**Xerostomia: An Update of Causes and Treatments**

**Xerostomia: An Update of Causes and Treatments**

DOI: 10.5772/intechopen.72307

Alejandro Escobar and Juan P. Aitken-Saavedra Alejandro Escobar and Juan P. Aitken-Saavedra Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.72307

#### **Abstract**

Xerostomia or dry mouth sensation is considered a complex condition that affects several stomatological functions that drives to the detriment of the quality of life of individuals who suffer from it. Often, xerostomia is accompanied by a decrease in salivary flow or hyposalivation, and this condition leads to oral health problems such as dental caries, candidiasis, and mucosal complications. Currently, the diagnosis and therapeutic methods for this condition are varied and it is difficult to achieve favorable results in all cases, since the etiology seems to be multifactorial where both local factors and systemic conditions would participate. This chapter presents, in a concise shape, the relevant data about etiology of xerostomia, such as age, autoimmune diseases, systemic diseases, infectious diseases, neuropathic complications, psychogenic factors and therapeutically consumption of drugs among others, and the current available treatments.

**Keywords:** xerostomia, etiology, diagnosis, clinical manifestation, treatments

#### **1. Introduction**

Xerostomia or dry mouth sensation is considered a complex condition that affects several stomatological functions and drives to the detriment of the quality of life of individuals who suffer from it. Often, xerostomia is accompanied by a decrease in salivary flow or hyposalivation with consequences such as oral lesions, alterations of taste, feeling of thick saliva, chewing problems, dental caries, dental demineralization, periodontal disease, salivary gland infection, cervical caries, fungal infections, and others [1]. Currently, the diagnosis and therapeutic methods for this condition are varied and it is difficult to achieve favorable results in all cases, since the etiology seems to be multifactorial where both local and systemic factors would participate [2–5]. Although xerostomia may occur frequently in the general population, clear and defined tools for diagnosis and treatment are still needed. Today, patients suffering from xerostomia visit numerous health professionals to solve this complex condition

Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons

that limits many functions of day-to-day life, and often does not find response or effective treatment. Regards the complexity of xerostomia and its importance in dental practice, this chapter reviews the relevant data about etiology, diagnosis, consequences, and the current available treatments to this condition.

digestive enzymes such as amylase and lipase, and antibacterial and antifungal enzymes, as well as mucins [14]. Ninety-three percent of its volume is secreted by the major salivary glands and the remaining 7% by the minor glands. Saliva production is controlled by the autonomous nervous system, mainly by parasympathetic nerve signals [18]. Saliva is very important for the preservation of general and oral homeostasis. It has a participation in digestives functions, cleaning, sense of taste, oral mucosa hydration, and defense of teeth trough pH control and its remineralizing potential. In addition, it has antimicrobial properties and controls the composition of oral microbiota by its antibacterial, antiviral, and antifungal capacities [14]. A summary

Xerostomia: An Update of Causes and Treatments http://dx.doi.org/10.5772/intechopen.72307 17

Several short and long-term conditions can interrupt salivary secretion, leading to xerosto-

(1) Factors affecting the salivary center: psychological problems (stress and anxiety), Parkinson's disease, Alzheimer's disease (changes in the ability to perceive oral sensations),

(2) Factors that alter nerve stimulation of saliva: encephalitis, brain tumors, smoking and dehydration (resulting from the deficiency of water intake, vomiting, diarrhea and polyuria), as well as the use of some drugs, including antihistamines, opioids, antidepressants,

(3) Alterations in salivary gland function as a consequence of obstruction, infection (sialodenitis), glandular tumors, calculi (sialolithiasis), autoimmune diseases (Sjögren's syndrome-SS-, rheumatoid arthritis, uncontrolled diabetes mellitus and systemic lupus erythematosus), and chemotherapy or radiotherapy performed as cancer therapy for the head and neck area. The extent of injury induced by radiotherapy depends on the volume

antiepileptics, anxiolytics, anticholinergics, antimuscarinics, and others;

of irradiated glands and the total dose and technique used [15, 19–23].

Digestion Amylase, lipase, ribonucleases, proteases, water, mucins

fluoride

Antimicrobial action Lysozyme, lactoferrin, lactoperoxides, mucins, cystins, histatins,

Buffer capacity and remineralization Bicarbonate, phosphate, calcium, staterin, proline-rich anionic proteins,

Preparing food for swallowing Water, mucins Digestion Amylase, lipase, ribonucleases, proteases, water, mucins

immunoglobulins, proline-rich glycoproteins, IgA

Lubrication Mucin, proline-rich glycoproteins, water

Maintaining mucosa integrity Mucins, electrolytes, water

of the Saliva components and functions can be seen in **Table 1**.

mia. Xerostomia can thus result from three basic causes:

**Functions Components**

Phonation Water, mucin Taste Water, gustin

Cleansing Water

**Table 1.** Saliva components and functions.

menopause, and others;
