Xerostomia: a common adverse effect of drugs and radiation

Xerostomia (dry mouth) is a relatively common condition and is due to salivary dysfunction. It has multiple causes, including developmental, inflammatory and neoplastic disorders. Common causes are anxiety, an adverse effect of drugs, and radiotherapy in the head and neck region. A decrease in the quantity or quality of saliva has a profound effect on the oral environment. This results in extensive and recurrent smooth surface dental decay, increased periodontal disease, significant worsening of any underlying mucosal disease and an increased likelihood of oral candidosis and difficulty with the retention of dentures. Ideally, before patients start taking drugs that can cause xerostomia or undergoing radiotherapy in the head and neck region, they should have a detailed dental check-up followed by treatment of any active disease. Topical agents can be very useful in reducing decalcification and promoting mineralisation of teeth. Dentists can advise patients on methods for the care of their teeth as well as methods to diminish the feeling of oral dryness that so profoundly affects patients' quality of life. Patients with xerostomia must have regular dental reviews and excellent oral hygiene as the removal of any teeth may result in them being unable to cope with dentures. Patients with Sjogren's syndrome also require long-term follow-up as they have a significantly higher incidence of lymphoma in their salivary glands.