Xerostomia Essay

Xerostomia is defined as dry mouth resulting from reduced or absent saliva flow (Darby, 2015). This is due to the salivary glands in your mouth not producing enough to keep your mouth moist. Wilkins (2017) reveals that saliva is important to lubricate your mouth, aid in swallowing, protect your teeth against bacteria, and aid in the digestion of food. The three major pairs of salivary glands are, parotid glands on the insides of the cheeks submandibular glands at the floor of the mouth, sublingual glands under the tongue. There are also several hundred minor salivary glands throughout the mouth and throat. Saliva drains into the mouth through small tubes called ducts. When there is a problem with the salivary glands or ducts, you may have many different symptoms. This can be illustrated by salivary gland swelling, dry mouth, pain, fever, and foul-tasting drainage into the mouth.

Dry mouth is known as xerostomia. Xerostomia is not a disease, but it may be a symptom of various medical conditions, a side effect of radiation to the head and neck, or a side effect of a wide variety of medications (Darby, 2015). Xerostomia can be a result of chemotherapy, dietary intake, medications, hormonal changes, and can have an effect on the patients quality of life. These results are significant because the main focus is preventing xerostomia through the many products and tips that can help prevent hypo salivary function, the formation of caries, demineralization, sensitivity, and oral infections. The effects of xerostomia are not confined to one section of the population. This calls attention for all age groups due to several different factors of dry mouth. 

In a study conducted by Timo O. Närhi, Jukka H. Meurman and Anja Ainamo (1999), their aim was to highlight xerostomia and hyposalivation causes and the consequences and treatment in the elderly population. This study focused on how the presence of saliva is hardly ever noticed. This is worth noting as can seriously damage the quality of life for those experiencing the sensation of oral dryness. These findings were crucial as they highlighted that some people do not recognize the absence or presence of saliva in their oral cavity. Xerostomia has often been considered synonymous to impaired salivary flow. However, it only describes the patient's complaint of dry mouth and the cause may be due to both salivary and non salivary factors. It is important to identify the individuals whose xerostomia is related to true saliva secretory hypofunction, as these individuals are at higher risk for oral diseases. 

Therefore, this article also gives prominence to the fact that medication is the main factor causing salivary gland hypofunction in the elderly. More than 400 pharmaceutical products have been considered to have adverse effects on the mechanisms responsible for salivary output (Närhi, et al, 1999). For example, modern selective serotonin reuptake inhibitors (SSRIs) do not decrease salivary flow rate although tricyclic antidepressants are well known for their hypo salivatory adverse effect. Drugs with experimentally proven hypo salivatory adverse effects and which are frequently prescribed for the elderly. While this study included a large list of examples, the most common medications that were listed would be antihistamines, anticholinergics, antihypertensives, and benzodiazepines. Drugs can further decrease salivation by causing vasoconstriction in the salivary glands, changing their fluid and electrolyte balance, or changing the acinar or ductal function (Närhi, et al, 1999).This is not the case with all medications, for example some antihypertensive drugs may cause xerostomia without affecting their biological salivary flow. One of the limitations of this article is that there is no definitive information on preventative and therapeutic measures that can help with dry mouth. With this being said, what was provided still portrays that the elderly population is at a much higher risk for xerostomia and other oral diseases, which is what this study achieved to portray. Medications are constantly being prescribed to improve or maintain the health of individuals while unknown side effects like xerostomia can occur. 

Not only are adults and the elderly affected by xerostomia, but there is also a high prevalence among common prescriptions that are given to children. One major medication that is used among children is the use of inhalation therapy. Inhalers are used as the main course of treatment for asthma and COPD. Ayinampudi (2016) calls attention to the evidence that only 10-20% of the dose reaches the lungs while the rest is retained in the oral cavity and oropharynx, it interferes with the normal oral tissues and causes adverse effects of inhalation therapy. This can lead to consequences in the oral tissues if preventative measures are not taken. The intensity and frequency of oral diseases occurring among inhalers users are dependent on the effects of the drugs used in inhalers, type, frequency of use, duration of use of inhalers and dosage of medication. The percentages of xerostomia (64.5%) and other oral lesions (45.2%) were higher among those with dry powder inhalers. These inhalers do not contain the pressurised inactive gas to administer the medicine (Ayinampudi, 2016). Patients have to push the canister to release a dose and dose is triggered by breathing in at the mouthpiece. This is worth noting because due to use of inhaled immunosuppressants, burning sensation, taste alterations, or sore mouth can occur. This information illustrates that several oral conditions and mainly xerostomia has been majorly associated with inhalation therapy. With the high prevalence of chronic respiratory diseases, proper optimal oral care to the individuals receiving inhalation therapy is needed. This article proved to have a very broad range of information making it difficult to decipher the actual facts that pertained to our scope of study which was xerostomia. Although, there was sufficient evidence in this study to show the prevalence of xerostomia among people using inhalation therapy. This study helped shed light on how xerostomia is not limited to just adults or the elderly population. 

To further our study, it was important to include how people who undergo head and neck radiation therapy experience xerostomia. Boston College Cancer Agency (2005) wrote an article that highlights the function of the salivary glands within the field of radiation. Significantly their data illustrates that salivary glands can be permanently destroyed during therapy. This also points to the fact that saliva can be reduced in amount and altered in consistency. Meaning reduction is dependent upon the total dose of radiation and degree of salivary gland involvement in the field of radiation. Salivary flow may be reduced 50% by the end of the first week, and further reduction in volume (up to 100%) may occur. The saliva produced is more mucinous, acidic, and may circulate less easily throughout the mouth. The Xerostomia is permanent, although some patients may perceive an improvement in salivary output over time” (BC Cancer, 2005).