symptoms of oral and dental disorders
mouth and dental disorders
Dry Mouth
Not all people with a dry mouth need to be immediately evaluated by a doctor. The following information can help people decide whether a doctor’s evaluation is needed and help them know what to expect during the evaluation. In people with dry mouth, certain symptoms and characteristics are cause for concern. They include Extensive tooth decay Dry eyes, dry skin, rash, or joint pain Transmission of HIV Infection None People who have warning signs should see a doctor right away. People with extensive tooth decay should have a dental examination. People with a dry mouth but no warning signs and who otherwise feel well may see their doctor within a week or so. Doctors first ask questions about the person’s symptoms and medical history. Symptoms of dry or irritated eyes, dry skin, rash, and/or joint pain raise the possibility of Sjögren Syndrome . Doctors also ask about a history of past or current radiation treatment, head and neck trauma, and a diagnosis of or risk factors for HIV infection. Doctors need to know all the medications a person is taking or substances being used to find out whether any are causing the dry mouth. Doctors then do a physical examination. The physical examination is focused on the mouth, to see the degree of dryness. If the degree of dryness is unclear, doctors can hold a tongue depressor against the inside of the cheek for 10 seconds. If the tongue depressor falls off immediately when released, the flow of saliva is considered normal. If there is difficulty removing the tongue depressor, the flow of saliva is not normal. The lipstick sign, where lipstick sticks to the front teeth, may be a useful indicator of dry mouth. and check the condition of the teeth (for instance, whether there are any cavities in unusual places). Unexpectedly severe and rapid tooth decay may be a sign of recreational and illicit drug use, particularly Amphetamines . What doctors find during the history and physical examination often suggests a cause of the dry mouth (see table) and the tests that may need to be done. If the dry mouth began shortly after a new medication was started, doctors often try stopping the medication to see whether symptoms go away. Sometimes, doctors test how well the salivary glands are functioning by measuring the flow of saliva (a test called sialometry). People chew paraffin or apply citric acid to the tongue to stimulate the flow of saliva, and then doctors collect the saliva. Measuring the flow of saliva can help doctors determine whether the dry mouth is getting better or worse. If doctors are unable to determine the cause of dry mouth, people should usually undergo a biopsy (removal of a sample of tissue for examination under a microscope) of a minor salivary gland on the lower lip to detect Sjögren Syndrome , 