CAUSES OF DRY MOUTH
Dry Mouth conditions range from very minor problems caused by over use of the voice or nervous tension, to total shut down of the saliva glands. Saliva has many functions. It lubricates the ingested foods and protects mucous membranes from irritation and toxic substances. The flow of saliva aids in removing materials from the mouth in a cleaning action. It maintains a neutral pH. thereby limiting the acid producing effect of the breakdown of sugars on the teeth and development of tooth decay. Saliva also has antibacterial and coagulation properties.
Salivary gland dysfunction (Dry Mouth) can be caused by local glandular effects or systemic disease. In terms of local glandular effects, two Dry Mouth conditions may arise: hyposalivation (moderate) or xerostomia (severe). The result is difficulty in chewing, swallowing and digesting food. The most prevalent forms of xerostomia are found in cancer patients taking radiation treatments. Especially those with cancer in the neck and head area.
Systemically, Sjorgren's Syndrome is the most prevalent cause of xerostomia. It is a chronic inflammatory autoimmune disease in which the body's exocrine secretions - the eyes, nose, mouth and vagina - dry up. Other systemic diseases such as sarcoidosis, cystic fibrosis, hormonal dysfunction (thyrotoxicosis and diabetes), seleroderma, hypertension, obesity, hyperlipidemia alcoholic cirrhosis, malnutrition and lichen planus are all associated with xerostomia. Additionally, it is estimated that 25% of the elderly and 10% of AIDS patients suffer from xerostomia.
DRUGS & DRY MOUTH
Drug Classes: Subtypes, Associated with xerostomic effects
Glandular effects that may occur in those people who are taking artificial prescribed drugs on a regular basis as indicated below:
Analgesics: narcotic Antidepressants: tricyclics, tetracyclics, MAO inhibitors, lithium
Antipruritics Anti-diarrheals: with anticholinergics
Antipsychotics Antihistamines: H 1 blockers and H2 blockers
Antinauseants/Antivertigo Antihypertensives: alpha-blockers, beta-blockers, ACE inhibitors
Antispasmodics: GI and urinary Antiparkinsonism drugs: antichollinergics and dopaminergics
Cough and Cold preparations Diuretics
Sedatives Muscle Relaxants: Flexeril, Lioresal, Norflex, diazepam
Vitamins Rocaltrol, Calderol.
Any drug that causes a decrease in blood flow to the salivary glands will lessen salivary secretions:
Anti hypertensives that lower blood pressure will decrease blood flow
Diuretics that decrease blood flow by decreasing blood volume affect blood
flow to the salivary glands.
Some specific drugs: e.g. isotretinoin (Accutane), gemfibrozil (Lopid), anti-inflammatories (NSAIDS), antineoplastics (Matulane, Myleran), anti-ulcer (Carafate), calcium supplement Neo Calglucon), antinauseants (Reglan), and nicotine patches, cause xerostomia.
Of the 25 most frequently prescribed drugs in 1992, the following drugs are associated with xerostomic side effects:
Zantac (ranitidine)
Xanax (alprazolam)
Seldane (terfenadine)
Naprosyn (naproxen) Prozac (fluoxetine)
Proventil (albuterol)
Tagamet (cimetidine)
Dyazide (triameterene)
Hydrochlorthiazide
In addition to prescribed medication, at least half of the doses ingested in the U.S. are over-the-counter drugs. Of those drugs, the most frequently used medications that have xerostomic side effects are as follows:
Laxatives - Chronulac, Phospho-Soda Antinauseants - Dramamine
Cold and Allergy products
antihistimines Anti-diarrheals - loperamide
Other drugs may also have xerostomic properties:
tobacco
marijuana
cocaine heroin
amphetamine
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