Atkinson J C, Fox P C
National Institute of Dental Research, National Institutes of Health, Bethesda, Maryland.
Clin Geriatr Med. 1992 Aug;8(3):499-511.
Clinically significant declines of salivary output are not a function of aging. Complaints of oral dryness (xerostomia) are common in the elderly patient, however. This complaint is most often a consequence of medications; tricyclic antidepressants, certain antihypertensives, and anticholinergics can cause marked decreases in salivary flow rates. Other medications such as diuretics may cause xerostomia without decreasing salivary output. Systemic diseases such as Sjögren's syndrome can destroy salivary glands. Specific serologic, ophthalmologic, and salivary findings are necessary for the diagnosis of Sjögren's syndrome. Radiation therapy for treatment of head and neck cancers also can damage salivary glands permanently. Infectious agents such as mycobacteria, Epstein-Barr virus, and various oral bacteria can infect human salivary glands. Diminished salivary output can lead to serious oral sequelae. Rapidly progressing dental caries and oral candidiasis are found frequently in this age group. Close supervision of the geriatric patient's oral and dental health is essential.
临床上唾液分泌量的显著下降并非衰老的必然结果。然而，老年患者主诉口腔干燥（口干症）却很常见。这种主诉通常是药物所致；三环类抗抑郁药、某些抗高血压药和抗胆碱能药可导致唾液流速显著降低。其他药物如利尿剂可能引起口干症但并不降低唾液分泌量。系统性疾病如干燥综合征可破坏唾液腺。干燥综合征的诊断需要特定的血清学、眼科和唾液检查结果。头颈部癌症的放射治疗也可永久性损伤唾液腺。诸如分枝杆菌、爱泼斯坦-巴尔病毒及各种口腔细菌等感染因子可感染人类唾液腺。唾液分泌量减少可导致严重的口腔后遗症。该年龄组中经常发现快速进展的龋齿和口腔念珠菌病。对老年患者的口腔和牙齿健康进行密切监测至关重要。
