Clinical implications of the dry mouth. Oral mucosal diseases.

Salivary hypofunction caused by salivary gland disease, medication, or radiation may predispose for secondary oral mucosal diseases. In these patients the protective coating of saliva is reduced or absent, leaving the oral mucosa more vulnerable. Candidiasis, burning mouth syndrome, and white lesions of the oral mucosa are increased in frequency. The aim of management is to prevent oral pathological changes. The management procedure may include proper oral hygiene, saliva-stimulating agents, or saliva substitutes, depending on the severity of the salivary dysfunction. Treatment includes antifungal therapy if candidiasis is diagnosed. In severely distressed patients, local or systemic corticosteroids may be indicated. Precautions, like refraining from smoking and avoiding toothpastes containing sodium lauryl sulfate, should also be taken. In the future, agents combining antibacterial and antiinflammatory actions, like triclosan, may show promising effects in patients with oral mucosal diseases secondary to salivary hypofunction.