Collaboration of Nadia Gomez.

Saliva is of vital importance for the maintenance of oral health, including the lubrication and repair of oral tissues, oral acid neutralization, maintenance, enamel in children, tooth remineralization, digestion, and speech.

Systemic disorders can result in salivary gland dysfunction, for instance: Sjögren syndrome, diabetes, depression, head and neck radiotherapy, acquired immunodeficiency syndrome, etc. Nonetheless, the most common cause is the use of medications.

Medication induced hyposalivation increases the risk for oral diseases, such as: dental caries, candidiasis, bad breath, taste disturbances, difficulties in chewing, speaking, and swallowing.

Common medications that cause xerostomia are, but not limited to:

· Antibone-resorptives (osteoporosis)

· Anticonvulsants

· Antidementia

· Antidepressants

· Antihypertensives

· Antimigraine

· Antimuscarinics

· Antiparkinson

· Antiperistaltic

· Antipsychotics

· Appetite suppressants

· Diuretics

· Muscle relaxants,

· Opioid-analgesics

· Psychostimulant

· Sedatives

Prevention:

Gentle massage of the major salivary glands; adequate fluid intake; sugarless candies, wiping the oral cavity with glycerin swabs to stimulate salivary flow; sugarless antifungal agents such as nystatin powder or clotrimazole troches are recommended as well.

Treatment

Salivary-gland destruction is irreversible regardless of the method of damage. However, saliva substitutes are available as rinses and gels. Sipping water, as well as sugarless candy and chewing gum provide relief for some patients due to the taste and mechanical stimulation of salivation.

REFERENCES

1. Aliko A, Wolff A, Dawes C, et al. World Workshop on Oral Medicine VI: clinical implications of medication-induced salivary gland dysfunction. Oral surgery, oral medicine, oral pathology and oral radiology. 2015;120(2):185-206. doi:10.1016/j.oooo.2014.10.027

2. Barbe AG. Medication-Induced Xerostomia and Hyposalivation in the Elderly: Culprits, Complications, and Management. Drugs & aging. 2018;35(10):877-885. doi:10.1007/s40266-018-0588-5

3. Wolff, Joshi RK, Ekström J, et al. A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective SIalorhhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI. Drugs in R &D (Online). 2017; 17(1):1-28. Doi: 10.1007/s40268-016-0153-9

4. Grisius MM. XEROSTOMIA. 2nd. ed. Springer Publishing Company; 2008:821

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