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The
most common approach to treatment of dry mouth is palliative.
Increased fluid intake, frequent sips of water, and humidification
may alleviate some of the symptoms.
Any maneuver
that will increase salivation will help relieve dry mouth symptoms.
It is recognized that saliva can be stimulated by oral activity.
Chewing will result in a robust increase in saliva output.
Salivation is also responsive to taste, particularly sour and bitter.
The use of flavored gums and lozenges will increase secretory
output transiently and remains a mainstay of palliative therapy of
xerostomia. The combination of gustatory and masticatory stimulation can
increase salivation for 30-60 minutes and relieve symptoms of oral
dryness. Patients with diminished salivation may be instructed to use
sugarfree gums, lozenges, candies or mints for symptomatic relief of
xerostomia. The use of sugarfree products must be stressed, as otherwise
the addition of sugar bathing the dentition will only increase
the caries risk and negate the benefit of increased salivary
output. Patients should be informed that sugarless foods are not
sugarfree -- they do contain sugars.
A
very large number of agents -- artificial salivas, oral rinses and gels,
flavored mouthwashes, etc. -- have been proposed to treat dry mouth. All
these topical therapies likely provide some degree of transient
salivary stimulation. There are few well-designed and controlled
clinical trials that have tested these in a formal manner.
In cases where
salivary function is completely absent, saliva replacement products
are the only available option. Patients should be instructed to
use these at night for comfort and at meals to aid in chewing
and swallowing. These agents are not highly effective and it appears
that different palliative treatments are favored by patients primarily
based on personal preference.
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