herbs for xerostomia
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Dry mouth, or xerostomia, happens when you don’t make enough saliva (spit). Saliva is important for mouth health. A lack of saliva can lead to tooth decay. Dry mouth symptoms include discomfort, sore throat and swallowing problems. Treatment for dry mouth includes steps to increase saliva production.
Dry mouth is a symptom of a condition, not a condition itself. Most often, it’s a side effect of certain medications, such as antihistamines or decongestants that you take for allergies or colds.
Hundreds of medications (prescription and over-the-counter) can reduce your body’s saliva production. If you check the information that comes with your medication, you may see “dry mouth” listed as a side effect.
Dry mouth treatment often involves several steps. First, your healthcare provider will review your medications in case they could be causing your dry mouth. You may be able to take a different drug instead.
Oral hygiene is essential if you have a dry mouth. Brush your teeth twice a day, and use mouthwash. Doing so will help prevent tooth decay. Cavities and decay are more common for people with dry mouth.
Patients with complaints of dry mouth should have a detailed health history (medical and dental) performed to help with early detection and identification of potential underlying causes.1, 2, 9 In patients with xerostomia or salivary gland hypofunction, oral examination may reveal dry and friable oral mucosa and the tongue may appear dry and fissured.1, 2, 5 Patients may commonly have dental caries (especially root, cervical, or incisal/cuspal tips), plaque accumulation, gingivitis, and/or periodontitis.1, 2, 5, 20 Infections (e.g., oral candidiasis) and enlargement of salivary glands from sialadenitis may also be present.1, 2, 5, 9, 20 Other oral manifestations evident on examination may include angular cheilitis, mucositis, traumatic oral lesions, and/or difficulty in wearing/retaining oral prostheses.5, 9, 20
A thorough head and neck examination, including an intraoral evaluation to identify the presence or absence of salivary pooling on the floor of the mouth, can help a dentist identify who will benefit from further diagnostic evaluations, such as salivary flow rate measurement, minor salivary gland biopsy, or blood and microbial tests.1, 2 A patient is considered to have reduced salivary flow if the unstimulated salivary flow is 0.1 mL/min or less (measured for 5 to 15 minutes) or if the chewing-stimulated salivary flow is 0.7 mL/min or less (measured for 5 minutes).5, 20
Management of xerostomia and hyposalivation should emphasize patient education and lifestyle modifications.1, 2 Various palliative and preventive measures, including pharmacologic treatment with salivary stimulants, topical fluoride, saliva substitutes, and use of sugar-free gum/mints may alleviate some symptoms of dry mouth and may improve a patient’s quality of life.1, 2, 5
Salivary Stimulants. Salivary stimulants should be considered in patients with residual salivary gland function.9, 12 Sugar-free chewing gum, candies, and mints can be used to stimulate salivary output.9 The FDA has approved the oral secretagogues pilocarpine (Salagen®, Eisai and generics)21 and cevimeline hydrochloride (Evoxac® capsules, Daiichi-Sankyo and generics)22 to treat symptoms of dry mouth.10, 13 Pilocarpine is typically administered at a dose of 5 mg three times a day for at least 3 months and cevimeline is prescribed at a dose of 30 mg three times a day for at least 3 months.10 Adverse effects include sweating, cutaneous vasodilation, nausea and vomiting, diarrhea, hiccup, hypotension and bradycardia, increased urinary frequency, bronchoconstriction, and vision problems.10
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