US8 Xerostomia

Abstract

The management of patients with xerostomia remains a challenge for all specialists of Oral Medicine in Europe. Xerostomia is a common symptom of patients who attend specialist clinics in Oral Medicine in Europe, and throughout the world. Longstanding xerostomia can often be an adverse side effect of many drug therapies, however, Sjogren's syndrome (the second most common connective tissue disorder) remains one of the most likely non‐iatrogenic causes of longstanding salivary dysfunction. It is also now recognized that HCV sialadenitis and HIV salivary gland disease commonly give rise to xerostomia, and a range of other disorders that cause parenchymal damage (e.g. sarcoidosis) and neural damage (e.g. cholinergic autonomic neuropathy) may rarely cause xerostomia. Long standing oral dryness gives rise to a spectrum of symptoms and signs, and can adversely affect the hard and soft tissues of the mouth. In addition the quality of life of affected persons can be adversely affected. As a consequence of the varied aetiology the investigation of longstanding xerostomia now includes a wide range of clinical, serological and radiological investigations. Despite enhanced understanding of the many causes of salivary gland dysfunction, the treatment of xerostomia remains a significant clinical challenge. In particular new immunologically active therapies do not lessen the severity of disease, and the outcomes of interferon and/or ribavirin upon HCV sialadenitis are unclear. Cholinergic agents may be of some benefit in the treatment of longstanding oral dryness, but the associated adverse side effects of these may limit their clinical application. New therapeutic strategies such as gene therapy may ultimately prove to be beneficial, however, these are unlikely to be available in the near future.