Management of xerostomia and salivary hypofunction

摘要

Xerostomia is a common complaint amongst individuals receiving palliative care and may reflect both the ageing process as well as adverse effects of drug administration, systemic disease or radiotherapy. Xerostomia should be considered a symptom of oral dryness with or without hyposalivation. Prevention is key in management of salivary hypofunction due to the lack of efficacy of saliva replacement therapy. Treatment is directed at the underlying cause and encompasses stimulation of saliva production, use of saliva substitutes and oral healthcare to prevent and manage caries, gingivitis and candidosis. A multidisciplinary approach is advocated. The objective of this article is to present evidence-based management guidelines for salivary hypofunction for the palliative care team and, in the absence of evidence, give consensus advice from appropriate resources. We also aim to review the main aetiological factors associated with this condition which directs investigation. A management algorithm for the care of radiation-induced salivary hypofunction is suggested.