Astor F C, Hanft K L, Ciocon J O
Department of Otolaryngology, Cleveland Clinic Florida, Ft. Lauderdale 33309, USA.
Ear Nose Throat J. 1999 Jul;78(7):476-9.
Although xerostomia is associated with aging, studies have determined that salivary gland function is well preserved in the healthy geriatric population. Therefore, dry mouth is probably not a condition of aging, but most likely one of systemic or extrinsic origin. Saliva seems to undergo chemical changes with aging. As the amount of ptyalin decreases and mucin increases, saliva can become thick and viscous and present problems for the elderly. One of the most prevalent causes of xerostomia is medication. Anticholinergics, such as psychotropic agents and antihistamines, and diuretics can dry the oral mucosa. Chronic mouth breathing, radiation therapy, dehydration, and autoimmune diseases, such as Sjögren's, can also diminish salivation, as can systemic illness such as diabetes mellitus, nephritis, and thyroid dysfunction. Xerostomia can lead to dysgeusia, glossodynia, sialadenitis, cracking and fissuring of the oral mucosa, and halitosis. Oral dryness can affect denture retention, mastication, and swallowing. Dry mouth symptom can be treated with hydration and sialagogues or with artificial saliva substitutes. Because patients are at risk for dental caries, they should be referred to a dentist for preventive care. In patients with Sjögren's syndrome and in those who have undergone radiation therapy, pilocarpine has been used recently with good results.
虽然口干与衰老有关，但研究已确定，在健康的老年人群中唾液腺功能保存良好。因此，口干可能并非衰老的一种表现，而极有可能是全身性或外在性原因导致的。随着年龄增长，唾液似乎会发生化学变化。由于唾液淀粉酶的量减少而粘蛋白增加，唾液会变得浓稠且粘稠，给老年人带来问题。口干最常见的原因之一是药物。抗胆碱能药，如精神药物和抗组胺药，以及利尿剂会使口腔黏膜干燥。长期张口呼吸、放射治疗、脱水以及自身免疫性疾病，如干燥综合征，还有全身性疾病，如糖尿病、肾炎和甲状腺功能障碍，也会减少唾液分泌。口干会导致味觉障碍、舌痛、涎腺炎、口腔黏膜皲裂和口臭。口腔干燥会影响假牙固位、咀嚼和吞咽。口干症状可用补水和催涎剂或人工唾液替代品进行治疗。由于患者有患龋齿的风险，应转诊至牙医处接受预防性护理。在干燥综合征患者和接受过放射治疗的患者中，毛果芸香碱最近已被使用，效果良好。
