Xerostomia and hyposalivation: Causes, consequences and treatment in the elderly

Drugs and Aging

Volumn 15, Issue 2, 1999, Pages 103-116

  Närhi, Timo O ^a,b   Meurman, Jukka H ^c   Ainamo, Anja ^c  

^a RADBOUD UNIVERSITY NIJMEGEN   (Netherlands)

^b UNIVERSITY OF TURKU   (Finland)

^c UNIVERSITY OF HELSINKI   (Finland)

Author keywords

[No Author keywords available]

Indexed keywords

ANTINEOPLASTIC AGENT; CARBACHOL; CHOLINERGIC RECEPTOR BLOCKING AGENT; DIURETIC AGENT; PILOCARPINE; PSYCHOTROPIC AGENT; YOHIMBINE;

ADULT; AGED; CANCER RADIOTHERAPY; CANDIDIASIS; DISEASE PREDISPOSITION; ELECTROSTIMULATION; FLUID INTAKE; HEAD AND NECK CANCER; HUMAN; HYDRATION; HYPOSALIVATION; MAJOR CLINICAL STUDY; MOUTH DISEASE; MOUTH HYGIENE; PRIORITY JOURNAL; REVIEW; SALIVA ANALYSIS; SALIVATION; SYMPTOM; XEROSTOMIA;

AGED; CLINICAL TRIALS; HUMANS; PALLIATIVE CARE; PHARMACEUTICAL PREPARATIONS; SALIVA; XEROSTOMIA;

EID: 0032840791     PISSN: 1170229X     EISSN: None     Source Type: Journal    
DOI: 10.2165/00002512-199915020-00004     Document Type: Review

References (150)

1. Fox PC, van der Ven PF, Sonies BC, et al. Xerostomia: evaluation of a symptom with increasing significance. J Am Dent Assoc 1985; 110 (4): 519-25
2. Sreebny LM, Valdini A. Xerostomia part 1: relationship to other oral symptoms and salivary gland hypofunction. Oral Surg Oral Med Oral Pathol 1988; 66 (4): 451-8
3. Sreebny LM, Valdini A, Yu A. Xerostomia part H: relationship to nonoral symptoms, drugs and diseases. Oral Surg Oral Med Oral Pathol 1989; 68 (4): 419-27
4. McDonald E, Marino C. Dry mouth: diagnosing and treating its multiple causes. Geriatrics 1991; 46 (3): 61-3
5. Narhi TO. Prevalence of subjective feelings of dry mouth in the elderly. J Dent Res 1994; 73 (1): 20-5
6. Nederfors T, Isaksson R, Mornstad H, et al. Prevalence of perceived symptoms of dry mouth in an adult Swedish population: relation to age, sex and pharmacotherapy. Community Dent Oral Epidemiol 1997; 25 (3): 211-6
7. Loesche WJ, Bromberg J, Terpenning MS, et al. Xerostomia, xerogenic medications and food avoidances in selected geriatric groups. J Am Geriatr Soc 1995; 43 (4): 401-7
8. Parvinen T, Parvinen I, Larmas M. Stimulated salivary Howrate, pH and lactobacillus and yeast concentrations in medicated persons. Scand J Dent Res 1984, 92 (6): 524-32
9. Schubert MM, Izutsu KT. Iatrogenic causes of salivary gland dysfunction. J Dent Res 1987; 66: 680-8
10. Atkinson JC, Travis WD, Pillemer SR, et al. Major salivary gland function in primary Sjogren's syndrome and its relationship to clinical features. J Rheumatol 1990; 18 (1): 318-22
11. Närhi TO, Meurman JH, Ainamo A, et al. Association between salivary flow rate and the use of systemic medication among 76-, 81- and 86-year-old inhabitants in Helsinki, Finland. J Dent Res 1992; 71 (12): 1875-80
12. Valdez IH, Atkinson JC, Ship JA, et al. Major salivary gland function in patients with radiation-induced xerostomia: flow rates and sialochemistry. Int J Radiat Oncol Biol Phys 1993; 25 (1): 41-7
13. Üsterberg T, Landahl S, Hedegård B. Salivary flow, saliva, pH and buffering capacity in 70- year-old men and women: correlation to dental health, dryness in the mouth, disease and drug treatment. J Oral Rehabil 1984; 11 (2): 157-70
14. Pajukoski H, Meurman JH, Snellman-Gråhn S, et al. Salivary flow and composition in elderly patients referred to an acute geriatric ward. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 84 (3): 265-71
15. Abu-Shara KA, Ghareeb MA, Zaher S, et al. Radiotherapeutic effect on oropharyngeal flora in patients with head and neck cancer. J Laryngol Otol 1993; 107(3): 222-7
16. Brown LR, Dreitzen S, Daly TE, et al. Interrelations of oral microorganisms, immunoglobulins, and dental caries following radiotherapy. J Dent Res 1978; 57 (9-10): 882-93
17. Meurman JH. Dental infections and general health. Quintessence Int 1997; 28 (12): 807-11
18. Meurman JH, Pyrhonen S, Teerenhovi L, et al. Oral sources of septicaemia in patients with malignancies. Oral Oncol 1997; 33 (6): 389-97
19. Herrera JL, Lyons 2nd MF, Johnson LF. Saliva: its role in health and disease. J Clin Gastroenterol 1988; 10 (5): 569-78
20. Tenovuo J. Oral defense factors in the elderly. Endod Dent Traumatol 1992; 8 (3): 93-8
21. Baum BJ, Ship JA, Wu AJ. Salivary gland function and aging: a model for studying the interaction of aging and systemic disease. Crit Rev Oral Biol Med 1992; 4 (1): 53-64
22. Sreebny LM. Xerostomia (dry mouth). In: Sreebny LM, editor. The salivary system. Boca Raton (FL): CRC Press, 1987: 179-202
23. Wolff M, Kleinberg I, Oral mucosal wetness in hypo- and normosalivators. Arch Oral Biol 1998; 43 (6): 455-62
24. Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc 1987; 115 (4): 581-4
25. Dawes C. Physiological factors affecting salivary flow rate, oral sugar clearance, and the sensation of dry mouth in man. J Dent Res 1987; 66: 648-53
26. Navazesh M, Christensen C, Brightman V. Clinical criteria for the diagnosis of salivary gland hypofunction. J Dent Res 1992; 71 (7): 1363-9
27. Spielman AI. Interaction of saliva and taste. J Dent Res 1990; 69 (3): 838-43
28. Rhodus NL, Brown J. The association of xerostomia and inadequate intake in older adults. J Am Diet Assoc 1990; 90 (2): 1688-92
29. Mandel ID, Wotman S. The salivary secretions in health and disease. Ural Sci Rev 1976; 8: 25-47
30. Adams D. The mucus barrier and absorption through the oral mucosa. J Dent Res 1975; 54: B19-26
31. Tabak LA, Levine MJ, Mandel ID, et al. Role of salivary mucins in the protection of the oral cavity. J Oral Pathol 1982; 11(1): 1-17
32. Tenovuo J. Nonimmunoglobulin defence factors in human saliva. In: Tenovuo JO, editor. Human saliva: clinical chemistry and microbiology. Vol. II. Roca Raton (FL): CRC Press, 1989: 55-91
33. Brandtzaeg P. Salivary immunoglobulins. In: Tetiovuo JO, editor. Human saliva: clinical chemistry and microbiology. Vol. II. Boca Raton (FL): CRC Press Inc, 1989: 1-54
34. Dawes C. Factors influencing in salivary flow rate and composition. In: Edgar WM, O'Mullane DM, editors. Saliva and oral health. 2nd ed. London: British Dental Association, 1996: 27-41
35. Baum BJ. Neurotransmitter control of secretion. J Dent Res 1987; 66: 628-32
36. Thaysen JH, Thorn NA, Schwartz IL. Excretion of sodium, potassium, chloride and carbon oxide in human parotid saliva. Am J Physiol 1954; 178: 155-9
37. Kerr AC, editor. The physiological regulation of salivary secretion in man [international series of monographs on oral biology; 1]. Oxford: Pregamon Press, 1961
38. Mandel ID. The role of saliva in maintaining oral homeostasis. J Am Dent Assoc 1989; 119 (2): 298-304
39. Parvinen T, Larmas M. Age dependency of stimulated salivary flow rate, pH and lactobacillus and yeast concentrations. J Dent Res 1982; 61 (9): 1052-5
40. Persson RE, Izutsu KT, Treulove EL, et al. Differences in salivary flow rates in elderly subjects using xerostomatic medications. Oral Surg Oral Med Oral Pathol 1991; 72 (1): 42-6
41. Ericsson Y, Hardwich L. Individual diagnosis, prognosis and counselling for caries prevention. Caries Res 1978; 12 Suppl. 1: 94-102
42. Sreebny LM. Xerostomia: diagnosis, management and clinical complications. In: Edgar WM, OÌMullane DM, editors. Saliva and oral health. 2nd ed. London: British Dental Association, 1996: 43-66
43. Ship JA, Fox PC, Baum BJ. How much saliva is enough? Normal function defined. J Am Dent Assoc 1991; 122 (3): 63-9
44. Scott J. Quantitative age changes in the histological structure of the human submandibular salivary glands. Arch Oral Biol 1977; 22 (3): 221-7
45. Baum BJ. Evaluation of stimulated parotid saliva flow rate in different age groups. J Dent Res 1981; 60 (7): 1292-6
46. Tylenda CA, Ship JA, Fox PC, et al. Evaluation of submandibular salivary flow rate in different age groups. J Dent Res 1988; 67 (9): 1225-8
47. Pedersen W, Schubert M, Izutsu K, et al. Age-dependent decreases in human submandibular gland flow rates as measured under resting and post-stimulation conditions. J Dent Res 1985; 64 (5): 822-5
48. Osterberg T, Birkhed D, Johansson C, et al. Longitudinal study of stimulated whole saliva in an elderly population. Scand J Dent Res 1992; 100 (6): 340-5
49. Gilbert GH, Minaker KL. Principles of surgical risk assessment of the elderly patient. J Oral Maxillofac Surg 1990; 48 (9): 972-9
50. Scott J. Structural age changes in the salivary glands. In: Ferguson DB, editor. The aging mouth. Basel: Karger, 1987: 40-62
51. Denny PC, Denny PA, Klauser DK, et al. Age-related changes in mucins from human whole saliva. J Dent Res 1991; 70 (10): 1320-7
52. Navaresh M, Mulligan RA, Kipnis V, et al. Comparison of whole saliva flow rates and mucin concentrations in healthy caucasian young and aged adults. J Dent Res 1992; 71 (6): 1275-8
53. Baum BJ, Kousvelari EE, Oppenheim FG, Exocrine protein secretion from human parotid glands during aging: stable release of the acidic proline-rich proteins. J Gerontol 1982; 37 (4): 392-5
54. Fox PC, Heft MW, Merrera M, et al. Secretion of antimicrobial proteins from the parotid glands of different aged healthy persons. J Gerontol 1987; 42 (5): 466-9
55. Smith DJ, Taubman MA, Ebersole JL. Ontogeny and senescence of salivary immunity. J Dent Res 1987; 66 (2): 451-6
56. Carlèn A, Olsson J, Ramberg P. Saliva mediated adherence, aggregation and prevalence in dental plaque of Streptococcus mutans, Streptococcus sanquis and Actinomyces spp. in young and elderly humans. Arch Oral Biol 1996; 41 (12): 1133-40
57. Rudney JD, Krig MA, Neuvar EK, et al. Antimicrobial proteins in human unstimulated whole saliva in relation to each other, and to measures of health status, dental plaque accumulation and composition. Arch Oral Biol 1991; 36 (7): 497-506
58. Streckfus CF, Welsh S, Strahl RC. Diminution of parotid IgA secretion in an elderly black population taking antihypertension medications. Oral Surg Oral Med Oral Pathol 1991; 71 (1): 50-4
59. Närhi TO, Tenovuo J, Ainamo A, et al. Antimicrobial factors, sialic acid, and protein concentration in whole saliva of the elderly. Scand J Dent Res 1994; 102 (2): 120-5
60. Atkinson JC, Fox PC. Sjögren's syndrome: oral and dental considerations. J Am Dent Assoc 1993; 124 (3): 74-6, 78-82, 84-6
61. Ship JA, Fischer DJ. The relationship between dehydration and parotid salivary gland function in young and older healthy adults. J Gerontol A Biol Sci Med Sci 1997; 52 (5): M310-9
62. Bergdahl M, Bergdahl J, Johansson I. Depressive symptoms in individuals with idiopathic subjective dry mouth. J Oral Pathol Med 1997; 26 (10): 448-50
63. Ship JA, DeCarli C, Friedland RP, et al. Diminished submandibular salivary flow in dementia of the Alzheimer type. J Gerontol 1990; 45 (2): M61-6
64. Conner S, Iranpour B, Mills J. Alteration in parotid salivary flow in diabetes mellitus. Oral Surg Oral Med Oral Pathol 1970; 30 (1): 55-9
65. Ben-Aryeh H, Cohen M, Kanter Y, et al. Salivary composition in diabetic patients. J Diabet Complications 1988; 2 (2): 96-9
66. Cherry-Peppers G, Sorkin J, Andres R, et al. Salivary gland function and glucose metabolic status. J Gerontol 1992; 47 (41): M130-4
67. Sreebny LM, Yu A, Green A, et al. Xerostomia in diabetes mellitus. Diabetes Care 1992; 15 (7): 900-4
68. Cherry-Peppers G, Ship JA. Oral health in patients with type II diabetes and impaired glucose tolerance. Diabetes Care 1993; 16 (4): 638-41
69. Närhi TO, Meurman JH, Ainamo A, et al. Oral health in the elderly with non-insulin-dependent diabetes mellitus. Spec Care Dentist 1996; 16 (3): 116-22
70. Meurman JH, Collin H-L, Niskanen L, et al. Saliva in noninsulin-dependent diabetic patients and control subjects. Oral Surg Oral Med Oral Pathol 1998; 85: 69-76
71. Bertram U, Kragh-Sörensen P, Rafaelsen OJ, et al. Saliva secretion following long-term antidepressant treatment with nor-triptyline controlled by plasma levels. Scand J Dent Res 1979; 87 (1); 58-64
72. Kreher JM, Graser GN, Handelman SL. The relationship of drug use to the denture function and saliva flow rate in a geriatric population. J Prosthet Dent 1987; 57 (5): 631-8
73. Levy SM, Baker KA, Semal TP, et al. Use of medications with dental significance by a non-institutionalized elderly population. Gerodontics 1988; 4 (3): 119-25
74. Feinberg M. The problems of anticholinergic adverse effects in older patients. Drugs Aging 1993; 3 (4): 335-48
75. Handelman SL, Baric JM, Espeland MA, et al. Prevalence of drugs causing hyposalivation in an institutionalized geriatric population. Oral Surg Oral Med Oral Pathol 1986; 62 (1): 26-31
76. Sreebny LM, Schwartz SS. A reference guide to drugs and dry mouth. Gerodontology 1986; 5 (2): 75-99
77. Hunter KD, Wilson WS. The effects of antidepressant drugs on salivary flow and content of sodium and potassium ions in human parotid saliva. Arch Oral Biol 1995; 40 (11): 983-9
78. Volz-Zang C, Waldhauser T, Schulte B, et al. Comparison of the effects of atropine in vivo and ex vivo (radioreceptor assay) after oral and intramuscular administration to man. Eur J Clin Pharmacol 1995; 49 (1-2): 45-9
79. Molander L, Birkhed D. Effect of single oral doses of various neuroleptic drugs on salivary secretion rate, pH, and buffer capacity in healthy subjects. Psychopharmacology (Berl) 1981; 75 (2): 114-8
80. Vargas R, McMahon FG, Ryan JR. A study of anticholinergic activity of terfenadine in normal volunteers. J Int Med Res 1989; 17 (2): 157-61
81. 1-selective antagonist metoprolol in a hypertensive patient population. Eur J Oral Sci 1996; 104 (3): 262-8
82. Findlay D, Lawrence JR. An alternative method of assessing changes in salivary flow: comparison of the effects of clonidine and tiamenidine (HOE 440). Eur J Clin Pharmacol 1978; 14 (4): 231-5
83. Hernandez YM, Raczkowski VF, Drectchen KL, et al. Cocaine inhibits sympathetic neural activity by acting in the central nervous system and at the sympathetic ganglion. J Pharmacol Exp Ther 1996; 277 (2): 1114-21
84. Steiner JE, Birnbaum D, Karmeli E, et al. Effect of diazepam on human salivary secretion. Digestion 1970; 3 (5): 262-8
85. Nagler A, Nagler R, Ackerstein A, et al. Major salivary gland dysfunction in patients with hematological malignancies receiving interleukin-2-based immunotherapy post-autologous blood stem cell transplantation (ABSCT). Bone Marrow Transplant 1997; 20 (7): 575-80
86. Atkinson JC, Shiroky JB, Macynski A, et al. Effects of furosemide on the oral cavity. Gerodontol 1989; 8 (1): 23-6
87. Meurman JH, Laine P, Keinänen S, et al. Five-year follow-up study in patients treated for lymphoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83 (4): 447-52
88. Nederfors T, Twetman S, Dahlöf C. Effects of the thiazide diuretic bendro-flumethiazide on salivary flow rate and composition. Scand J Dent Res 1989; 97 (6): 520-7
89. von Knorring L, Mörnstad H. Saliva secretion rate and saliva composition as a model to determine the effect of antidepressant drugs on cholinergic and noradrenergic transmission. Neuropsychobiology 1986; 15 (3-4): 146-54
90. Mörnstad H, von Knorring L, Forsgren L, et al. Acute effects of some different antidepressant drugs on saliva secretion and composition. Neuropsychobiology 1986; 15: 73-9
91. Mörnstad H, von Knorring L, Forsgren L, et al. Long-term effects of two principally different antidepressant drugs on saliva secretion and composition. Scand J Dent Res 1986; 94(5): 461-70
92. Nederfors T, Dahlöf C, Ericson T, et al. Effects of the antihypertensive drug captopril on human salivary secretion rate and composition. Eur J Oral Sci 1995; 103 (6): 351-4
93. Laurikainen K, Laurikainen E, Tenovuo J, et al. Effects of β-blocking agent, timolol maleate, on saliva in healthy volunteers. Scand J Dent Res 1988; 96 (2): 121-7
94. Nederfors T, Dahlöf C. Effects of β-adrenoreceptor antagonist atenelol and propranolol on human whole saliva flow rate and composition. Arch Oral Biol 1992; 37 (7): 579-84
95. Nederfors T, Ericsson T, Twetman S, et al. Effects of the β-adrenoreceptor antagonists atenelol and propranolol on human parotid and submandibular-sublingual salivary secretion. J Dent Res 1994; 73 (1): 5-10
96. Nederfors T, Dahlöf C, Twetman S. Effects of the β-adrenoreceptor antagonists atenelol and propranolol on human unstimulated saliva flow rate and protein composition. Scand J Dent Res 1994; 102 (4): 235-7
97. Lau KR, Howorfh AJ, Case RM. The effects of bumetanide, amiloride and Ba2+ on fluid and electrolyte secretion in rabbit salivary gland. J Physiol (Lond) 1990; 425: 407-27
98. Hollmann M, Mller-Peltzer H, Greger G, et al. Pharmacokinetic-dynamic study on different oral biperiden formulations in volunteers. Pharmacopsychiatry 1987; 20 (2): 72-7
99. DeVault KR, Castell DO. Effects of antireflux therapies on salivary function in normal humans. Dig Dis Sci 1987; 32 (6): 603-8
100. Teichman SL, Ferrick A, Kim SG, et al. Disopyramide-pyridostigmine interaction: selective reversal of anticholinergic symptoms with preservation of antiarrhythmic effect. J Am Coll Cardiol 1987; 10 (3): 633-41
101. Johnson DA, Cortez JE. Chronic treatment with beta adrenergic agonists and antagonists alters the composition of proteins in rat parotid saliva. J Dent Res 1988; 67 (8): 1103-8
102. Dehpour AR, Ghafourifar P. Massoudi S, et al. On the relation of calcium channel blockers to rat parotid and submandibular glands function in vivo. Gen Pharmacol 1995; 26 (3): 619-22
103. von Knorring L. Changes in saliva secretion and accommodation width during short-term administration of imipramine and zimelidine in healthy volunteers. Int Pharmacopsychiatry 1981; 16 (2): 69-78
104. Stanovnik L, Erjavec F. The inhibition of salivary secretion by histamine H2 antagonists: a study on the cat submandibular gland. Agents Actions 1983; 13 (2-3): 196-9
105. Volz HP, Gleiter CH. Monoamine oxidase inhibitors: a perspective on their use in the elderly. Drugs Aging 1998 13 (5): 341-55
106. Melsom M, Myren J, Larsen S, et al. Comparison of glucagon and pethidine plus atropine as premedication for peroral endoscopy: a double blind study. Endoscopy 1977; 9 (2): 79-82
107. Scarlett SM, Sagstràm S, Sagulin GB, et al. Effects of chronic furosemide treatment on rat exocrine glands. Exp Mol Pathol 1988; 48 (2): 206-15
108. Streckfus CF. Salivary function and hypertension: a review of the literature and a case report. J Am Dent Assoc 1995; 126 (7): 1012-7
109. National Centre for Health Statistics. Drug utilization: national ambulatory medical care survey. Washington, DC: National Center for Health Statistics, 1988
110. Lassila HC, Stocher GP, Ganguli M, et al. Use of prescription medications in an elderly rural population: the MoVIES Project. Ann Pharmacother 1996; 30 (6): 589-95
111. Landahl S. Drug treatment in 70-82-year-old persons: a longitudinal study. Acta Med Scand 1987; 221 (2): 179-84
112. Thorselius I, Emilson C-G, Österberg T. Salivary conditions and drug consumption in older age groups of elderly Swedish individuals. Gerodontics 1988; 4 (2): 66-70
113. Thomson WM, Brown RH, Williams SM. Medication and perception of dry mouth in a population of institutionalized elderly people. N Z Med J 1993; 106 (957): 219-21
114. Birkhed D, Heintze U. Salivary secretion, buffer capacity and pH. In: Tenovuo JO, editor. Human saliva: clinical chemistry and microbiology, volume I. Roca Raton (FL): CRC Press, 1989: 25-73
115. Söderling E. Practical aspects of salivary analyses. In: Tenovuo JO, editor. Human saliva: chemical chemistry and microbiology. Vol. I. Boca Raton (FL): CRC Press, 1989: 1-24
116. Sreebny LM, Banoczy J, Baum BJ, et al. Saliva: its role in health and disease. Int Dent J 1992; 42 Suppl. 2: 291-304
117. Rudney JD, Larson CJ. The prediction of saliva swallowing frequency in humans from estimates of salivary flow rate and the volume of saliva swallowed. Arch Oral Biol 1995; 40 (6): 507-12
118. Arendorf TM, Walker DM. The prevalence and intraoral distribution of Candida albicans in man. Arch Oral Biol 1980; 25 (1): 1-10
119. Parvinen T, Larmas M. The relation of stimulated salivary flow rate and pH to lactobacillus and yeast concentrations in saliva. J Dent Res 1981; 60 (12): 1929-35
120. Rask PI, Emilson CG, Krasse H, et al. Denial caries and salivary and microbial conditions in 50-60-year-old persons. Community Dent Oral Epidemiol 1991; 19 (2): 93-7
121. Närhi TO, Ainamo A, Meurman JH, Salivary yeasts, saliva, and oral mucosa in the elderly. J Dent Res 1993; 72 (6): 1009-14
122. Närhi TO, Ainamo A, Meurman JH. Mutans streptococci and lactovacilli in the elderly. Stand J Dent Res 1994; 102 (2): 97-102
123. Wahlin YB. Salivary secretion rate, yeast cells, and oral candidosis in patients with acute leukemia. Oral Surg Oral Med Oral Pathol 1991; 71 (6): 689-95
124. Meurman JH, Pajukoski H, Snellman S, et al. Oral infections in home-living elderly patients admitted to an acute geriatric ward. J Dent Res 1997; 76 (6): 1271-6
125. Holmstrup P, Axéll T. Classification and clinical manifestations of oral yeast infections. Acta Odontol Scand 1990; 48 (1); 57-9
126. Hase JC, Birkhed D, Lagerlöf F, et al. Oral retention of glucose at pharmacologically reduced salivary flow in man. Scand J Dent Res 1994; 102 (3): 180-5
127. Risheim H, Arneberg P, Birkhed D. Ural sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms. Caries Res 1992; 26 (6): 439-44
128. Fox PC. Differentiation of dry mouth etiology. Adv Dent Res 1996; 10 (1): 13-6
129. Jensen-Kjeilen JC, Brodin B, Aars H, et al. Parotid salivary flow in response to mechanical and gustatory stimulation in man. Acta Physiol Scand 1987; 131 (2): 169-75
130. Järvinen VK, Rytömaa II, Heinonen OP. Risk factors in dental erosion. J Dent Res 1991; 70 (6): 942-7
131. Meurman JH, Sorvari R, Pelttari A, et al. Hospital mouth-cleaning aids may cause dental erosion. Spec Care Dentist 1996; 16 (6): 247-50
132. Mäkinen KK, Mäkinen P-L, Chen C Y, et al. Polyol-combinant saliva stimulants and oral health in Veterans Affairs patients: an exploratory study. Spec Care Dentist 1996: 16 (3): 104-15
133. Risheim H, Arneberg P. Salivary stimulation by chewing gum and lozenges in rheumatic patients with xerostomia. Scand J Dent Res 1993; 101 (1): 40-3
134. Wiseman LR, Faulds D. Oral pilocarpine: a review of its pharmacological properties and clinical potential in xerostomia. Drugs 1995; 49 (1): 143-55
135. Johnson JT, Ferreti GA, Nethery WJ, et al. Oral pilocarpine for post-irradiation xerostomia in patients with head and neck cancer. N Engl J Med 1993; 329 (6): 390-5
136. Rieke JW, Hafermann MD, Johnson JT. Oral pilocarpine for radiation-induced xerostomia: integrated efficacy and safety results from two prospective randomized clinical trials. Int J Radiat Oncol Biol Phys 1995; 31 (3): 661-9
137. Joensuu H, Boström P, Makkonen T. Pilocarpine and carbacoline in treatment of radiation-induced xerostomia. Radiother Oncol 1993; 26 (1): 33-7
138. Bagheri H, Schmitt L, Berlan M, et al. A comparative study of the effects of yohimbine and anetholtrithione on salivary secretion in depressed patients with psychotropic drugs. Eur J Clin Pharmacol 1997; 52 (5): 339-42
139. Weiss WW, Brenman HS, Katz P, et al. Use of an electronic stimulator for the treatment of dry mouth. J Oral Maxillofac Surg 1986; 44 (11): 845-50
140. Blom M, Dawidson I, Augmar-Mansson B. The effect of acupuncture on salivary flow rates in patients with xerostomia. Oral Surg Oral Med Oral Pathol 1992; 73 (3): 293-8
141. Schou L, Holm-Pedersen P, Lang NP. Preventive dental care for elderly people. In: Holm-Pedersen P, Löe H, editors. Textbook of geriatric dentistry. 2nd ed. Copenhagen: Munksgaard, 1996: 302-18
142. Dreizen S, Brown LR, Daly TE, et al. Prevention of xerostomia- related dental caries in irradiated cancer patients. J Dent Res 1977; 56 (2): 99-104
143. Billings RJ, Meyerowitz C, Featherstone JDB, et al. Retention of topical fluoride in the mouths of xerostomic subjects. Caries Res 1988; 22 (5): 306-10
144. Zero DT, Raubertas RF, Fu J, et al. Fluoride concentrations in plaque, whole saliva, and ductal saliva after application of home-use topical fluorides. J Dent Res 1992; 71 (11): 1768-75
145. Lagerlöf F, Ekstrand J, Rölla G. Effect of fluoride addition on ionized calcium in salivary sediment and in saliva. Scand J Dent Res 1988; 96 (5): 399-404
146. Dawes C, Weatherell JA. Kinetics of fluoride in the oral fluids. J Dent Res 1990; 69: 638-44
147. 'S-Gravenmade EJ, Roukema PA, Panders AK. The effect of mucin-containing artificial saliva on severe xerostomia. Int J Oral Surg 1974; 3 (6): 435-9
148. Shannon IL, McCrary BR, Starcke EN. A saliva substitute for use by xerostomic patients undergoing radiotherapy to the head and neck. Oral Surg Oral Med Oral Pathol 1977; 44 (5): 656-61
149. Regelink G, Vissink A, Reintsema H, et al. Efficacy of a synthetic polymer saliva substitute in reducing oral complaints of patients suffering from irradiation-induced xerostomia. Quintessence Int 1998; 29 (6): 383-8
150. Visch LL, 'S-Gravenmade EJ, Panders AK, et al. A double-blind crossover trial of CMC - and mucin-containing saliva substitutes. Int J Oral Maxillofac Surg 1986; 15 (4): 395-400