Kserostomiya – the insufficient salivation which is followed by the increased dryness of a mucous membrane of an oral cavity. It is shown by feeling of dryness in a mouth and a throat, burning of language, difficulty of chewing, swallowing, the speech, violation of taste and feeling of metal smack in a mouth. Often happens display of the main disease (diabetes, Parkinson's disease, HIV, etc.), side effect of drugs, beam or chemotherapy. Treatment from a kserostomiya depends on a possibility of elimination of the reason of its emergence. Symptomatic therapy includes purpose of a galantamin, potassium of iodide, pilocarpine, novokainovy blockade and physiotherapeutic procedures to area of salivary glands.
Kserostomiya is a symptom of dryness in a mouth which appears at reduction of a salivation, or at complete cessation of salivation. Kserostomiya is not an independent disease, but with constant dryness it is necessary to undergo comprehensive examination for identification of pathological states which caused kserostomiya symptoms in a mouth.
Reasons of kserostomiya
Saliva is the greasing substance which facilitates process of chewing and swallowing, besides it washes away bacteria from teeth and possesses anti-inflammatory action. The substances which are contained in saliva remineralizut enamel and neutralize effect of acids and alkalis which arrive with food.
Most often kserostomiya are side effect of medicines. People of senile age are more subject to the phenomena of constant dryness in a mouth because of acceptance of a large amount of medicines of different pharmacological groups. The combined effect of medicines increases probability of side effects and does their manifestations more expressed.
Symptoms of a kserostomiya can be shown at diabetes, iron deficiency anemias and a hypertension. Cystous fibrosis, rheumatoid arthritis and HIV infection often are followed by kserostomiya. At Shane's syndrome autoimmune violations cause dystrophy of salivary and plaintive glands that is shown by dryness mucous a mouth, a kserostomiya and hypofunction of plaintive glands. The parotitis and other viral infections affecting salivary glands, system of an innervation and blood supply influence production of saliva and cause kserostomiya symptoms.
Short-term kserostomiya cause any conditions of dehydration of an organism. These are feverish states, loss of liquid because of vomiting and diarrhea, blood loss, a burn disease and limited intake of liquid in an organism. During radiation therapy and some time after cancellation of treatment is observed a kserostomiya symptom. Especially brightly kserostomiya are expressed at radiation therapy of oncological diseases of the head and neck.
During surgical removal of salivary glands the kserostomiya gains constant character and the only option of correction is use of the means moistening an oral cavity. Violations of the central mechanism of salivation as nevrogenny kserostomiya are often observed at a back sukhotka, bruises of a brain and at toksiko-infectious damages of the central nervous system. Senile atrophies of salivary glands, sialoadenit, Mikulich's disease are risk factors. At these states the probability of development of kserostomiya increases.
Temporary kserostomiya can develop also in the absence of pathologies, for example at violations of nasal breath to which can lead nose polyps, a curvature of a nasal partition. At elderly people because of weakness of the muscles raising the lower jaw, the kserostomiya arises from that, during a night dream of companies is constantly open. Unreasonable and frequent rinsings of a mouth, especially aggressive disinfectants lead to an atrophy of salivary glands and to emergence of symptoms of a kserostomiya.
Clinical manifestations of kserostomiya
Kserostomiya are characterized by dryness in a mouth. As the salivation decreases, the probability of suppurations increases. At kserostomiya the risk of infectious diseases of soft tissues of oral cavity including fungal character increases. At increase of dryness in a mouth of a kserostomiya are shown by perversions of taste and decrease in flavoring feelings.
Extent of manifestation of kserostomiya is defined by expressiveness of signs. So, in initial stages of a kserostomiya parotid and submaxillary salivary glands mark out amount of saliva within norm therefore the condition of compensation of salivation is noted. At this stage of a disease dryness in a mouth appears only after the long talk and overfatigue. At survey a mucous membrane of an oral cavity damp, saliva a little foamy.
Further the period of a partial decompensation begins. Signs of a kserostomiya become more expressed that is shown by constant dryness in a mouth, the speech and meal is at a loss. Patients already at this stage feel dryness in a mouth during food therefore wash down dry food with water. The mucous membrane of an oral cavity is moistened poorly, has a light pink shade and shines.
The III degree of a kserostomiya is characterized by full oppression of functions of salivary glands. Patients show complaints to sharp dryness in a mouth, morbidity during the conversation and acceptance of food. Glossita, stomatitises join; because of dryness mucous the oral cavity is covered with ulcers and erosion. Lips too dry and shelled, are sometimes covered with crusts. If dysfunction of salivary glands is the reason of kserostomiya, then often except dryness in a mouth multiple caries is noted.
Besides the main manifestations at kserostomiya thirst, problems with swallowing of food and fetid breath can be observed. Patients often have quinsy, and during recovery the hoarseness and a sore throat cause discomfort and are the main reason for problems with the speech. With kserostomiya language gains bright red color from patients, there are zayeda and cracks in mouth corners which are often infected. In a stage of partial compensation and in a stage of a decompensation dryness in nasal passes appears, the carious disease joins, periodontium pathologies are possible. If patients carry removable artificial limbs, then there are difficulties with their operation and frequent injuries mucous a mouth.
Diagnostics and treatment of kserostomiya
Diagnostics of kserostomiya includes detailed poll of the patient for the purpose of examination what medicines it accepted including without recipe of the doctor. Carry in addition out ultrasonography of salivary glands and a sialografiya.
Symptomatic therapy at kserostomiya considerably facilitates a condition of the patient, but after the termination of treatment of manifestation of kserostomiya appear again. Therefore it is important to stomatologist to establish the main reason for this symptom. Kserostomiya, arisen owing to reception of medicinal substances, obezvozhivaniye corrections quickly give in. Whereas kserostomiya after radiation therapy cannot almost be eliminated as radiation can reduce ability of salivary glands to produce saliva.
Pathogenetic therapy of kserostomiya is directed to elimination of the causes of dryness in a mouth. For improvement of a state appoint solutions of potassium of iodide, pilocarpine and a galantamin. Greasing of an oral cavity solution of vitamin A promotes both to decrease in symptoms of dryness, and healing of wounds and microcracks. Novokainovy blockade in the field of parotid and submaxillary salivary glands and physiotherapeutic procedures, such as a galvanoterapiya of salivary glands, an electrophoresis with iodide potassium and vibromassage, are capable to improve a condition of the patient even with kserostomiya in a decompensation stage.
That the oral cavity always was humidified, it is recommended to drink in often small portions water. Not aerated mineral or drinking water if to drink it during the day and during night awakenings is symptomatic means, however considerably improves a condition of a mucous membrane of a mouth. Firm lollipops without sugar promote improvement of work of salivary glands and increase in total amount of saliva. Usually patients with kserostomiya chew chewing gums, it promotes increase in salivation, but it is necessary to recommend chewing gums without the content of sugar to reduce probability of developing of caries.
At kserostomiya it is necessary to avoid consumption of salty and dry products, and also products and drinks with the content of caffeine and high content of sugar. Alcoholic beverages and the liquids containing alcohol for rinsing of an oral cavity dry mucous and cause a giposalivation. With kserostomiya it is recommended to patients to refuse smoking, to use the means and toothbrushes moistening an oral cavity with a soft bristle not to injure thinned and dry mucous a mouth.
After successful elimination of symptoms of a kserostomiya, it is necessary to avoid a recurrence. It is reached due to rational drug treatment of diseases, it is necessary to use those medicines which do not influence work of salivary glands. The forecast at kserostomiya is defined by the nature of the main disease and extent of violations of functions of salivary glands. But in all cases, except a full atrophy of salivary glands, it is possible to achieve considerable improvement of a state or full treatment.