (desert like)

CONTIt is symptoms of various medical condition, a side effect of a radiation to the head & neck or side effect of a wide variety of medication. It is also associated with decreased salivary gland function.Common complaint found often among older adults, affecting approximately 20% of the elderly.It can produced serious negative effects on the patients quality of life, affecting dietary habits, nutrition status ,speech ,taste ,tolerance to dental Prosthesis and increased susceptibility to dental caries.

ETIOLOGY1.DEVELOPMENTAL ORIGIN Salivary gland aplasia2.WATER /METABOLIC LOSS. Impaired fluid intake Hemorrhage Vomiting ,diarrhea3.IATROGENIC ORIGIN Medication Radiation therapy to the head &neck region Chemotherapy.

Systemic diseases.Sjogren syndromeDiabetes mellitusDiabetes insipidusSarcoidosis HIV infectionPsychogenic disorder

CONT Medication-Antihistaminic agents

Antidepressant.Antihypertensive Anticholinergic agent.

Sedatives and angiolytics.

CONT..Local factorsDecrease mastication Smoking Mouth breathing

CERVICAL CARIES DUE TO RADIATION

RADIATION MUCOSITIS

Gingival Hyperplasia

Xeerostomia Due To Sjogrens Syndrome

Partial Depapillation And Cobblestone Pattern Due To Chronic Xerostomia

Extensive Cervical Caries Developed Due To Severe Xerostomia

CLINICAL FEATURES1.EFFECTS OF XEROSTOMIA ON ORAL FUCTIONS.2.SALIVARY GLAND ENLARGEMENT.3.EFFECT OF XEROSTOMIA ON NORMAL FUNCTIONS.4.CLINICAL SINGS OF XEROSTOMIA.5.CANDIDIASIS.6.RESIDUAL SALIVA.

EFFECTS OF XEROSTOMIA ON ORAL FUNCTIONPatient may notice increased thrust &increase uptake of fluid specially while eating.Patient also get difficulty in swallowing , speech, eating dry food.Burning and tinglining sensation on mouth.Frequent oral infection .Intolerance to dental appliance & abnormal taste in mouth.

EFFECT OF XEROSTOMIA ON NORMAL FUNCTIONSMany times xerostomia is accompanied by hypofunction of other secretory gland.Blurred visionOcular dryness.Itching burning and sandy sensation in eye.Also dryness of pharynx and skin.Itching and burning sensation of vagina.

CLINICAL SIGNS OF XEROSTOMIADryness of lining oral mucosa.Oral mucosa appears thin, pale,and feels dry.Tongue may manifest deficiency by atrophy of papillae, inflammation, fissuring, craking and denudation.There is increased incidence of dental caries.

CANDIDIASISPsuedomembranous and form of candidiasis occurs .The reason for occurrence candidiasis is absence of normal cleansing and antimicrobial activity of the saliva.

RESIDUAL SALIVAResidual saliva which remains foamy, thick, and ropey.

MANAGEMENTSTIMULATION OF SALIVARY PRODUCTION 1.local stimulation-Chewing of gums.Mints.Paraffin.Citric acid containing lozenges and rinses.

2.SYSTEMIC STIMULATION.Bromhexine mucolytic &and mucokinetic agents.Anethole trithione-neurostimulatorPilocarpine (cholinergic parasympathomimetic agents)Increase secretion by exocrine glands & can affects the sweat , salivary, lacrimal glands.

CONT.Oral hygiene product Like lactoperoxidase, lysozyme and lactoferrin.Discontinuation of drug. AVOIDANCE OF CERTAIN THINGSLike dry foods such as cookies ,toast ,crackers,Sticky things - chocolates,pasty , peanut butter.Salty foods.

SYMPTOMATIC TREATMENTSalivary substitute commonly contain carbomethyl cellulose or hydroxyethylcelluloseor lubricant and variety of artificial sweetners, preservative and chloride or fluoride salts.Artificial saliva

summaryXerostomia is the subjective clinical condition of less then normal amount of saliva. It is dryness of mouth which is a clinical manifestation of salivary gland dysfunction. A no. of factor may play role in the cause of xerostomia like drugs ,radiation,systemic disease .It causes difficulty in mastication,swallowing & speech.It inceases the susceptibity to dental caries

CONCLUSIONComplain of dry mouth &diminished salivary out put (salivary hypofunction ) are common in elderly people as a result of plethora of salivary gland disorders medication use & medical disorder .It has a clinically significant deleterious impact on oropharyngeal health.

BIBLIOGRAPHY1.ORAL AND MAXILLOFACIAL PATHOLOGY NEVILLE ,DAMM , ALLEN , BOUQUOT , 3rd EDITION.2.TEXT BOOK OF ORAL PATHOLOGY SHAFERs , 6th EDITION.3.TEXT BOOK OF ORAL MEDICINE ANIL GOVINDRAO GHOM , 2nd EDITION.4.COLOR ATLAS OF CLINICAL ORAL PATHOLOGYNEVILLE,DAMM,ALLEN,2nd EDITION5.INTERNET

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