Dry Mouth: a Clinical Guide on Causes, Effects and Treatments, DOI 10.1007/978-3-642-55154-3 214 Index

Index

A autoimmune hepatitis , 16 Acupuncture, SGD management , 61 chronic infl ammatory bowel diseases , Adult stem cells , 201–203 15–16 Afferent signalling, MISGD , 39–40 chronic infl ammatory connective tissue Aggregatibacter actinomycetemcomitans , diseases, 9–14 87, 89, 96 endocrine diseases , 17–18 Alpha-2 adrenoceptor (α2Ad) agonists neurological diseases , 18–20 activation , 44–45 primary biliary cirrhosis , 16 central signalling , 43–44 primary sclerosing cholangitis , 16 Alzheimer’s disease (AD) , 19–20 sarcoidosis , 14 American College of Rheumatology Autoimmune hepatitis (AIH) , 16 (ACR) , 13 American-European classifi cation criteria, Sjögren’s syndrome, 9, 10 B Amifostine , 198 Battery-type approaches Amphetamine , 44 Challacombe scale , 107 Amyloidosis , 16 item content , 106 Anorexia nervosa , 23 summated rating scale , 108–111 Antimuscarinic effect , 42 visual analogue scale , 107–108 Arc therapies , 161 Bell’s palsy , 19 Artifi cial salivas BMS. See Burning mouth syndrome (BMS) acidic pH , 170 Bother 1 xerostomia index (BI1) , 130, 131 advantage , 181 Bother 5 xerostomia index (BI5) , 129–131 bioactives , 169 Bulimia nervosa , 23 carboxymethylcellulose/xanthan gum , 169 Burning mouth syndrome (BMS) , 20 composition , 169–170 defi ciency , 165 effi cacy , 168 C elasticity , 170, 171 Candida albicans , 86–87, 90, 94, 95 food proteins , 171 Carbonic anhydrase VI , 74 intraoral lubrication and hydration , Cell models of oral mucosa , 168 167–168 Cerebral palsy syndromes , 18 and natural salivas, physical properties , Cevimeline, MIX treatment , 46 170, 171 Challacombe scale , 4, 107 randomised controlled trial , 166 Chewing gum surface tension , 168 and lozenges , 177 usage , 167 and saliva substitutes , 46–47 viscosity , 165 SGD management , 59 Autoimmune diseases side effects , 59 amyloidosis , 16 sugar-free , 96, 123, 181–182

Clinical oral dryness score (CODS) Epstein-Barr virus (EBV) , 21 features , 121–123 European League Against Rheumatism mild dryness , 123, 124 (EULAR) classifi cation criteria , 13 moderate dryness , 124 External beam radiotherapy, HNC , 148 mucosal dryness , 121–123 mucosal wetness , 125, 127, 128 vs. salivary fl ow , 125, 126 F sensitivity , 128 Focus scoring system , 10 severe dryness , 124 CNS trauma , 18 CODS. See Clinical oral dryness score G (CODS) Genetic and developmental diseases, oral Coeliac disease , 15–16 dryness , 22 Crohn’s disease (CD) , 15 Gingivitis , 96 Cuckoo spit , 171–172 Cystic fi brosis (CF) , 22 Cytomegalovirus (CMV) , 21 H Head and neck cancer (HNC) external beam radiotherapy , 148 D PG-sparing IMRT , 153, 154 Dehydration , 23, 76 photon-proton techniques , 206 Dental caries prophylactic pilocarpine administration , mutans streptococci , 92–93 196 occurrence , 91 radiotherapy , 195–196, 204–205 prediction models , 91–92 Hepatitis C virus (HCV) , 21 saliva , 92 Human immunodefi ciency virus (HIV) , Dental panoramic radiographs , 140 20–21 Dental plaque Hyposalivation development , 84 aging , 176 intensive care units vs. healthy controls , 91 dehydration , 23 low pH , 91, 92 description , 8 microbial composition , 84 oral symptoms , 129 Diabetes mellitus (DM) , 17 signs , 120 Dietary intake , 75 Sjögren’s syndrome , 9 chewing and swallowing process , 70, 72 healthy eating index , 71 oral pain and discomfort , 70, 72 I salivary secretion , 70–73 Induced pluripotent stem (iPS) cells , 201, 202 Digital subtraction fl uoroscopy , 138 Infectious diseases, oral dryness Draining method , 8 hepatitis C virus , 21 human immunodefi ciency virus , 20–21 In silico planning comparative (ISPC) E studies , 206–207 Eating disorders Intensity-modulated radiation therapy (IMRT) anorexia nervosa , 23 concave and convex shape , 152 bulimia nervosa , 24 description , 151–152 Ectodermal dysplasia (ED) , 22 dose escalation , 153 Efferent signalling, MISGD HNC treatment , 153 dual parasympathetic/sympathetic nerve national and international experience , stimulation experiments , 40 157–158 muscarinic acetylcholine receptors , 41–42 oral mucosa (see Oral mucosa (OM)- tricyclic antidepressants , 42 sparing IMRT) Embryonic stem (ES) cells , 201–202 principle , 151–152 Endoscopy , 142 quality of life , 196 Epidemic parotitis , 21 Intraoral radiographs , 140 Index 215

L Molecular pharming , 172 Labial salivary gland biopsy , 16 MUC5B , 84, 179 Lactobacillus species Mucosa-associated lymphoid tissue (MALT) anterior sites , 93 lymphoma diagnosis, 137 dental caries , 93 Mucosal dryness and CODS , 121–123 intestinal fl ora , 94 Mucosal wetness and CODS , 125, 127, 128 pH level , 94, 95 Multi-item approaches, xerostomia measure- posterior sites , 93–94 ment. See Battery-type approaches Mumps. See Epidemic parotitis Muscarinic acetylcholine receptors (mAchRs) , M 41–42 Magnetic resonance imaging (MRI), salivary gland study , 141–142 Mastication N aging , 188 National Cancer Institute Common defi nition , 190 Terminology Criteria for Adverse gustatory stimuli , 176 Events (CTCAE) , 56, 57 oral food processing , 190–191 Nerve-mediated refl ex , 39 resistance training , 189 Neurological disorders Medication-induced dry mouth Alzheimer’s disease , 19–20 description , 35 Bell’s palsy , 19 xerogenic drugs , 34 cerebral palsy , 18 Medication-induced salivary gland hypofunc- CNS trauma , 18 tion (MISGD) Parkinson’s disease , 19 afferent signalling , 39–40 Nonprescriptive sialogogues age groups , 39 chewing gum and lozenges , 177 central interruption of refl ex signalling , complaints and side effects , 181 42–45 MUC5B , 179 defi nition , 35, 37 mucin gum , 180 efferent signalling oral cavity lubrication , 179 dual parasympathetic/sympathetic organic acids , 180 nerve stimulation experiments , 40 patients’ preferences on products , 180, 181 muscarinic acetylcholine receptors , saliva stimulation , 178–179 41–42 taste stimulus , 178 tricyclic antidepressants , 42 Normosalivators , 182 salivary refl ex , 37, 38 UWMS fl ow rate , 37 Medication-induced xerostomia (MIX) O assessment , 35 Obstructive salivary gland disease , 135, 136 description , 35 Oral Balance® gel , 62 dose and duration , 36 Oral disease severity scoring systems , selective serotonin reuptake inhibitors , 36 120–121 serotonin and noradrenaline reuptake Oral dryness inhibitors , 36, 37 artifi cial saliva uasge , 96–97 severity , 36 autoimmune diseases (see Autoimmune treatment diseases) drug substitution , 45–46 dietary intake , 70, 71 gum chewing and saliva substitutes , prevalence , 69–70 46–47 Oral microbiome pharmacological stimulation , 46 hyposalivation , 85 Mesenchymal stem cells (MSCs) , 200–201 and saliva MISGD. See Medication-induced salivary antimicrobial activity , 84 gland hypofunction (MISGD) microbial attachment , 84 MIX. See Medication-induced xerostomia (MIX) nutrient availability , 83–84 Mixed connective tissue disease (MCTD) , 14 survival , 83 216 Index

Oral microfl ora MIX treatment , 46 artifi cial saliva , 96–97 SGD management , 60 hyposalivation due to medication , 89–91 Plain radiographs, salivary glands , 140–141 primary Sjögren’s syndrome , 88–89 Polypharmacy , 176 radiation-induced hyposalivation , 85 Porphyromonas gingivalis , 87, 89, 96 buccal mucosa , 86 Prader-Willi syndrome (PWS) , 22–23 dorsum of the tongue , 86 Primary biliary cirrhosis (PBC) , 16 gingival crevice region , 87 Primary sclerosing cholangitis (PSC) , 16 supragingival plaque , 87, 88 Probiotics , 94 vestibulum in molar region , 86 Progenitor cells , 199, 200 xerostomia treatment , 96 Protein-energy malnutrition (PEM) , 76–77 Oral mucosal infections , 94–95 Proton therapy Oral mucosa (OM)-sparing IMRT , 159–160 . advanced scanned technique , 207 See also Intensity-modulated Bragg peak , 205, 206 radiation therapy (IMRT) depth dose profi les, photons vs. proton , Oral taste buds , 73–74 205, 206 Organic acids, SGD management , 59 in silico planning comparative studies , Organs at risk (OARs) , 204 206–207 Oropharyngeal carcinoma, 2D-RT treatment , PWS. See Prader-Willi syndrome (PWS) 151, 152

R P Radiation-induced hyposalivation Parasympathomimetics, MIX treatment , 46 gene therapy , 197–198 Parkinson’s disease (PD) , 19 prevention , 198–199 Parotid gland (PG) proton therapy , 205–207 dose-response relationship and radiation radioprotectors , 198–199 tolerance, 150–151 stem cell therapy , 201–205 normal tissue complication probability stimulation of regeneration curves , 150, 151 basic ﬁ broblast growth factor , 200 radiotherapy analysis , 150 mesenchymal stem cells , 200–201 Parotid gland (PG)-sparing IMRT. See also progenitor cells , 199, 200 Intensity-modulated radiation roscovitine , 200 therapy (IMRT) Wnt/β-catenin, 200 EORTC QOL HN35 dry mouth subscale Rheumatoid arthritis (RA) score, 153–155 onset , 12–13 HNC treatment , 153, 154 salivary gland enlargement , 13 LENT-SOMA subjective xerostomia , 153, symptoms , 13 155 Roscovitine , 200 local disease control , 160 non-nasopharyngeal carcinoma patients , 153, 154, 156 S PARSPORT trial , 153 Saliva Orthana® , 62 randomised controlled trials Salivary bicarbonate , 74 vs. conventional 2D radiotherapy , Salivary gland dysfunction (SGD). See also 153–156 Salivary gland hypofunction (SGH); vs. 3D-CRT , 156 Xerostomia salivary gland dysfunction , 54 cancer patients Particle therapies , 161 avoiding acidic and sugar-sweetened Periodontitis , 96 drinks/foods/medication, 63 Pharmacological mechanisms avoiding xerostomic medication , 63 centrally acting xerogenic drugs , 44 causes , 53 peripherally acting xerogenic drugs , 41 clinical features , 54 Pilocarpine complications , 54, 55 Index 217

drug treatment , 58 organic acids , 59 fl uoridated toothpaste , 63 parasympathomimetic drugs , 60–61 maintaining oral hygiene , 62 Saliva substitutes National Cancer Institute CTCAE , 56, artifi cial saliva , 61–62 57 water , 61 parotid-sparing intensity-modulated Sarcoidosis , 14 radiotherapy , 54 Scintigraphy , 142 prevention , 58 Scleroderma , 14 regular dental review , 63 Semi-quantitative clinical score , 121 saliva stimulants , 58–61 SGD. See Salivary gland dysfunction (SGD) saliva substitutes , 61–62 Sialography defi nition , 51 MRI , 141 Salivary gland hypofunction (SGH) , 103 salivary glands , 137–140 clinical features , 54 Single-item approaches, xerostomia measure- defi nition , 51 ment , 104–106 presence/absence , 125, 127 16 S ribosomal RNA sequencing , 82 prevalence , 52 Sjögren’s syndrome (SS) signs , 56 American-European classifi cation criteria , Salivary glands 9, 10 imaging modalities , 133 autoantibodies , 11 endoscopy , 142 cytokines , 12 MRI examination , 141–142 labial and parotid biopsies , 11 plain radiographs , 140–141 labial salivary gland specimens , 9, 10 scintigraphy , 142 lymphocytic infi ltrates , 10 sialography , 137–140 occurrence , 9 ultrasonography , 134–137 oral microfl ora, primary , 88–89 radiotherapy paraffi n chewing-stimulated whole saliva human studies , 149–150 fl ow rate , 12 IMRT ( see Intensity-modulated prevalence , 9 radiation therapy (IMRT)) salivary gland enlargement , 12 preclinical data , 149 scintigraphy , 142 response to radiation , 196–197 sialochemical analyses , 12 Salivary secretion , 3, 178 sialography , 138, 140 alpha-2 adrenoceptor agonists , 43, 44 sialometry , 11 autonomic nerve-mediated signals , 40 unstimulated whole saliva fl ow rate , 11–12 bite/occlusal force , 187–188 South Australian Dental Longitudinal Study chewing and swallowing process , 72, 73 (SADLS), 109 cytostatic drugs , 82 SS. See Sjögren’s syndrome (SS) dietary intake , 70–73 Stem cell therapy gland size , 184, 186 adult stem cells , 201–203 muscarinic acetylcholine receptor embryonic stem cells , 201–202 activation , 41 good manufacturing practice regulations , number of natural teeth , 186–187 204 nutritional status induced pluripotent stem cells , 201, 202 dehydration , 76 proton therapy (see Proton therapy) malnutrition and micronutrients salisphere-derived cells , 203 defi ciency , 76–77 tissue stem cells , 201, 202 oral pain and discomfort , 72 Streptococcus mutans , 84, 89, 91 regular chewing , 183–186 Submandibular gland (SG)-sparing IMRT , resting rate , 3 158–160 tricyclic antidepressants , 42 Sugar-free chewing gum Saliva stimulants advantages , 181–182 acupuncture , 61 description , 96 chewing gum , 59 Summated rating scale , 108–111 218 Index

Summated Xerostomia Inventory vs. stimulated saliva , 182 (SXI), 110–111 taste perception , 182–183 Systemic lupus erythematosus (SLE) Unstimulated whole saliva fl ow rate characterisation , 13 (UWSFR), 8, 11, 54, 70–71 onset , 13 oral symptoms , 13 Systemic sclerosis , 14 V Venlafaxine , 44–45 Ventilator-associated pneumonia , 91 T Visual analogue scale (VAS) , 107–108 Taste alteration , 75–76 Taste sensation , 74 99m Technetium-pertechnetate , 142 W Tempol , 198 Wnt/β-catenin, 200 3D conformal radiotherapy (3D-CRT) , 151, 153, 156, 159 Thyroiditis , 18 X Tiotropium , 41–42 Xerostomia , 4 Tramadol , 45 assessment , 120 Tricyclic antidepressants (TCAs) , 36, 42 cancer patients , 55 2D radiotherapy (2D-RT) , 151, 152 causes , 82 Type 1 and 2 diabetes , 17 chemotherapy , 53 clinical features , 54, 56 defi nition , 51, 103 U dehydration , 23 Ulcerative colitis (UC) , 15 description , 8 Ultrasonography head and neck region, radiotherapy , 52 advantage , 137 oral-health-related quality of life , 112 principle , 134–135 oral symptoms , 129 salivary glands pathophysiology , 54 ductal obstruction , 135, 136 prevalence , 8, 51, 52 hyperechoic , 135 radioactive iodine , 52 Sjogren’s syndrome , 136, 137 subjective measurement Unstimulated saliva conceptual model , 104 fl ow in oral cavity , 182, 183 multi-item approaches , 106–111 masticatory function reliability , 104 masticatory muscles and dentition , self-report , 104 188–190 single-item approaches , 104–106 oral food processing , 190–191 validity , 104 salivary secretion ventilator-associated pneumonia , 91 bite/occlusal force , 187–188 Xerostomia Inventory (XI) body position , 184 description , 108–109 circadian rhythm , 184 development , 109–110 circannual rhythm , 184 original and short-form versions , 108, 109 exposure to light , 184 SXI , 110–111 gland size , 184, 186 validity , 110 hydration level , 184 number of natural teeth , 186–187 previous stimulation , 184 regular chewing , 183–186