Specialty Care, Department of General Dentistry, Eastman Institute of Oral Health, University of Rochester, Rochester, NY, USA.
Department of Community Dentistry and Oral Disease Prevention, University of Rochester, Rochester, NY, USA; Center for Oral Biology, University of Rochester, Rochester, NY, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Dec;132(6):662-670. doi: 10.1016/j.oooo.2021.08.015. Epub 2021 Aug 29.
Salivary glands are among the most sensitive target organs of medications with anticholinergic (AC) properties, interrupting the neural stimulation of saliva secretion and reducing saliva flow. Hyposalivation results in dry mouth, leading to dental caries, intraoral infection, orofacial pain, problems with speaking and swallowing, and diminished oral health--related quality of life. Current understanding of the pharmacokinetics of AC medications and their effect on muscarinic receptors in the salivary glands were reviewed to assist clinicians in predicting salivary damage in patients with AC medication-induced dry mouth.
We summarized the literature related to the mechanisms and properties of AC medications, anticholinergic adverse effects, and their effect on salivary function and management strategies to prevent oral health damage.
Although a large number of studies reported on the frequencies of medication-induced dry mouth, we found very limited data on predicting individual susceptibility to AC medication--caused hyposalivation and no prospective clinical studies addressing this issue.
Dry mouth is most frequently caused by medications with AC properties, which interrupt the neural stimulation of saliva secretion. Interdisciplinary care should guide pharmacotherapeutics and dental interventions should aim in preventing AC salivary adverse effects and reducing the oral health burden from AC medication-induced dry mouth.
唾液腺是具有抗胆碱能 (AC) 特性的药物最敏感的靶器官之一，这些药物会中断唾液分泌的神经刺激，减少唾液流量。唾液分泌减少会导致口干，从而导致龋齿、口腔内感染、口面疼痛、言语和吞咽困难以及口腔健康相关生活质量下降。本研究旨在综述 AC 药物的药代动力学及其对唾液腺毒蕈碱受体的影响，以帮助临床医生预测 AC 药物引起的口干症患者的唾液损伤。
我们总结了与 AC 药物的作用机制和特性、抗胆碱能不良反应及其对唾液功能的影响以及预防口腔健康损害的管理策略相关的文献。
尽管大量研究报告了药物引起的口干症的频率，但我们发现，关于预测个体对 AC 药物引起的唾液分泌减少的易感性的数据非常有限，也没有前瞻性的临床研究来解决这个问题。
口干症最常由具有 AC 特性的药物引起，这些药物会中断唾液分泌的神经刺激。多学科护理应指导药物治疗，牙科干预措施应旨在预防 AC 唾液不良作用，并减轻 AC 药物引起的口干症对口腔健康的负担。
