Management Of Xerostomia Research Articles

Etiology, evaluation, and management of xerostomia

Xerostomia is defined as the complaint of oral dryness. It is a condition that primarily affects older adults and can have a significant negative effect on one’s quality of life. Patients with xerostomia often do not have objective signs of hyposalivation. The underlying etiology of xerostomia includes a variety of systemic diseases and local factors. Our aim is to provide a comprehensive review of the differential diagnosis, evaluation, and management of xerostomia. Prompt diagnosis and management can alleviate the clinical manifestations of this debilitating condition.

Merits of Oil Pulling Therapy in the Management of Xerostomia and Stomatopyrosis in Burning Mouth Syndrome

Merits of Oil Pulling Therapy in the Management of Xerostomia and Stomatopyrosis in Burning Mouth Syndrome

How do Australians living with MS experience oral health and accessing dental care? A focus group study.

The symptoms of multiple sclerosis (MS) can affect oral care and access to dental services, but there is limited literature describing the oral health and perceived oral healthcare needs of people with MS. This study aimed to explore the oral health experiences, oral health behaviours and barriers to accessing dental care perceived by people living with MS in Australia. Six focus groups were held across two metropolitan areas (Brisbane, Queensland and Melbourne, Victoria) and one regional area (Toowoomba, Queensland). Focus group data were analysed using thematic analysis. Living with MS was a highly individual experience due to the range of symptoms that may be experienced. In addition to having different symptom experiences to others with MS, individual symptoms also differed on a daily basis as the disease relapsed and remitted. The physical expressions of MS directly and indirectly affected the oral health of participants. Additionally, oral health was affected by the side effects of medications and orofacial pain symptoms. Depending on the symptoms experienced by the individual, personal oral hygiene was affected and professional dental appointments were difficult. Participants also experienced structural barriers to accessing professional dental care including difficulty accessing transport to-and-from dental appointments, space limitations in the dental surgery and financial barriers to care. Dental care was perceived to be inflexible and was not tailored to individual experiences of MS, which contributed to perceptions of poor quality and appropriateness of care. It is important for dental professionals to offer tailored and individualized dental care when treating people with MS. Our findings suggest that there needs to be greater interprofessional communication and referral to manage atypical dental pain symptoms. Oral health education for people with MS should include altered strategies to performing daily oral hygiene, the management of xerostomia and advice regarding low cariogenic diets suitable for dysphagia. Additionally, policy and strategies to improve the oral health of people with MS should focus on enhancing access through transport, reducing the cost of dental services to the individual and providing domiciliary oral health care.

Effectiveness of acupuncture and related therapies for palliative care of cancer: Overview of systematic reviews

Acupuncture and related therapies such as moxibustion and transcutaneous electrical nerve stimulation are frequently used in the management of cancer-related symptoms. Their effectiveness and safety of acupuncture and related therapies are discussed controversial. The authors aim was to provide an overview to summarise the evidence on acupuncture for palliative care of cancer. A systematic review of 23 systematic reviews was conducted. The systematic review synthesised the results from clinical trials of patients with any type of cancer. The methodological quality of the 23 systematic reviews was assessed using the Methodological Quality of Systematic Reviews Instrument. The methodological quality of the 23 systematic reviews was regarded satisfactory. Evidence was found for acupuncture for the management of cancer-related fatigue, chemotherapy-induced nausea and vomiting and leucopenia in patients with cancer. For the treatment of cancer-related pain, hot flashes and hiccups, and improving patients’ quality of life there are conflicting results. There is currently insufficient evidence to support or refute the potential of acupuncture and related therapies in the management of xerostomia, dyspnea and lymphedema and in the improvement of psychological well-being. No serious adverse effects were reported in any study. The results of the study suggest that there is evidence for the use of acupuncture for the management of cancer-related fatigue, chemotherapy-induced nausea and vomiting and leucopenia in patients with cancer. As acupuncture appears to be relatively safe, it could be considered as a complementary form of palliative care for cancer patients.

Analysis of Postsurgical Health-Related Quality of Life and Quality of Voice of Patients With Laryngeal Carcinoma

This study aims to analyze the postsurgical health-related quality of life (HRQOL) and quality of voice (QOV) of patients with laryngeal carcinoma with an expectation of improving the treatment and HRQOL of these patients. Based on the collection of information of patients with laryngeal carcinoma regarding clinical characteristics (age, TNM stage, with or without laryngeal preservation and/or neck dissection, with or without postoperative irradiation and/or chemotherapy, etc.), QOV using Voice Handicap Index (VIH) scale and HRQOL using EORTC QLQ-C30 and EORTCQLQ-H&N35 scales, the differences of postsurgical HRQOL related to their clinical characteristics were analyzed using univariate nonparametric tests, the main factors impacting the postsurgical HRQOL were analyzed using regression analyses (generalized linear models) and the correlation between QOV and HRQOL analyzed using spearman correlation analysis. A total of 92 patients were enrolled in this study, on whom the use of EORTC QLQ-C30, EORTC QLQ-H&N35 and VHI scales revealed that: the differences of HRQOL were significant among patients with different ages, TNM stages, and treatment modalities; the main factors impacting the postsurgical HRQOL were pain, speech disorder, and dry mouth; and QOV was significantly correlated with HRQOL. For the patients with laryngeal carcinoma included in our study, the quality of life after open surgeries were impacted by many factors predominated by pain, speech disorder, and dry mouth. It is suggested that doctors in China do more efforts on the patients' postoperative pain and xerostomia management and speech rehabilitation with the hope of improving the patients' quality of life.

Effectiveness of acupuncture and related therapies for palliative care of cancer: overview of systematic reviews.

Acupuncture and related therapies such as moxibustion and transcutaneous electrical nerve stimulation are often used to manage cancer-related symptoms, but their effectiveness and safety are controversial. We conducted this overview to summarise the evidence on acupuncture for palliative care of cancer. Our systematic review synthesised the results from clinical trials of patients with any type of cancer. The methodological quality of the 23 systematic reviews in this overview, assessed using the Methodological Quality of Systematic Reviews Instrument, was found to be satisfactory. There is evidence for the therapeutic effects of acupuncture for the management of cancer-related fatigue, chemotherapy-induced nausea and vomiting and leucopenia in patients with cancer. There is conflicting evidence regarding the treatment of cancer-related pain, hot flashes and hiccups, and improving patients’ quality of life. The available evidence is currently insufficient to support or refute the potential of acupuncture and related therapies in the management of xerostomia, dyspnea and lymphedema and in the improvement of psychological well-being. No serious adverse effects were reported in any study. Because acupuncture appears to be relatively safe, it could be considered as a complementary form of palliative care for cancer, especially for clinical problems for which conventional care options are limited.

Xerostomia: An overview

Xerostomia is a subjective sensation of dry mouth with objective evidence of decreased salivary flow. It is a multifactorial condition which increases the risk of oral diseases and has a significant effect on the person's quality of life. So, these patients need special care for maintenance of oral and general health. We, being oral health care professionals, it is our responsibility to diagnose and treat the condition accordingly using a multidisciplinary approach. This paper enlightens the etiology and management of xerostomia.

Prevalence of xerostomia in patients attending Shorish dental speciality in Sulaimani city.

Objectives: The aim of this study was to investigate the prevalence of xerostomia among dental patients and explore the possible risk factors and symptoms associated with this condition. Patient and Methods: The prevalence of xerostomia and its associations were investigated among patients (n=1132) who were visiting the department of oral medicine at shorish dental speciality in sulaimani city. The age range was between 10-79 years. 512 (45.2%) of participants were males and 620 (54.8%) were females. The data collected were age, sex, systemic diseases, medications and habit of smoking. Logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association of xerostomia with age, systemic diseases and medications and Chi Square test was also used to analyze the data. Results: Prevalence of xerostomia was 16.07%. Prevalence of xerostomia was significantly higher among females (19.51%) than males (11.91%) (P=0.001). The most common diseases with the highest prevalence of xerostomia were psychological disorders (57.14%) followed by diabetes mellitus (53.84%), neurological disorders (40%), thyroid disorders (37.5%) and hypertension (36.48%). The most common medication with the highest prevalence of xerostomia was antihistamine (66.66%) followed by psychotherapeutic medications (60%), pain medications (55.88%), endocrinologic agents (51.21%), antidyslipidic agents (50%) and antihypertensive medication (38.98%). Xerostomia was significantly associated with ageing (OR: 1.02, P=0.000), systemic diseases (OR: 2.80, P=0.000) and medications (OR: 5.17, P=0.000). There was a high prevalence of reported symptoms of xerostomia and these symptoms were more prevalent among females, Prevalence of xerostomia was higher in heavy smoker patients (19.48%) than non smoker patients but not significantly (16.14%) (p= 0.44). Conclusions: There was a high prevalence of xerostomia among dental patients; xerostomia was significantly more prevalent among females and significantly associated with age, systemic diseases and medications; xerostomia adversely affects oral functions; dentist must be familial with sign and symptoms of xerostomia and can have an active role in the management of xerostomia and preventing or treating complications. Key words:Ageing, medications, xerostomia, prevalence.

Stem Cells in Management of Xerostomia

Stem Cells in Management of Xerostomia

Importance of acupuncture in controlling gag reflex and anxiety in general dental practice

Acupuncture is a traditional and complementary system of medicine that has history of more than 3000 years. It is used in the management of various conditions, especially in the relief of pain. It has various applications in dentistry such as reducing anxiety, stress and gag reflex in the dental patients; in the management of xerostomia due to sjogren’s syndrome and chemoradiotherapy; musculoskeletal pain such as temporomandibular joint dysfunction syndrome; bell’s palsy, facial pain and in relief from postoperative pain. There is enough evidence in the literature that acupuncture is beneficial in the practice of dentistry. Acupuncture can be used as supplementary form of management in dentistry. Dentist can learn this traditional system of acupuncture in a 3-4 days basic course within their scope. The article aims to realize the benefits of acupuncture in controlling anxiety and gagging among dental patients in the setting of dental practice. Though the use of acupuncture in dentistry is still in its infancy, it is a worth exploring area.

Efficacy and safety of a new oral saliva equivalent in the management of xerostomia: a national, multicenter, randomized study

The clinical efficacy, safety, and acceptability of a new oral saliva equivalent (Novasial) administered four times daily in the treatment of xerostomia in various medical conditions was compared with that of oxygenated glycerol triester oral spray (Aequasyal) and a moisturizing spray (Biotene) in a 2-week, multicenter, randomized, crossover study. Assessment included patient-based evaluation of mouth dryness score (primary endpoint) with a visual analog scale (VAS), blinded assessment of the oral tissue condition by a four-point ordinal scale, and patient-based assessment of tolerability and acceptability. At day 14, Novasial decreased oral mouth dryness by 19.5%, (12.5 ± 22.6 mm, P < .0001 versus baseline), versus 10% (6.6 ± 17.9 mm with Aequasyal, P < .0001 versus Baseline; and P < .0156 versus Novasial) and 13% (8.6 ± 18.9 mm) with Biotene (P < .0001 versus baseline). The 50% decrease in the primary endpoint was not achieved, and the overall efficacy of Novasial and Aequasyal were similar with respect to xerostomia. Novasial was preferred to Aequasyal and Biotene in alleviating taste alteration and chewing difficulty. Treatment compliance was higher with Novasial (P = .0014 versus Aequasyal). The treatments improved the oral condition with equal efficacy and were safe and well tolerated (VAS 72-77 mm). Novasial was a safe, well-tolerated, and acceptable treatment in patients with xerostomia induced by various treatments or pathologic conditions.

Diagnosis and management of xerostomia and hyposalivation.

Xerostomia, the subjective complaint of dry mouth, and hyposalivation remain a significant burden for many individuals. Diagnosis of xerostomia and salivary gland hypofunction is dependent upon a careful and detailed history and thorough oral examination. There exist many options for treatment and symptom management: salivary stimulants, topical agents, saliva substitutes, and systemic sialogogues. The aim of this review is to investigate the current state of knowledge on management and treatment of patients affected by xerostomia and/or hyposalivation.

Aetiology and management of xerostomia and salivary gland hypofunction.

Dry mouth can be disabling for the patient and challenging for the clinician to manage. Xerostomia is the subjective perception of oral dryness whereas salivary hypofunction is an objectively measured decrease in whole saliva production. Management includes saliva substitutes and stimulants which may only give partial symptom relief.

The Use of Xylitol for the Prevention of Xerostomia in Patients Receiving Intensity Modulated Radiation Therapy for Head and Neck Cancers

The Use of Xylitol for the Prevention of Xerostomia in Patients Receiving Intensity Modulated Radiation Therapy for Head and Neck Cancers

Management of Xerostomia in Older Adults: A Systematic Review

Background: Xerostomia (dry mouth) is a common adverse effect of many medications and can severely diminish quality of life for older adults. Objective: To assess the effectiveness of 3 categories of interventions used to manage drug-induced xerostomia and xerostomia secondary to Sjögren syndrome and radiation treatment for head and neck cancer in older adults: saliva substitutes, saliva stimulants, and topical fluoride. Data Sources: The Cochrane Library, PubMed, EMBASE (to July 2009) and CINAHL (to February 2010) were searched for randomized or quasi-randomized studies involving older adults with drug- or radiation-induced xerostomia or Sjögren syndrome. Study Selection and Data Extraction: An updating search focusing on systematic reviews (to June 2012) was conducted prior to publication. Outcomes included perceived dryness of the mouth, reduced sialometry, or increased root caries. Duplicate study selection and data extraction were conducted. Risk of bias was assessed. A random effects meta-analysis was employed. Data Synthesis: Four studies of saliva substitutes (N = 116), 3 studies of saliva stimulants (N = 361), and 1 of fluoride treatment (N = 334) met selection criteria. Saliva substitutes were more effective than other treatments at improving perceived dryness of the mouth as determined on a 10-point visual analog scale (weighted mean difference [WMD] −1.91 [95% CI −2.54 to −1.29]) but less effective than placebo (WMD 0.26 [95% CI 0.51–1.02]). Parasympathetic stimulants were more effective than placebo in improving oral dryness (OR = 0.37 [95% CI 0.19–0.72]). Due to lack of data, quantitative synthesis of results for topical fluoride was not possible. Conclusions: There is evidence to suggest that saliva substitutes improve symptoms but the clinical significance is minimal. The evidence more strongly supports the effect of saliva stimulants, although the quality of evidence is poor and adverse effects from these medications cannot be overlooked. Evidence demonstrating efficacy of topical fluoride in disease prevention was inconclusive. Addressing underlying causes of xerostomia, including drug choices, may help mitigate the burden of illness and effects on quality of life.

Xerostomia Management for Pediatric Oncology Patients with Lactoperoxidase Included Oral Health Care Products

Aim: Evaluating the efficacy of lactoperoxidase included oral care products for xerostomia in children with cancer undergoing chemotherapy and / or radiotherapy and to present an easy to follow oral care protocol. Design: The study subjects consisted of twenty one pediatric cancer patients (mean age of 11,3±) with either leukemia or lymphoma used lactoperoxidase-system-containing mouth rinse (Biotene ® ) combined with (Biotene ® ) gel or (Biotene®) chewing gum for 3 weeks. Unstimulated saliva samples were collected at the base line and 4 weeks after the usage of the products. They were analyzed for selected biochemical factors and subjective symptoms as intra-oral dryness (xerostomia), eating ability and oral discomfort were graded by visual analogue scale. Results: No major changes occurred in the level of saliva Thiocyanite and Peroxidase activity, but there was a increase in salivary pH and also salivary flow rate was notably higher in groups using Lactoperoxidase products. Changes related to buffering capacity of saliva were also recorded. Conclusion: There is no clearly effective treatment for xerostomia but we have observed in our practice that the use of non-immunologic antimicrobial agents relieves subjective oral symptoms in most xerostomic pediatric patients.

Low level laser therapy in patients with systemic lupus erythematosus: a therapeutic approach in management of xerostomia and hyposalivation

Low level laser therapy in patients with systemic lupus erythematosus: a therapeutic approach in management of xerostomia and hyposalivation

Low level laser therapy in patients with Systemic Lupus Erythematosus: a therapeutic approach in management of xerostomia and hyposalivation

Low level laser therapy in patients with Systemic Lupus Erythematosus: a therapeutic approach in management of xerostomia and hyposalivation

Advanced dental disease in people with severe mental illness: systematic review and meta-analysis

Psychiatric patients have increased comorbid physical illness. There is less information concerning dental disease in this population in spite of risk factors including diet and psychotropic side-effects (such as xerostomia). Aims To compare the oral health of people with severe mental illness with that of the general population. A systematic search for studies from the past 20 years was conducted using Medline, PsycINFO, Embase and article bibliographies. Papers were independently assessed. The primary outcome was total tooth loss (edentulousness), the end-stage of both untreated caries and periodontal disease. We also assessed dental decay through standardised measures: the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS). For studies lacking a control group we used controls of similar ages from a community survey within 10 years of the study. We identified 21 papers of which 14 had sufficient data (n = 2784 psychiatric patients) and suitable controls (n = 31 084) for a random effects meta-analysis. People with severe mental illness had 3.4 times the odds of having lost all their teeth than the general community (95% CI 1.6-7.2). They also had significantly higher scores for DMFT (mean difference 6.2, 95% CI 0.6-11.8) and DMFS (mean difference 14.6, 95% CI 4.1-25.1). Fluoridated water reduced the gap in oral health between psychiatric patients and the general population. Psychiatric patients have not shared in the improving oral health of the general population. Management should include oral health assessment using standard checklists that can be completed by non-dental personnel. Interventions include oral hygiene and management of xerostomia.

Diagnosis and management of xerostomia

Diagnosis and management of xerostomia