The use of drugs for the treatment of xerostomia – brief review

Abstract

Inadequate production of saliva causes an oral imbalance that has a great impact on the individual's quality of life. Diseases of various types are responsible for impaired production of saliva and dry mouth, as happens in xerostomia. It is usually associated with hypofunction of the salivary glands, which shows signs of dryness on oral mucosa, and other morphological features in the oral cavity. Saliva is composed of water and 1% of electrolytes and immunoglobulins, enzymes and other proteins. Its fluid component, which contains ions, is mainly produced by parasympathetic stimulation, while the protein component, produced in the acinar secretory vesicles, is released by sympathetic stimulation. The use of certain drugs is a major cause of xerostomia. Among these we found analgesics, anticonvulsants, antihistamines, antihypertensives, diuretics and antidepressants. The treatment is mainly done by saliva substitutes such as sodium chloride, potassium chloride, monopotassium phosphate and dipotassium phosphate. However, in some cases, stimulants, such as citric acid and sodium citrate, or even topical salivary substitutes can be effective. Furthermore, the use of specific oral care products is well accepted by the patients. The treatment is selected according to the ability of the glands to produce saliva. It is still not fully known what mechanism of action drugs that cause hyposalivation, dry mouth or changes in saliva composition use. Yet, it is important to know the side effects of prescribed drugs.