Putri Nadia Tiara, Ridho Faiznur, Wahyuni Indah Suasani
Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia.
Oral Health Polyclinic, Oral Medicine Division, Dr. Rivai Abdullah Central General Hospital, Palembang, South Sumatera, Indonesia.
Int Med Case Rep J. 2024 Oct 23;17:869-877. doi: 10.2147/IMCRJ.S480332. eCollection 2024.
The incidence of post-pandemic psychiatric disorders has increased globally in recent decades. Generalized anxiety disorder (GAD) is one of the psychiatric disorders that are partially associated with emotional factors. It can affect the quantity and quality of saliva, present as xerostomia, and trigger the emergence of the geographic tongue (GT).
This case report aims to discuss the management of xerostomia and geographic tongue in a patient with GAD.
A 26-year-old male patient complained of dry and sore mouth for one month after taking medication from the psychiatry department, was diagnosed with GAD, and had already consumed the antidepressant sertraline. Extraoral examination showed dry and exfoliative lips. Intraoral examination showed white plaque with depapilation on the dorsal tongue, frothy saliva, buccal mucosa and dorsal tongue sticking to the dental mirror. The unstimulated salivary flow rate was <0.2 mL/min (sialometry method). The Depression, Anxiety, and Stress Scale-21 (DASS-21) questionnaire was used to estimate the psychological condition and showed an extremely severe level of anxiety (score = 13). The established oral diagnoses were GT with mild xerostomia and exfoliative cheilitis.
For two months, patients received hyaluronic acid gel and mouthwash, as well as a non-pharmacological approach to healthy lifestyle counseling. There was an improvement in xerostomia, and the GT became asymptomatic, with a reduction of DASS score in this patient.
Improved psychological conditions will improve xerostomia, but the clinical appearance of the geographic tongue is more difficult to eliminate.
近几十年来，全球大流行后精神障碍的发病率有所上升。广泛性焦虑症（GAD）是一种与情绪因素部分相关的精神障碍。它会影响唾液的量和质，表现为口干，并引发地图舌（GT）的出现。
本病例报告旨在探讨广泛性焦虑症患者口干和地图舌的治疗。
一名26岁男性患者在服用精神科药物一个月后出现口干和口腔疼痛，被诊断为广泛性焦虑症，且已服用抗抑郁药舍曲林。口外检查显示嘴唇干燥、脱屑。口内检查显示舌背有白色斑块伴乳头萎缩、唾液呈泡沫状、颊黏膜和舌背与口镜粘连。非刺激性唾液流速<0.2毫升/分钟（唾液测量法）。使用抑郁、焦虑和压力量表-21（DASS-21）问卷评估心理状况，结果显示焦虑程度极其严重（得分=13）。确诊的口腔疾病为轻度口干和脱屑性唇炎伴地图舌。
两个月来，患者接受了透明质酸凝胶和漱口水治疗，以及健康生活方式咨询的非药物治疗方法。口干症状有所改善，地图舌无症状，该患者的DASS评分降低。
心理状况的改善将改善口干，但地图舌的临床表现更难消除。
