Pathophysiology: Dry mouth or xerostomia is a condition in which mouth is unusually dry. Most often, dry mouth is the result of a decrease in saliva produced by the glands in the mouth (salivary glands), and it's frequently a side effect of medication. Cause of Dry mouth includes: • Side effect of certain medications. Dry mouth is a common side effect of many prescription and nonprescription drugs, including drugs used to treat depression, anxiety, pain, allergies, colds, obesity and Parkinson's disease. Dry mouth can also be a side effect of muscle relaxants and sedatives. • Side effect of certain diseases and infections. Dry mouth can be a side effect of medical conditions, including, HIV/AIDS, Alzheimer's disease, diabetes, anemia, cystic fibrosis,rheumatoid arthritis, hypertension, Parkinson's disease, stroke, and mumps. • Side effect of certain medical treatments. Damage to the salivary glands, the glands that make saliva, can reduce the amount of saliva produced. For example, the damage could stem from radiation to the head and neck, and chemotherapy treatments, for cancer. • Nerve damage. Dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery. • Dehydration. Conditions that lead to dehydration, such as fever, excessive sweating, vomiting, diarrhea, blood loss, and burns can cause dry mouth. • Surgical removal of the salivary glands. • Lifestyle. Smoking or chewing tobacco can affect how much saliva you make and aggravate dry mouth. Breathing with your mouth open a lot can also contribute to the problem. Statistical report: To examine xerostomia in 50-, 65- and 75-year-olds, background factors and effect on Oral Impacts on Daily Performances (OIDP). A questionnaire was sent to all 50-year-old persons (n = 8888) in two Swedish counties. In 2007, the same questionnaire was sent to all 65-year-olds (n = 8313) in the two counties and to all 75-year-olds (n = 5195). Response rate was for the 50, 65 and 75 year olds 71.4, 73.1 and 71.9%, respectively. Xerostomia was higher in women than in men in all age groups. There was higher prevalence of xerostomia with increasing age in both sexes and it was more frequent at night than during daytime. 'Often mouth dryness' was 2.6-3.4 times more prevalent in those who reported an impact from OIDP. The highest odd ratios were for daytime xerostomia and for the variables burning mouth (17.1), not feeling healthy (4.5), daily smoking (4.4), and medication (4.1). The dramatic increase of xerostomia between age 50 and 75, especially amongst women, needs to be considered in the management of this age group.
Treatment depends on the cause of the dry mouth. Some of the treatment procedures include: • Change medications that cause dry mouth. If your doctor believes medication to be the cause, he or she may adjust your dosage or switch you to another medication that doesn't cause a dry mouth. • Recommend products to moisturize your mouth. These can include prescription or over-the-counter mouth rinses, artificial saliva or moisturizers to lubricate your mouth. If you have severe dry mouth, your doctor or dentist may: • Prescribe medication that stimulates saliva. Your doctor may consider prescribing pilocarpine or cevimeline to stimulate saliva production. • Protect your teeth. To prevent cavities, your dentist might fit you for fluoride trays, which you fill with fluoride and wear over your teeth for a few minutes at night. Your dentist may also recommend weekly use of a chlorhexidine rinse to control cavities.
Research work: The journal Tissue Engineering Part A, a team from the University of Texas at San Antonio describes how they used silk fibers to provide salivary gland stem cells with a 3D scaffold on which to grow a matrix of salivary gland stem cells. Senior author Chih-Ko Yeh, a professor in comprehensive dentistry who runs a lab focusing on salivary gland research, says: "The cells had many of the same characteristics as salivary gland cells that grow in the mouth." The achievement is significant because "salivary gland stem cells are some of the most difficult cells to grow in culture and retain their function, his findings bring promise to 4 million Americans with an autoimmune disease called Sjögren's syndrome - a condition where the body attacks its own tear ducts and salivary glands. They also bring hope to thousands of others who have poor salivary function as a result of radiation treatment for head and neck cancer, and the 50% of older Americans whose medications can cause dry mouth. For their study, the team made a silk framework from purified silk fibers, populated it with stem cells from rat salivary glands and added a nourishing medium to encourage growth. After several weeks in culture, the cells produced a 3D matrix covering the silk scaffolds. Prof. Yeh explains that silk is a good choice as a scaffolding for the stem cells because it is a natural product, it biodegrades and is flexible and porous.