JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 55 No. 1       2009

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

All of the persons who attended the Dry Mouth Clinic at Tsurumi University Dental Hospital complaining of dry mouth sensation were regarded to be dry mouth patients even if no hyposalivation was apparent. The management of dry mouth patients at the Dry Mouth Clinic is herein described. This study addressed two subjects, namely, the effectiveness of cevimeline hydrochloride on saliva secretion for Sjögren's syndrome patients, and the effectiveness of using a night guard for the treatment of sleep related dry mouth. There was a female preponderance among the dry mouth patients and the most common age group was individuals in their 60's. Dry mouth (44.1 %) was the most frequent complaint, followed by pain (28.7 %). It was noteworthy that 70 % of all dry mouth patients had pain, such as a burning mouth sensation. Oral candidiasis was the most important causes of the pain in most dry mouth patients. Sjögren's syndrome (SS) was diagnosed according to either the Japanese or American-European diagnostic criteria and 7 % of the dry mouth patients fulfilled these criteria. In other cases, the causes of dry mouth were complex and the cause of hyposalivation could not be easily determined. Cevimeline hydrochloride, a muscarinic (M3) receptor agonist, is widely used as a secretagogue for SS patients. However, the correlation between the severity of SS and the effectiveness of cevimeline has not been well documented. The current results demonstrated a relationship between the effect of cevimeline on saliva secretion and the degree of salivary gland destruction as evaluated by sialography and the histopathological findings in the labial minor salivary glands. These diagnostic approaches could provide useful prognostic information on the efficacy of cevimeline in SS patients. Nocturnal xerostomia is a sensation of dry mouth associated with a complaint of either mouth and/or throat discomfort which thus causes individuals to have to wake up in the middle of the night in order to drink water. The application of a night guard is a useful and simple method for the management of nocturnal xerostomia. This device is fabricated from a soft material, which is often used as a sports mouth guard or as a night guard for the treatment of nighttime bruxism and it covers the dental arch and the hard palate. This device may be useful even for SS patients. Key words: dry mouth Sjögren's syndrome, cevimeline hydrochloride, nocturnal xerostomia, night guard.

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