Overview
Drug-induced xerostomia, or dry mouth, results from medications that interfere with salivary gland function, commonly affecting older adults due to polypharmacy 1.Diagnosis
Self-reported symptoms of dry mouth are primary 1.
No specific diagnostic tests; clinical evaluation and patient history are crucial 2.
Grading often based on severity and impact on daily activities 2.Management
Reduce or adjust offending medications when possible 1.
Salivary stimulants: Pilocarpine (5-10 mg three times daily) or Cevimeline (10-30 mg three times daily) 2.
Hydration and frequent sips of water throughout the day 2.
Use of saliva substitutes and moisturizing oral rinses 2.
Regular dental check-ups to manage oral complications 2.Special Populations
Elderly: Higher prevalence due to multiple medications 1.
Comorbidities: Management must consider interactions with existing conditions 2.Key Recommendations
Evaluate number of medications as a risk factor for xerostomia in older adults (Evidence: Moderate) 1.
Implement salivary stimulants like pilocarpine or cevimeline for symptomatic relief (Evidence: Expert opinion) 2.
Prioritize patient education on hydration and oral care practices to mitigate symptoms (Evidence: Expert opinion) 2.References
1 Storbeck T, Qian F, Marek C, Caplan D, Marchini L. Dose-dependent association between xerostomia and number of medications among older adults. Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry 2022. link
2 Potgieter E, Phillips VM. Oral health management of a medically compromised patient with medication induced xerostomia--a case study. SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging 2009. link