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
...Preve...
...y-modulated radiation therapy (IMRT) should b...
...ther radiation modalities that limit cumulat...
...may be offered during radiation ther...
...c administration of the sialagogue bethane...
...n E or other antioxidants should not be used to re...
...ns insufficient for a recommendation for or agai...
...nce remains insufficient for a recommen...
...ns insufficient for a recommendation for or ag...
Management
...M...
...l mucosal lubricants/saliva substitutes...
Other radiation modalities that limit cumulative d...
...ilocarpine, and cevimeline where available, may be...
...be offered post-radiation therapy in head and...
...electrostimulation or acupuncture-lik...
...mains insufficient for a recommendation for or...
Table 1. Definitions Related to Dysfunction of the Salivary Glands
...ble 1. Definitions Related to Dysfunction of the S...