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ZWR - Das Deutsche Zahnärzteblatt 2008; 117(7/08): 349-356
DOI: 10.1055/s-0028-1085939
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Parodontologie
© Georg Thieme Verlag Stuttgart · New York

Xerostomie – Ätiologie, Klinik, Diagnostik und Therapie

Xerostomia – Aetiology, Clinical Manifestations, Diagnosis and TreatmentS. Hahnel1 , R. Bürgers1 , G. Handel1
  • 1Poliklinik für Zahnärztliche Prothetik, Universitätsklinikum Regensburg
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Publication History

Publication Date:
18 August 2008 (online)

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Xerostomie ist ein Krankheitsbild, mit dem der praktisch tätige Zahnarzt zunehmend konfrontiert wird. Die Ursachen reichen von der Einnahme systemisch wirkender Medikamente bis hin zu Autoimmunerkrankungen; ebenso können die klinischen Symptome äußerst vielfältig sein. Aus diesen Gründen gestalten sich Diagnose und Therapie der Krankheit oft schwierig. In der vorliegenden Übersichtsarbeit soll ein Überblick über Ätiologie und Klinik der Xerostomie sowie über potenzielle Therapiekonzepte gegeben werden.

A steadily increasing number of people is suffering from xerostomia. The reasons for xerostomia are manifold, reaching from the side effects of systemic drugs to autoimmune diseases. The clinical manifestations may be manifold, too. Thus, diagnosis as well as treatment of xerostomia may be complex. The aim of this article is to give a review on the etiology and clinical manifestations of xerostomia as well as potential therapeutical concepts.

Schlüsselwörter:

Xerostomie - Sjögren–Syndrom - Speichelersatzmittel

Keywords

Xerostomia - Sjoegren's Syndrome - Saliva Substitute

Literatur

  • 1 Al–Hashimi I.. The management of Sjögren's syndrome in dental practice.  J Am Dent Assoc. 2001;  132 1409-1417
    PubMedSearch in Google Scholar
  • 2 Atkinson JC, Wu AJ.. Salivary gland dysfunction: causes, symptoms, treatment.  J Am Dent Assoc. 1994;  125 409-416
    PubMedSearch in Google Scholar
  • 3 Brown LR, Dreizen SA, Daly TE.. Interrelations of oral microorganisms, immunoglobulins, and dental caries following radiotherapy.  J Dent Res. 1978;  57 882-893
    PubMedSearch in Google Scholar
  • 4 Cassolato SF, Turnbull RS.. Xerostomia: clinical aspects and treatment.  Gerodontology. 2003;  20 64-77
    CrossrefPubMedSearch in Google Scholar
  • 5 Christersson CE, Lindh L, Arnebrant T.. Film–forming properties and viscosities of saliva substitutes and human whole saliva.  Eur J Oral Sci. 2000;  108 418-425
    CrossrefPubMedSearch in Google Scholar
  • 6 Dawes C.. Physiological factors affecting salivary flow rate, oral sugar clearance, and the sensation of dry mouth in man.  J Dent Res. 1987;  66 648-653
    PubMedSearch in Google Scholar
  • 7 Dreizen S, Brown LR, Handler S, Levy BM.. Radiation–induced xerostomia in cancer patients. Effect on salivary and serum electrolytes.  Cancer. 1976;  38 273-278
    CrossrefPubMedSearch in Google Scholar
  • 8 Epstein JB, Loh R, Stevenson–Moore P. et al. . Chlorhexidine rinse in prevention of dental caries in patients following radiation therapy.  Oral Surg Oral Med Oral Pathol. 1989;  68 401-405
    CrossrefPubMedSearch in Google Scholar
  • 9 Felst E, Dörner T, Hansen A.. Indikation und Option neuer immunmodulatorischer Therapien beim Sjögren–Syndrom.  Z Rheumatol. 2007;  66 679-685
    CrossrefPubMedSearch in Google Scholar
  • 10 Fox PC.. Management of dry mouth.  Dent Clin North Am. 1997;  41 863-876
    PubMedSearch in Google Scholar
  • 11 Garg AK, Malo M.. Manifestations and treatment of xerostomia and associated oral effects secondary to head and neck radiation therapy.  J Am Dent Assoc. 1997;  128 1128-1133
    PubMedSearch in Google Scholar
  • 12 Gelhard TB, Fidler V, s'Gravenmade EJ, Vissink A.. Remineralization of softened human enamel in mucin– or CMC–containing artificial salivas.  J Oral Pathol. 1983;  12 336-341
    CrossrefPubMedSearch in Google Scholar
  • 13 Ghezzi EM, Lange LA, Ship JA.. Determination of variation of stimulated salivary flow rates.  J Dent Res. 2000;  79 1874-1878
    PubMedSearch in Google Scholar
  • 14 Greenspan D, Daniels TE.. Effectiveness of pilocarpine in postradiation xerostomia.  Cancer. 1987;  59 1123-1125
    CrossrefPubMedSearch in Google Scholar
  • 15 Guchelaar HJ, Vermes A, Meerwaldt JH.. Radiation–induced xerostomia: pathophysiology, clinical course and supportive treatment.  Support Care Cancer. 1997;  5 281-288
    PubMedSearch in Google Scholar
  • 16 Guggenheimer J, Moore PA.. Xerostomia: etiology, recognition and treatment.  J Am Dent Assoc. 2003;  134 61-69
    PubMedSearch in Google Scholar
  • 17 Guijarro Guijarro B, López AF Sánchez, Hernández G. Vallejo. Treatment of Xerostomia. A review.  Med Oral. 2001;  6 7-18
    PubMedSearch in Google Scholar
  • 18 Gupta A, Epstein JB, Sroussi H.. Hyposalivation in elderly patients.  J Can Dent Assoc. 2006;  72 841-846
    PubMedSearch in Google Scholar
  • 19 Hatton MN, Levine MJ, Margarone JE. et al. . Lubrication and viscosity features of human saliva and commercially available saliva substitutes.  J Oral Maxillofac Surg. 1987;  45 496-499
    PubMedSearch in Google Scholar
  • 20 Imfeld T.. Oligosialia and xerostomia. II. Diagnosis, prevention and treatment.  Schweiz Monatsschr Zahnmed. 1984;  94 1083-1096
    PubMedSearch in Google Scholar
  • 21 Imfeld T.. Reduzierter Speichelfluß: Ursachen, Folgen und Diagnose. in: Reduzierter Speichelfluß und Mundtrockenheit: Herausforderung zur Zusammenarbeit in der Kariesprophylaxe. München: MSC Medizinischer Creativ Service GmbH 1995
    Search in Google Scholar
  • 22 Johnson JT, Ferretti GA, Nethery WJ. et al. . Oral pilocarpine for post–irradiation xerostomia in patients with head and neck cancer.  N Engl J Med. 1993;  329 390-395
    CrossrefPubMedSearch in Google Scholar
  • 23 Joyston–Bechal S, Kidd EA.. The effect of three commercially available saliva substitutes on enamel in vitro.  Br Dent J. 1987;  163 187-190
    PubMedSearch in Google Scholar
  • 24 Kassan SS, Moutsopoulos HM.. Clinical ma– nifestations and early diagnosis of Sjogren syn– drome.  Arch Intern Med. 2004;  164 1275-1284
    CrossrefPubMedSearch in Google Scholar
  • 25 Keene HJ, Fleming TJ.. Prevalence of caries–associated microflora after radiotherapy in patients with cancer of the head and neck.  Oral Surg Oral Med Oral Pathol. 1987;  64 421-426
    CrossrefPubMedSearch in Google Scholar
  • 26 Kielbassa AM, Shohadai SP.. Die Auswirkungen von Speichelersatzmitteln auf die Läsionstiefe von demineralisiertem Schmelz.  Dtsch Zahnarztl Z. 1999;  54 757-763
    PubMedSearch in Google Scholar
  • 27 Kielbassa AM, Meyer–Lückel H.. Die Auswirkungen von Speichelersatzmitteln und Mundspüllösungen auf Dentin.  Schweiz Monatsschr Zahnmed. 2001;  111 1060-1066
    PubMedSearch in Google Scholar
  • 28 Kielbassa AM, Shohadai SP, Schulte–Mönting J.. Effect of saliva substitutes on mineral content of demineralized and sound dental enamel.  Support Care Cancer. 2001;  9 40-47
    PubMedSearch in Google Scholar
  • 29 Le Veque FG, Montgomery M, Potter D. et al. . A multicenter, randomized, double–blind, placebo–controlled, dose–titration study of oral pilocarpine for treatment of radiation–induced xerostomia in head and neck cancer patients.  J Clin Oncol. 1993;  11 1124-1131
    PubMedSearch in Google Scholar
  • 30 Levine MJ.. Artificial salivas: present and future.  J Dent Res. 1987;  66 693-698
    PubMedSearch in Google Scholar
  • 31 Meyer–Lückel H, Kielbassa AM.. Die Verwendung von Speichelersatzmitteln bei Patienten mit Xerostomie.  Dtsch Zahnarztl Z. 2002;  57 335-344
    PubMedSearch in Google Scholar
  • 32 Meyer–Lückel H, Schulte–Mönting J, Kielbassa AM.. The effect of commercially available saliva substitutes on predemineralized bovine dentin in vitro.  Oral Dis. 2002;  8 192-198
    CrossrefPubMedSearch in Google Scholar
  • 33 Meyer–Lückel H, Tschoppe P, Kielbassa AM.. Linseed based saliva substitutes and their effect on mineral dissolution of predemineralized bovine dentin in vitro.  J Dent. 2006;  34 751-756
    CrossrefPubMedSearch in Google Scholar
  • 34 Meyer–Lückel H, Kielbassa AM.. Influence of calcium phosphates added to mucin–based saliva substitutes on bovine dentin.  Quintessence Int. 2006;  37 537-544
    PubMedSearch in Google Scholar
  • 35 Meyer–Lückel H, Chatzidakis AJ, Kielbassa AM.. Effect of various calcium/phosphates ratios of carboxymethylcellulose–based saliva substitutes on mineral loss of bovine enamel in vitro.  J Dent. 2007;  35 851-857
    CrossrefPubMedSearch in Google Scholar
  • 36 Momm F, Volegove–Neher NJ, Schulte–Mönting J. et al. . Different saliva substitutes for treatment of xerostomia following radiotherapy.  Strahlenther Onkol. 2005;  181 231-236
    CrossrefPubMedSearch in Google Scholar
  • 37 Mühlemann HR.. Das Verhalten von Kiefer und Zähnen bei der Radiotherapie von malignen Tumoren der Mundhöhle und des Pharynx.  Schweiz Monatsschr Zahnmed. 1945;  55 641-688
    PubMedSearch in Google Scholar
  • 38 Nagy K, Urban E, Fazekas O. et al. . Controlled study of lactoperoxidase gel on oral flora and saliva in irradiated patients with oral cancer.  J Craniofac Surg. 2007;  18 1157-1164
    CrossrefPubMedSearch in Google Scholar
  • 39 Nederfors T, Isaksson R, Mörnstad H. et al. . Prevalence of perceived symptoms of dry mouth in an adult Swedish population: relation to age, sex and pharmacotherapy.  Community Dent Oral Epidemiol. 1997;  25 211-216
    CrossrefPubMedSearch in Google Scholar
  • 40 Scully C.. Drug effects on salivary glands: dry mouth.  Oral Dis. 2003;  9 165-176
    CrossrefPubMedSearch in Google Scholar
  • 41 Scully C, Felix DH.. Oral medicine – update for the dental practitioner. Dry mouth and disorders of salivation.  Br Dent J. 2005;  199 423-427
    PubMedSearch in Google Scholar
  • 42 Ship JA, Pillemer SR, Baum BJ.. Xerostomia and the geriatric patient.  J Am Geriatr Soc. 2003;  50 535-543
    PubMedSearch in Google Scholar
  • 43 Smith RG, Burtner AP.. Oral side–effects of the most frequently prescribed drugs.  Spec Care Dentist. 1994;  14 96-102
    CrossrefPubMedSearch in Google Scholar
  • 44 Sreebny LM, Schwarts SS.. A reference guide to drugs and dry mouth.  Gerodontology. 1986;  5 75-99
    CrossrefPubMedSearch in Google Scholar
  • 45 Stratmann U, Mokrys K.. Mundtrockenheit – Ursachen und Symptomatik.  Zahnarztl Mitt. 2000;  90 62-64
    PubMedSearch in Google Scholar
  • 46 Tenovuo J, Lumikari M, Soukka T.. Salivary lysozyme, lactoferrin and peroxidases: antibacterial effects on cariogenic bacteria and clinical applications in preventive dentistry.  Proc Finn Dent Soc. 1991;  87 197-208
    PubMedSearch in Google Scholar
  • 47 Tschoppe P, Meyer–Lueckel H, Toll R. et al. . In vitro analysis of a new saliva substitute (Saliva natura) on enamel and dentin.  Laryngorhinootologie. 2007;  86 723-727
    Thieme ConnectPubMedSearch in Google Scholar
  • 48 Turner MD, Ship JA.. Dry mouth and its effect on the oral health of elderly people.  J Am Dent Assoc. 2007;  138 15-20
    PubMedSearch in Google Scholar
  • 49 van der Reijden WA, van der Kwaak H, Vissink A. et al. . Treatment of xerostomia with polymer–based saliva substitutes in patients with Sjögren`s syndrome.  Arthritis Rheum. 1996;  39 57-63
    CrossrefPubMedSearch in Google Scholar
  • 50 van der Reijden WA, Vissink A, Veerman EC. et al. . Treatment of oral dryness related complaints (xerostomia) in Sjögren`s syndrome.  Ann Rheum Dis. 1999;  58 465-474
    CrossrefPubMedSearch in Google Scholar
  • 51 Ventafridda V, De F Conno, Ripamonti C. et al. . Quality–of–life assessment during a palliative care programme.  Ann Oncol. 1990;  1 415-420
    PubMedSearch in Google Scholar
  • 52 Wiseman LR, Faulds D.. Oral pilocarpine: a review of its pharmacological properties and clinical potential in xerostomia.  Drugs. 1995;  49 143-155
    CrossrefPubMedSearch in Google Scholar
  • 53 Wolpert E, Jung F, Middelhoff HD. et al. . Treatment of drug–induced dryness of mouth in psychiatric patients – a controlled comparative study.  Fortschr Neurol Psychiatr Grenzgeb. 1980;  48 224-233
    PubMedSearch in Google Scholar
  • 54 Wynn RL, Meiller TF.. Artificial saliva products and drugs to treat xerostomia.  Gen Dent. 2000;  48 630-636
    PubMedSearch in Google Scholar

Korrespondenzadresse

Dr. Sebastian Hahnel

Poliklinik für Zahnärztliche Prothetik Universitätsklinikum Regensburg

93042 Regensburg

Email: Sebastian.Hahnel@klinik.uni-regensburg.de