Dry mouth - Causes, Symptoms and Treatment .MF .
Dry mouth (xerostomia) - dryness of the oral mucosa, due to the decrease or cessation of secretion of salivary glands.In chronic dryness of the mouth is difficult for man to speak, chew, swallow, and to taste, all in general makes life pretty uncomfortable.
Typical symptoms of this condition are:
- The feeling of "stickiness" and dryness in the mouth
- Increased thirst
- Land irritation to the oral mucosa;cracks on the lips and in the corners of the mouth
- Sensation of dryness in the throat
- Burning or itching in the mouth (especially the language)
- Language blushes, becomes dry and rough
- Difficulty in speech, taste, chewing and swallowing
- Hoarsenessvoice, dry mucous membranes of the nasal passages, sore throat
- Bad breath
oral mucosa can respond to a variety of pathological processes and functional disturbances of many body systems.
Causes of dry mouth, not associated with the disease
1. Inadequate water schedule (with a deficit of water in hot weather, when used silnosolёnoy food).
2. Application of significant amounts of various drugs (anticancer, atropine, psychotropic agents, diuretics, sympathomimetics group etc.) Has side effects such as dry mouth.Even antihypertensives, vasoconstrictors and antihistamines help to reduce the production of saliva.
3. When breathing through the mouth (in the elderly at night while you sleep with your mouth open due to the weakness of the muscles, leading to the upper jaw, with difficulty in nasal breathing due to polyps, deviated septum, etc.).
4. Frequent unfounded mouthwash.
6. Alcohol intoxication.
diseases in which there is a dry mouth
1. Diseases of the salivary glands (mumps, sialadenitis, sialolithiasis, sialostaz, Mikulicz disease).Common features for each of these pathologies is a violation of saliva, until the complete cessation, cancer pain, its increase, salivary colic (in salivary gland pain during eating), swelling in the salivary gland.
2. Infectious diseases.Dryness in the mouth arises as a consequence of elevated body temperature and sweating (flu, sore throat, etc.) and due to the significant loss of fluid from the vomit and excrement (cholera, dysentery, and others.).
3. Endocrine diseases.Diabetes - a disease which is based on absolute or relative deficiency of insulin in the body, causing a violation of carbohydrate and other metabolic processes in the body.The characteristic symptoms of overt diabetes is thirst, dry mouth, weight loss, weakness and polyuria (increased urine output).The amount allocated per day of urine may be 3-6 liters and more.Thirst and dry mouth associated with a decrease in the fluid in the body and oppression of function of the salivary glands.
Hyperthyroidism - a pathological condition of the body, which develops due to the increased blood thyroid hormones.Hyperthyroidism is a complication of diffuse toxic goiter, thyrotoxic adenoma, multinodular goiter gipertireoidnog.Patients complain of anxiety, irritability, insomnia, tremor of the hands and the whole body, tachycardia, sweating, frequent diarrhea, vomiting, dry mouth, decreased appetite.Xerostomia is caused by metabolic disorders, and increased excretion of fluid from the body.
4. Neoplasms mouth (malignant and benign).Most often affects the parotid and submandibular salivary glands.Benign tumors are often located in the prostate tissue, but there may be shallow.They are painless education with a smooth surface or krupnobugristoy, plotnoelasticheskoy consistency, with clearly marked capsule.Malignant tumors are dense painless node or infiltration in the gland, without clear boundaries.With disease progression, pain.The tumor spreads rapidly to surrounding tissues and organs, and gives regional metastases.If it affects the parotid gland paralysis of facial muscles.Dry mouth can be observed due to the presence of the tumor itself (fracture, compression gland and its ducts), and as a complication of radiation therapy of oncological processes of maxillofacial area due to the direct action of ionizing radiation on the neurosecretory machinery, and breast tissue.
cancer parotid gland
5. deficiency of retinol (vitamin A) appears pale and dry skin, peeling it, a tendency to pustular lesions.There is a dry and dull hair, dry mouth, photophobia, conjunctivitis, blepharitis, frequent respiratory diseases, brittle nails and striation, cracks in the corner of the mouth, hyperkeratosis (increased keratinization) oral mucosa.Vitamin A deficiency leads to serious violations of the epithelium, which changes the course of physiological regeneration (recovery) and develops its atrophy.Increased shedding of the newly formed epithelium of the excretory ducts of the salivary glands leads to clogging them and the formation of retention cysts.The secretion of saliva when it slows down, although the breast tissue is not affected.
6. pathological processes that lead to increased fluid loss : internal and external bleeding, massive burns, fever, frequent vomiting and persistent diarrhea, increased sweating.
7. Surgical removal of the salivary glands conducted at a major trauma, oncological processes occurring in chronic inflammatory diseases, if other treatments have been ineffective.
8. Injury major salivary glands. dry mouth observed at wound parotid, submandibular, sublingual area.Trauma can lead to rupture of the tissue and breast ducts, which can lead to violations of the formation and release of saliva in the mouth.
9. damaged nerves (especially the facial and glossopharyngeal cranial nerves) that contribute to the work of the salivary glands and salivary center (the nucleus of the facial and glossopharyngeal nerves in the medulla oblongata).
10. Anemia .Iron deficiency anemia is characterized by pallor of the skin and mucous membranes, weakness, physical fatigue and mental lethargy, shortness of breath with movement, frequent dizziness, tinnitus, dry mouth, dysgeusia (taste for chalk, coal, izvёstke).
11. nervous excitement .Excitement, stress, high psycho-emotional stress sometimes cause the appearance of dryness in the mouth in people with increased nervous excitability.Dry mouth is held together with the symptoms of stress.
12. System disease.Systemic scleroderma
polisindromnoe disease characterized by progressive fibrosis of the skin, internal organs (heart, lungs, gastrointestinal tract, kidneys) and cardiovascular disorders such as obliterating endarteritis with common vasospastic (reduction of vascular lumen due to the contraction of the smooth muscle of their walls) disorders.Clinic reflects specific skin lesion that changes the appearance of the patient form (mask-like face, sclerodactyly) and the various systems of the body (polyarthralgia, esophagitis, peptic ulcers, pulmonary fibrosis, cardio, glomerulonephritis, etc..), Symptoms progress over time.A frequent symptom is a nail osteolysis of the phalanges, which leads to a shortening and deformation of fingers and toes.The defeat of the mucous membranes manifested by dryness in the mouth, thickening and shortening of the frenum.Scleroderma is often associated with Sjogren's syndrome.
disease Sjogren - systemic autoimmune disease characterized by dryness of mucous membranes caused by the proliferation of lymphoid glands of external secretion.
Syndrome Sjögren - syndrome characterized by a combination of signs of exocrine glands lesions (usually salivary and lacrimal) to a number of autoimmune diseases.
course of the disease and Sjogren's syndrome are identical.However, the disease is a distinct disease, and syndrome occurs in conjunction with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and other diseases.Manifestations of disease can be divided into systemic damage (recurrent non-erosive arthritis, myositis, interstitial nephritis, etc.) and symptoms related to exocrine gland hypofunction (dry mucous membranes of the mouth, nasopharynx, trachea, eye, vagina, gastrointestinaltract).Patients complain of itching, burning, pain, eyelid, photophobia.May develop recurrent bacterial conjunctivitis.The defeat of the salivary glands leads to the development, most often, chronic mumps, accompanied by pain, swelling of the salivary gland tissue, increase in body temperature to 38 - 40 ° C.In the later stages there is a sharp dry mouth, inability to talk, swallow food without added liquid.
Cystic fibrosis - an inherited disease characterized by systemic lesions of exocrine glands, manifested by severe disorder of the respiratory function, gastrointestinal tract and other organs and systems.The disease manifests in the neonatal period.With a good appetite children do not gain weight, there is paroxysmal coughing, dry mucous membranes of the oral cavity, saliva is viscous.There's constant shortness of breath and cyanosis.
diagnosis of dry mouth
On examination the patient clarify childhood diseases (mumps), which takes drugs now, bad habits.Inspect the area and overtures of the salivary glands.On the basis of data already obtained a doctor makes a presumptive diagnosis and determine a strategy for further examination.
Laboratory and instrumental examination of dry mouth
1. complete blood count (hemoglobin and decrease the number of red blood cells in iron deficiency anemia, scleroderma, increased white blood cells in inflammatory diseases);
2. Urinalysis - microscopic hematuria (the appearance of red blood cells in the urine), proteinuria (protein in the urine), cylindruria, leucocyturia in systemic sclerosis;
3. Blood glucose (normal 3,3-5,5 mmol / L increase in glucose level indicates a possible diabetes);
4. Blood on the thyroid hormones T3, T4, TSH.When thyrotoxicosis increases T3 levels, decreased T4 and TSH;
5. Biochemical analysis of blood: retinol with vitamin A deficiency is below 100 mg / l, carotene - below 200 mg / l;
6. ELISA (enzyme-linked immunosorbent assay) - antinuclear antibodies in scleroderma;
7. Serological analysis: rheumatoid factor titer of 1:80 with Sjogren's syndrome;
8. ultrasound is performed to determine the size of the salivary glands, the presence of stones, tumors, cysts, neuritis, etc .;
9. Sialostsintigrafiya - gives an indication not only of the secretory function of salivary glands in general, but also about every phase of the formation of saliva alone;
10. Panoramic radiography - the method used for sialolithiasis (ptyalolithiasis), with the possibility of foreign bodies of the salivary glands, damaged portions of the jaw and facial bones;
11. Sialoadenolimfografiya - used for suspected metastasis to the salivary glands;
12. Sialometriya - held with the need to assess the ability of the excretory salivary glands.Normal figures: 1.0 ml of saliva for 7-20 minutes;
13. Probing the ducts of the salivary glands are used to assess their permeability;
14. A biopsy and cytology obtained by biopsy and saliva - is used in the presence of tumors of the salivary glands;
15. CT (computed tomography) - effective method for the diagnosis of tumors in the salivary glands;
16. MRI (magnetic resonance imaging) identifies the cause of the pathology of the salivary glands, neuralgia glossopharyngeal and facial nerves;
17. If necessary, study the qualitative composition of saliva may determine the level of antibodies, proteolytic enzymes, amylase, macro- and microelements and other
dry mouth treatment
Treatment should be comprehensive, coordinated with the physician and include:.
1. Treatment of the underlying disease causing dryness in the mouth.
2. Refusal of bad habits (smoking).
3. If dry mouth is caused by drugs, then on the advice of a doctor, try to reduce the dose.
4. Do not eat food often silnosolёnuyu.
5. If necessary - excessive drinking.
6. Avoid alcohol-containing mouthwashes.
7. Perhaps the use of drugs, replacing saliva.
How dangerous dry mouth
Dry mouth can be one of the first symptoms of many systemic diseases.Therefore, if possible, in the shortest possible time, contact your doctor for examination passage.Dry mouth increases the risk of gingivitis (inflammation of gum disease), tooth decay and various oral infections (eg, thrush).Also dry mouth may hinder the wearing of dentures.
Which doctor contact with dry mouth
therapist, endocrinologist, rheumatologist, a dentist.
therapists Klentkina Y.