salivary glands stimulating saliva secretion. Contraindications to these medications include narrow-angle glaucoma, uncontrolled asthma and acute inflammation of the iris. Sweating is the most common side effect that patients may experience. Patients may choose to concomitantly use saliva substitutes or salivary stimulants along with their medication.

 

ROLE OF THE PHARMACIST

Dry mouth can significantly affect an individual’s quality of life, impacting speech, swallowing, the need to frequently sip liquids and dental care. Medications are the most common cause of dry mouth, prompting pharmacists to identify patients at risk and provide appropriate education on prevention of complications and treatment options. Unfortunately medication-

adherence rates may decrease for those patients experiencing symptoms of dry mouth. It may cause patients to completely discontinue or skip doses of their medication which has additional consequences on their other medical conditions. Although alternative medications may not be a reasonable solution in some cases, pharmacists need to educate patients on treating their symptoms and preventing dental complications. To allow patients to get involved with the management of their dry mouth pharmacists can recommend various Web-based resources so patients can obtain general information on the condition (Table 7). Emphasis needs to be placed on preventive oral care when counseling patients. Correct brushing and flossing techniques as well as appropriate toothpaste and

TABLE 7

Patient resources

Organization

The Sjögren’s Syndrome Foundation
Oral Cancer Foundation
American Dental Association
National Institute of Dental
and Craniofacial Research

MayoClinic Foundation

 

mouth rinse products should be reviewed with all patients at risk of dry mouth even if they are currently asymptomatic. Toothpastes with sodium lauryl sulfate and mouth rinses containing alcohol should be avoided to limit further irritation to a dry mouth. Proper hydration, salivary stimulation, oral lubrication and lifestyle changes can improve the

Web site

www.sjogrens.org www.oralcancerfoundation.org www.ada.org www.nidcr.nih.gov

www.mayoclinic.com

 

symptoms of dry mouth. Encourage patients to speak to their healthcare provider so proper intervention can be made to prevent dental complications.

 

For a complete
list of references, visit
www.cedrugstorenews.com.

Successful completion of “Dry mouth and oral health” (lesson 401-000-08-007-H01) is worth two contact hours of credit. Mail completed answer sheet to DrSN/Pharmacy Practice, P.O. Box 31180, Tampa, FL 33631-3180. For faster service, fax to (813) 626-7203. For fastest service, visit our Web site at www.cedrugstorenews.com.

 

1. Dry mouth is directly associated with aging. a. True. b. False.

 

2. Functions of saliva include: a. Aiding in speech. b. Digestion. c. Antimicrobial activity. d. All of the above.

 

3. Which neurotransmitter is related to the triggering of salivary flow? a. Acetylcholine. b. Dopamine. c. Norepinephrine. d. Serotonin.

 

4. All individuals with hyposaliva-tion will have symptoms of dry mouth. a. True. b. False.

 

5. All of the following classes of medication may induce dry mouth EXCEPT: a. Anxiolytics. b. Antihypertensives. c. Antimicrobials. d. Antidepressants.

 

6. Which question would provide

information on whether the patient is experiencing reduction of saliva stimulation?

a. Does the amount of saliva in your mouth seem to be too little?

b. Does your mouth usually feel
dry?
c. Have you been experiencing
dry mouth for more than one
week?

d. Does your mouth feel dry when eating a meal?

 

7. Which component of saliva has antimicrobial activity? a. Amylase. b. Lactoperoxidase. c. Mucin. d. Potassium bicarbonate.

 

8. Which disease state is most commonly associated with dry mouth? a. Hypertension. b. Rheumatoid arthritis. c. Sjögren’s syndrome. d. Thyroid disease.

 

9. Which is an appropriate counseling point for a patient experiencing medication-induced dry mouth?

a. “Take the medication 1 hour after a meal.”

b. “Drink plenty of water before and after taking the medication.”

c. “Take the medication with a caffeinated beverage.”

d. “Crush the tablet and mix with food.”

 

10. Which toothpaste-containing ingredient should be avoided in those with dry mouth?

a. sodium lauryl sulfate (SLS).
b. Fluoride.
c. Triclosan.
d. Xylitol.

 

11. High content of which mouth rinse ingredient should be avoided in those with dry mouth? a. Menthol. b. Thymol. c. Alcohol. d. Eucalyptol.

 

12. Which product is classified as a salivary stimulant? a. Gum. b. Lozenge. c. Cevimeline. d. All of the above.

 

13. Which ingredient of saliva substitutes mimics real saliva’s viscosity? a. Methylparaben. b. Carboxymethylcellulose. c. Sorbitol. d. Fluoride.

 

14. Xylitol-containing products have which of the following effects? a. Decrease risk of dental caries. b. Reduce plaque formation. c. Increase salivary flow. d. All of the above.

 

15. Which of the following patients should be referred to their healthcare provider?

a. Patient experiencing oral pain along with dry mouth.

b. Patient complaining of reduced denture-wearing time as a result of dry mouth.

c. Patient requesting a saliva substitute for medication-induced dry mouth.

d. A and B.

 

16. Oral candidiasis is the most common oral infection associated with dry mouth. a. True. b. False.

 

17. Which symptom associated with dry mouth requires physician referral? a. Altered sense of taste. b. Fever. c. Bad breath. d. Trouble speaking.

 

18. Steps for good dental hygiene include:

a. Toothbrush replacement every six months.

b. Avoid cigarette tobacco only. c. Self-exam of mouth regularly.

 

19. Dosing guidelines for saliva substitutes include:

a. Do not use more than 6 times per day.

b. Apply at least four times per day. c. Do not use before bedtime.

d. Use before bedtime and as often as needed.

 

20. Pharmacists should not be concerned about dry mouth—that’s the dentist’s job. a. True. b. False.