Evaluation, differential diagnosis, and treatment of xerostomia

The salivary component of Sjogren's syndrome (SS) is defined as xerostomia (dry mouth). However, xerostomia is a common symptom associated with quanti tative and qualitative changes in saliva, which are generally referred to a s salivary hypofunction. This can be caused by various systemic diseases (i ncluding SS), anticholinergic effects of many drugs, psychological conditio ns, and physiological changes. Chronic salivary hypofunction is clinically significant because it can cause oral dysfunction, dental destruction, and mucosal infection. Evaluating patients complaining of xerostomia requires p articular attention to their current medications and physical examination o f the major salivary glands, teeth, and oral mucosa. Based on that informat ion and the differential diagnosis of salivary hypofunction, appropriate te sts can then be selected to develop a final diagnosis. Effective treatment of patients with chronic salivary hypofunction requires a combination of: ( 1) ongoing dental decay prevention and treatment supervised by their dentis t; (2) salivary flow stimulation; (3) recognition and treatment of chronic oral candidiasis; (4) selective use of saliva substitutes; and (5) prescrip tion drug review.