Home' Australian Pharmacist : Australian Pharmacist September 2015 Contents Australian Pharmacist September 2015 I ©Pharmaceutical Society of Australia Ltd.
Continuing Professional DeveloPment
decrease in fluid intake (due to illness
or a reduced thirst mechanism).
Dehydration is a common phenomenon
in people who spend extended
periods of time in hot or humid
In hot environments,
the core body temperature raises,
and as a consequence the body’s
sweat rate rises, in order to lower
there is the loss of both fluid and
electrolytes. Common symptoms of
mild-to-moderate dehydration are
increased thirst, a sticky or dry mouth,
dark yellow urine, reduced sweating,
lethargy, headaches and a loss of skin
In cases of severe dehydration
(more than 5% of the body weight lost
through fluid) patients can experience
rapid breathing, altered consciousness
and if untreated, this can lead
Upon further questioning, you
discover that Peter has not been
experiencing any of the additional signs or
symptoms of dehydration. He is only
complaining of a dry mouth. In addition,
Peter has been consuming additional
water throughout the day, and he is very
conscious of having breaks from the heat
while he is at work. It seems unlikely that
dehydration is the cause of his dry mouth
on this occasion.
Endocrine disorders, such as diabetes,
can cause xerostomia (dry mouth).5
Diabetes is commonly associated with
oral health conditions such as teeth loss,
gingivitis and dry mouth.6 Oral dryness
in patients with diabetes is caused
by a reduction in saliva secretion and
reduced salivary flow.
patients with poor glycaemic control
have a greater chance of decreased
salivary flow and subsequent dry
Dry mouth in diabetes
can lead to a difficulty swallowing,
speech problems, and an increased
chance of oral infections (predominantly
caused by candidiasis).
Peter confirms that he does not yet
have confirmed diabetes. He is not
very well at the moment, and as
mentioned, his doctor has indicated he
has metabolic syndrome, which means he
has a higher risk of cardiovascular disease.
Peter has started to implement diet and
lifestyle measures to improve his health,
and he hopes this will be successful.
As Peter does not have diagnosed
diabetes, it seems unlikely that is the cause
of his current symptoms.
Salivary gland dysfunction, caused
by Sjogren’s syndrome, can cause
xerostomia.8 Sjogren’s syndrome is an
autoimmune condition that can result in
infiltration of lymphocytes in the salivary
As a result, patients experience
a reduction in salivary and lacrimal
Patients with Sjogren’s
syndrome also suffer from mucosal
atrophy and dental demineralisation
caused by a lack of saliva, which usually
exerts a buffering role on the oral
cavity.9 Other, more general symptoms
of Sjogren’s syndrome include dry eyes,
arthralgia and fatigue.5 Along with dry
mouth, patients can also experience
issues with taste, chewing, speaking,
Peter informs you that he is not
suffering from Sjogren’s syndrome.
He has been spending a lot of time at the
doctor’s surgery lately, and has had
extensive tests to check his health.
In addition, Peter is not experiencing any
other symptoms that may be suggestive of
this syndrome. Although Sjogren’s
syndrome is a cause of dry mouth, it is not
likely to be the cause for Peter.
Lifestyle factors such as smoking,
chewing tobacco, drinking alcohol,
and habitual mouth breathing can also
contribute to xerostomia.
table 1. medicines which can commonly cause dry mouth5,9,11–14
proton pump inhibitors
alpha-adrenergic agonists, i.e. clonidine
tricyclic antidepressants, i.e. amitriptyline, imipramine
Links Archive Australian Pharmacist August 2015 Australian Pharmacist October 2015 Navigation Previous Page Next Page