Xerostomia as a public health problem
Ivana Jurčić Čulina
University of Applied Health Sciences, Zagreb
Statistical data from developed countries clearly indicate that the number of elderly people in the structure of the general population is growing, that the age of the population is increasing, and that people are living longer. By prolonging life expectancy, the incidence of chronic diseases and the use of various drugs increases, which affects the health of the oral cavity as well as the health in general. Numerous studies showed an increase in the prevalence of xerostomia among the elderly population which enables us to talk about xerostomia as a public health problem. One of the most common and unpleasant oral symptoms is dry mouth or xerostomia. Xerostomia should be distinguished from hyposalivation because dry mouth does not necessarily mean reduced salivation. The difference between xerostomia and hyposalivation can be objectively determined by measuring the amount of total unstimulated saliva with sialometric test. Xerostomia is most often the result of salivary gland dysfunction, but it can also be associated with various systemic diseases, diseases of the central and peripheral nervous system, drug use, autoimmune diseases, radiation in the area of the head and neck, chemotherapy, mental conditions, infectious diseases and others. Histological changes in the salivary glands manifested by increased connective tissue production, fat deposition, and decreased number of acini that produce primary saliva may also cause xerostomia, which is in this case a result of the age-related changes. Oral symptoms suggestive of xerostomia are dry mouth and throat, thirst, food retention on teeth and mucous membranes of the mouth, difficulty speaking, chewing and swallowing, difficulty wearing prosthetic prostheses, bad breath, hypogeusia and/or dysgeusia, burning and/ or painful sensations of the oral mucosa. Xerostomia increases the risk of dental caries, dental erosions, periodontal diseases, oral infections and inflammation of the salivary glands. Diagnosis of salivary gland disease begins with inspection and a thorough medical history. The quantitative sialometry method collects saliva, immediately determines the degree of gland dysfunction, and confirms hyposalivation or xerostomia. Depending on the cause of xerostomia and the degree of damage to the salivary glands, we distinguish three types of treatment approaches: etiological approach, method of stimulating saliva secretion and symptomatic/palliative approach to the treatment of dry mouth. The aim of this paper is to point out the need for the education of health professionals in all fields for the purpose of interdisciplinary cooperation in order to better, faster and more efficiently solve the problem of dry mouth as a public health problem. The aim is also to encourage the health education of patients, which according to the directions of the World Health Organization (WHO) is the first and most important step in the prevention of oral diseases.
Key words: xerostomia as a public health problem, dry mouth, hyposalivation, saliva, xerostomia/causes, xerostomia/ treatment, xerostomia/diagnosis, xerostomia/oral manifestations/prevention