Xerostomía:Diagnóstico y Manejo Clínico

  1. Emilio González Jiménez 1
  2. Mª José Aguilar Cordero 1
  3. Rafael Guisado Barrilao 1
  4. Juan Miguel Tristán Fernández 1
  5. Pedro Antonio García López 2
  6. Judit Álvarez Ferre 3
  1. 1 Departamento de Enfermería. Escuela Universitaria de Ciencias de la Salud. Universidad de Granada. Granada
  2. 2 Departamento de Estadística. Facultad de Ciencias. Universidad de Granada. Granada
  3. 3 Hospital Universitario San Rafael. Granada
Revista:
Revista Clínica de Medicina de Familia

ISSN: 2386-8201

Ano de publicación: 2009

Volume: 2

Número: 6

Páxinas: 300-304

Tipo: Artigo

Outras publicacións en: Revista Clínica de Medicina de Familia

Resumo

Xerostomia is a condition in which the patient perceives a scarcity or total lack of saliva in his/her mouth. Also called dry mouth, it is not a disease in itself, but rather a direct manifestation of glandular dysfunction. As such, it may have a wide range of causes. For example, xerostomia may be a symptom of an underlying disease such as diabetes mellitus or primary and secondary Sjögren’ syndrome, which affects the auto-immune system. It can also be caused by certain medications, especially chemotherapy drugs or treatments which apply ionizing radiation (radiation therapy). Generally speaking, and despite the obvious discomfort suffered by the patient, xerostomia has not been the focus of much research because it has always been regarded as a secondary symptom or effect. However, due to increased survival rates, many patients (especially cancer survivors) perceive it as a potential enemy that signifi cantly lowers their quality of life. The aim of this review is to provide an update of the physiopathological aspects of this condition as well as the different procedures presently used for its diagnosis and clinical management.

Referencias bibliográficas

  • Aguilera S, Lobo G, Ladrón de Guevara D, Zerboni A. Utilidad de la escintigrafía de las glándulas salivares en el síndrome se Sjögren y su relación con el resultado de la biopsia de labio. Estudio comparativo con una población control. Rev Med Chil 2000; 128:877–86.
  • Bartley AG. Suppresion of saliva. Med Times Gazete 1868; 54:603.
  • Bergdahl J, Anneroth G, Anneroth I. Clinical study of patients with burning mouth. Scand J Dent Res 1994; 102:299–305.
  • Carmona L. Terapia local del síndrome de Sjögren. Una revisión práctica. Rev Esp Reumatol 1994; 21:259–62.
  • Douglas H. Protective and maintenance functions of human saliva. Quintessence Int 1993; 24:813–6.
  • Eli I, Baht R, Littner MM, Kleinhauz M. Detection of psychopatologic trends in glossdynia patients. Psychosom Med 1994; 56:389–94.
  • Fox PhC, Weiffwnbach JM, Van der Ven PF, Baum BJ, Sonies BC. Xerostomía: evaluation of a symptom with increasing signifi cance. J Am Dent Ass 1985; 110:519–25.
  • Fox RI. Fifth International Symposium on Sjögren´s Syndrome. Arthritis Rheum 1996; 9:195–6.
  • Glick D, Ben-Aryeh H, Gutman D, Szangel R. Relation between idiopathic glossodynia and salivary fl ow rate and content. Int J Oral Surg 1976; 5:161-5.
  • González E, López A, Granados M, Hernández G. Hiperplasiasgingivales farmacoinducidas. Aten Primaria 1995; 16:367–72.
  • Grand H, Grushka M, Yanover L. Drug induced xerostomía. The effects and treatment. J Can Dent Assoc 1985; 4:296–9.
  • Guchelaar HJ, Vermes A, Meerwaldt JH. Radiation–induced xerostomía: pathophysiology, clinical course and supportive treatment. Support. Care Cancer 1997; 5:281–8.
  • Hermann GA, Vivino FB, Shnier D, Krumm RP, Mayrin V. Diagnostic accuracy of salivary scintigraphic indices in xerostomic populations. Clinical Nuclear Medicine 1999; 24:167–72.
  • Hugunin P, Glanzmann C, Taussky D, Lutolf UM, Schmid S. Hyperfractionated radiotherapy and simultaneous cisplatin for the stage – III and IV carcinomas of the head and neck. Long–term results including functional outcome. Strahlenther Onkol 1998; 174:397–402.
  • Joyston–Bechal. Prevention of dental disease following radiotherapy and quemotherapy. Int Dent J 1992; 42:47–53.
  • Junfi n G, Van Dis M, Langlais R, Miles D. Xerostomía: diagnosis and treatment planning considerations. Oral Surg 1984; 58:248–52.
  • López P, Bermejo A. Xerostomía en el paciente geriátrico. En: Odontoestomatología geriátrica. Madrid: Coordinación Editorial; 1996. p. 211–28.
  • Mandel I. Impact of saliva on dental caries. Compend Cotin Educ Dent 1989; 13:476–81.
  • McDonald E, Marino C. Dry mouth: diagnosis and treating its multiple causes. Geriatrics 1991; 46:61–3.
  • Navasesh M, Christensen CM. A comparison of whole mouth restingand stimulate salivary measurements procedures. J Dent Res 1982; 61:1158–62.
  • Oliva AH, Aguilera TB, Segura PG, Rivas MC. Patología de la glándula salivar labial en el síndrome por aceite tóxico adulterado en España: una forma de síndrome de Sjögren secundario. Rev Clin Esp 1988; 182:71–8.
  • Ramírez V, Silverman S, Mayer P, Tyler M, Quivey J. Candidal colonization and oral candidiasis in patients undergoing oral and pharyngeal radiation therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 84:149-53.
  • Rhodus NL, Brown J. The association of xerostomía and inadequate intake in older adults. J Am Dietetic Assoc 1990; 90:1688–92.
  • Ritchie JR. Dental care for the irradiated cancer patients. Quintessence Int 1985; 12:837–43.
  • Scully C, Epstein JB. Oral health care for the cancer patient. Eur J Cancer B Oral Oncol 1996; 32B:281–92.
  • Seifret G, Miehlke A, Haubrich J, Chilla R. Disorders of secretion. En: Seifert G, ed. Diseases of the salivary glands. Pathology – diagnosis - treatment. Stuttgart, Germany: Theme Vertag Theem; 1986. p. 71– 6.
  • Ship J, Baum B. Is reduced salivary fl ow normal in old people? Lancet 1990; 336:1507.
  • Sreebny LM, Broich G. Xerostomíaa. En: Sreebny LM, ed. The salivary system. Miami, USA: CRC Pres; 1987. p. 17997.
  • Steckfus C. Salivary function and hypertension: a review of the literature and a case report. J Am Dent Assoc 1995; 126:1012–17.
  • Toth BB, Martin JW, Fleming TJ. Oral complication associated with cancer therapy. J Clin Period 1990; 17:508–15.