Sreebny L M
School of Dental Medicine, State University of New York, Stony Brook 11794-8702.
Int Dent J. 1989 Sep;39(3):197-204.
Salivary problems, particularly in the aged, are frequent but often not well recognized. Symptomatic dryness (xerostomia) is accompanied by objective evidence of reduced salivary secretion in about half the cases. Dry mouth is not an age change but most often follows salivary gland disturbance of external origin or due to systemic disease. It may herald the presence of widespread symptoms of exocrine gland hypofunction. Resting and stimulated salivary flow rates are useful measures of dryness. Xerostomia may be accompanied by an increase in caries rate, candidosis, cheilitis, dysgeusia or dysphagia. Prominent causes of salivary gland hypofunction are drugs, irradiation, organic diseases, psychogenic factors and decreased mastication. However, a cause cannot always be found and even when identified its effects cannot always be reversed, e.g. in Sjögren's syndrome. Locally acting stimulants of salivary flow or saliva substitutes may alleviate symptoms but systemically acting sialogogues need to be used with caution. The dentist has an important role in identifying xerostomia, an identification that can lead to the diagnosis of previously unrecognized disease.
唾液问题，尤其是在老年人中，很常见，但往往未得到充分认识。约半数有症状的口干（口腔干燥症）病例伴有唾液分泌减少的客观证据。口干并非年龄变化所致，而是最常继发于外部原因引起的唾液腺紊乱或全身性疾病。它可能预示着外分泌腺功能减退的广泛症状。静息和刺激唾液流速是评估口干程度的有用指标。口腔干燥症可能伴有龋齿率增加、念珠菌病、唇炎、味觉障碍或吞咽困难。唾液腺功能减退的主要原因包括药物、辐射、器质性疾病、心理因素和咀嚼减少。然而，病因并不总是能找到，即便病因明确，其影响也并非总能逆转，例如在干燥综合征中。局部作用的唾液分泌刺激剂或唾液替代品可能缓解症状，但全身性作用的催涎剂需谨慎使用。牙医在识别口腔干燥症方面起着重要作用，这一识别可能会促成对先前未被认识疾病的诊断。
