Clinical approach to xerostomia

Dr. Abbas Javadzadeh Dr. Atessa Pakfetrat

Associate Professor of Oral medicine Department Mashhad Dental School

�َXerestomia is a

symptom not a diagnosis

or disease

Clinical evaluation of xerostomia

1. Subjective or objective

signs and symptom

2. Permanent or temporary?

Acute or chronic?

Clinical course?

Clinical evaluation of xerostomia

3. Symptoms of salivary gland

dysfunction

Clinical evaluation of xerostomia

4. Associated diseases

5. History

Review of system

PMH, PDH

Clinical evaluation of xerostomia

EtiologyEtiology1-Iatrogenic

Drugs

Radiation

chemotherapy

2- Developmental

Salivary gland agenesis

3- Water/metabolite loss 3- Water/metabolite loss

Impaired fluid intake

Hemorrhage

Vomiting/diarrhea

4- Systemic disease 4- Systemic disease Sjogren syndrome

Renal failure

Diabete

Granulomatose diseases

HIV infection

Malnutrition

Late stage liver disease

GVHD

Primary Biliary cirrhosis

Chronic Active Hepatitis

Vasculitis, …..

5- Psychological Factors

Affective disorders

6- Local factors

Decreased mastication

Smoking

Mouth breathing

7- Rarities

Amyloidosis

Bell’s palsy

Cystic fibrosis

hemochromatosis

Para clinic

Imaging Serologic tests

Biopsy

Sialometry

Salivary gland

function test

..……

Treatment

Systemic stimulation Symptomatic

Treatment of associated diseases

Psychological Treatment and consult

Drug substitution

Non-DrugStimulation

بوی باران ، بوی سبزه ، بوی خاکشاخه های شسته ، باران خورده ، پاک

آسمان آبی و ابر سپيدبرگهای سبز بيد

عطر نرگس ، رقص بادنغمه و بانگ پرستوهای شادخلوت گرم کبوترهای مستنرم نرمک ميرسد اينک بهار

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