Xerostomia or dryness of the mouth is a clinical manifestation of salivary gland dysfunction. The term is derived from the greek word (xeros) meaning “dry“ and (stoma) meaning “mouth”. Clinically, different degrees of Xerostomia exist. Sometimes the patient complains of a dry and burning sensation. Sometimes there is complete lack of saliva. When the deficiency of saliva is pronounced there is severe alteration in the mucous membrane and the patient may have extreme discomfort. The mucosa will appear dry and inflamed or most often pale and translucent. The tongue may show inflammation, fissuring and cracking and in severe cases, areas of denudation. Soreness, burning and pain of the mucous membrane and tongue are common symptoms.

Causes: Administration of drugs such as atropine or some patients using antihistamines drugs as a prophylactic measure against chronic sinusitis, hay fever and many allergies.

Salivary gland aplasia i.e. lack of salivary glands

Xray radiation usually administered in a treatment of tumor, inducing prompt dryness. This dryness is a temporary phenomenon lasting for a few weeks or months. However, in some cases the change is permanent when the glands atrophy due to the xray radiation.

Vitamin deficiency- deficiency of vitamin A affects the specialized epithelium throughout the body including the cells of the salivary glands. Xerostomia has been reported in patients with riboflavin and niacin acid deficiency.

Sjögren syndrome where Xerostomia occurs because of the destruction and atrophy of the tissues in the salivary gland.

Dry mouth is also seen pernicious anaemia and iron deficiency anaemia.

Loss of fluid from the body through hemorrhage, excessive sweating diarrhea and vomiting leads to diminished salivary secretions.

The polyuria accompanied by Diabetes mellitus and Diabetes insipidus probably accounts for the diminished salivary secretion and consequent thirst in patients with this disease.

Blockage of salivary duct by calculus.

Clinical significance

Chronic xerostomia predisposes to rampant dental caries and subsequent loss of teeth.- Moreover persons with xerostomia have difficulty with artificial dentures.

Dental appliances are disagreeable against dry mucosa and cannot be tolerated by some patients.

Treatment of Xerostomia depends on the nature of the disease causing it. The cause is to be diagnosed and accordingly corrected. Majority of the patients however, can be offered only symptomatic relief.

By Dr Siena Pacheco