Salivary Gland Hypofunction and/or Xerostomia
Background
Background
- Saliva plays a crucial role in the maintenance of tooth integrity, food and bacterial clearance, mechanical cleansing of the oral cavity, and oral comfort. Saliva also provides antimicrobial activity preventing oral infections and plays an important role in upper gastrointestinal functions including taste perception, formation of food bolus, facilitation of mastication, swallowing and speech, as well as lubrication of oropharyngeal and upper esophageal mucosa. Thus, salivary gland hypofunction is associated with an increased risk for oral infections, carious destruction of teeth, dysgeusia, oral mucosal discomfort, and a worsened nutritional state.
- Cancer patients may experience salivary gland hypofunction and xerostomia as a consequence of cancer therapy. This is most notable in head and neck cancer patients treated with external beam radiation therapy. In this setting, salivary gland hypofunction and xerostomia may be severe and permanent. This results in a profound, potentially life-long adverse impact on oral health and oral health-related quality of life. While radioactive iodine, total body irradiation, and high-dose chemotherapy with hematopoietic stem cell transplantation as well as moderate-dose chemotherapy for solid tumors may also cause salivary gland hypofunction, in these settings function loss and associated symptoms tend to be less severe and often less long-lasting.
Prevention
Preventi...
...ated radiation therapy (IMRT) should be...
...adiation modalities that limit cumulativ...
...e may be offered during radiation therapy for head...
...administration of the sialagogue bethanechol...
...other antioxidants should not be used to reduce...
...nce remains insufficient for a rec...
...ins insufficient for a recommendation for or ag...
...remains insufficient for a recommendatio...
Management
...nagement...
...osal lubricants/saliva substitutes (agents dir...
Other radiation modalities that limit...
...l pilocarpine, and cevimeline where...
...be offered post-radiation therapy in head...
...ous electrostimulation or acupuncture-like transcu...
...remains insufficient for a recommendation for...
Table 1. Definitions Related to Dysfunction of the Salivary Glands
...efinitions Related to Dysfunction of the Salivar...