According to abbreviationfinder, the physician understands hyposalivation as the lack of secretion of saliva. The oral mucosa reddens with this phenomenon, it hurts and is sometimes inflamed. Therapeutic methods such as the administration of saliva substitutes can be used to combat dry mouth.
What is hyposalivation?
When there is hyposalivation, the saliva loses its buffering function. This means that the oral mucosa is reddened and vulnerable to inflammation. Sometimes gums bleed.
The lack of secretion of saliva is known as hyposalivation. The opposite is the above-average secretion of saliva, which is also known as hypersalivation. When the flow of saliva is reduced to half the normal value, medicine also speaks of a xerostomia or dry mouth. Xerostomia is a special form of hypersalivation, in which the entire oral mucosa is no longer wetted with sufficient amounts of saliva.
In addition to moistening the mucous membranes in the mouth, saliva also has a function in food intake that can no longer be satisfactorily fulfilled if there is a lack of salivary secretion. From diseases to hormonal changes or medication, various causes can trigger hyposalivation or dry mouth. In a healthy organism, the salivary gland releases about one milliliter of saliva per minute. This value is reduced to less than 0.5 milliliters when the mouth is dry.
Causes
The most common cause of hyposalivation or dry mouth are physiological signs of aging. Salivary secretion naturally decreases with age because the salivary glands are less active. In addition, many people of a certain age take medication that can reduce the flow of saliva. These drugs include, for example, antihypertensives, anticholinergics, tricyclic antidepressants, antihistamines and cytostatics.
More than 400 drugs describe hyposalivation in their side effects. Amphetamines can also have a throttling effect on salivary secretion. Dehydration and dehydration can also dry out the mouth. That being said, psychological factors like stress can minimize saliva production. Radiation therapy is just as often a cause.
The causative diseases are Morbus Zagari, Sjögren ‘s or Heerfordt’s syndrome as well as AIDS and sepsis. In addition, inflammation and tumors of the salivary glands can result in hyposalivation.
Symptoms, Ailments & Signs
When there is hyposalivation, the saliva loses its buffering function. This means that the oral mucosa is reddened and vulnerable to inflammation. Sometimes gums bleed. Pain in the mouth is therefore a frequent side effect of hyposalivation. Above all, a burning sensation on the tongue characterizes the clinical picture. The risk of tooth decay also increases with reduced saliva secretion.
Harmful acids in the mouth are hardly neutralized by the lack of saliva. Bad breath sets in. After a long time, the entire oral mucosa atrophies. Chewing is difficult in many cases. The same applies to the swallowing movement. In addition, the sense of taste can be affected. Patients often have above-average thirst. Instead of a clear liquid, the oral fluid becomes foamy. Sometimes patients with extreme dry mouth can hardly speak.
Diagnosis & course of disease
Hyposalivation is usually diagnosed by palpation. The doctor uses a glove that sticks to the oral mucosa if there is insufficient saliva secretion in the oral vestibule. When he tries to smear the salivary glands, the glands do not produce any salivary secretion. In visual diagnosis, reddened areas and possible inflammation and caries lesions indicate hyposalivation.
The anamnesis can also provide important information about the lack of secretion. In order to initiate a course of therapy, the physician must determine the cause of the hyposalivation. The prognosis is also determined by the cause. A good prognosis exists, for example, with medication that only has to be taken for a certain period of time. Dry mouth due to minimal fluid intake also has a favorable prognosis. Less favorable are diseases of the salivary glands.
Complications
Hyposalivation mainly causes discomfort in the oral cavity. The mucous membrane becomes reddened and pain and inflammation occur. In most cases, hyposalivation also means that the patient is no longer able to eat or drink normally, so that the patient usually suffers from being underweight or suffering from various deficiency symptoms. It is not uncommon for the tongue to burn and the gums to bleed.
Bleeding from the gums is very uncomfortable and causes pain. Caries and other dental diseases are also common. Patients also complain of a strong and unpleasant bad breath, which can also have a negative impact on the environment. This can lead to social problems or exclusion.
Furthermore, those affected suffer from swallowing difficulties, which can lead to pain, especially if there is increased thirst. The mouth is very dry and the person affected can hardly speak. In most cases, hyposalivation can be treated relatively easily and quickly. There are no further complications. The treatment is causal and depends on the underlying disease. Life expectancy is not reduced by hyposalivation.
When should you go to the doctor?
Symptoms such as repeated bleeding from the gums and a burning sensation on the tongue indicate hyposalivation. A doctor’s visit is indicated if the symptoms persist over a longer period of time and no clear cause can be determined. If other symptoms such as bad breath or difficulty swallowing appear, medical advice is required. Caries or a generally unpleasant feeling in the mouth also indicate problems with salivation, which must be clarified by a doctor. Individuals who regularly take medication are particularly prone to developing hyposalivation.
Radiation therapy, stress and diseases such as AIDS and sepsis are also possible triggers. Anyone who belongs to the risk groups should consult a doctor if the symptoms and complaints mentioned occur. Children who suddenly refuse to eat should be taken to the pediatrician immediately. Bleeding on the gums and pain are also symptoms that indicate hyposalivation in the child and must be clarified immediately. In addition to the general practitioner, the dentist can also be involved.
Treatment & Therapy
The treatment of hyposalivation is based on the cause. If too little liquid has simply been taken in, then the deficiency can be easily regulated. If the lack of saliva is due to the patient sleeping with his mouth open at night, the nose must be opened so that nasal breathing can replace mouth breathing.
If reduced salivary secretion is a symptom of another condition that may not be curable, the patient is given saliva substitutes. The administration of these remedies can alleviate the symptoms symptomatically. Sugar-free chewing gum is often recommended because it stimulates the flow of saliva. Instead of chewing gum, certain medications can also stimulate the glands to secrete saliva.
If necessary, medicinal salivary stimulation can be applied via the substance pilocarpine. Patients with hyposalivation are also often encouraged to practice good oral hygiene. The reduced salivation otherwise increases the risk of inflammatory reactions and tooth decay. If drugs are responsible for the hyposalivation, the benefits and risks of these drugs are discussed.
Since hyposalivation usually entails a lower risk than not taking a certain medication, stopping the medication is not usually recommended.
Prevention
Most causes of hypersalivation or dry mouth cannot be counteracted. Hyposalivation as a result of dehydration can be avoided by drinking at least 1.5 liters of fluids per day. Dry mouth caused by mouth breathing while sleeping can be prevented by removing the polyps.
Aftercare
For follow-up care for hyposalivation, doctors often recommend sugar-free chewing gum. These increase the flow of saliva, which reduces the risk of inflammation and tooth decay. Depending on how severely the saliva stimulation is impaired, medication can also be used. In patients who suffer from the disease due to other medications, however, doctors usually advise against further medication.
As part of the follow-up treatment, good oral hygiene is therefore more important. Together with the normal flow of saliva, this reduces the risk of inflamed areas in the mouth. To counteract the dry mouth, it often helps to drink more. Patients should consume at least 1.5 liters a day to avoid the special type of dehydration.
If the problems do not improve over a longer period of time, the cause is investigated in detail. Among other things, mouth breathing while sleeping can be responsible for the reduced salivation. Surgically removing the polyps may help. Other measures against unconscious mouth breathing can also improve the situation.
Sometimes it helps not to lie on your back, but on your side. Those affected should have chewing gum to hand against acute dry mouth. Sugar-free chewing gum, which does not damage dental health, is best.
You can do that yourself
In the case of hyposalivation, the person concerned has a number of options for self-help, so that a doctor does not always have to be consulted.
In most cases, hyposalivation occurs due to insufficient fluid intake. If the person concerned does not drink enough fluids, this habit must be changed. As a rule, the patient should then drink about two liters of liquid a day. Sleeping with your mouth open can also promote hyposalivation and should be avoided. If there is an acute lack of saliva in the mouth, this can also be stimulated relatively well by chewing chewing gum. Sugar-free chewing gum is particularly suitable in order not to damage the teeth.
Some medications can also promote the disease. They can also be discontinued or replaced by others in consultation with a doctor. However, a doctor should always be consulted first. If the symptoms cannot be treated by self-help, the person concerned is usually dependent on a visit to the doctor.
