Investigations | Potential results | Clinical management plan |
---|---|---|
Actions from history, medication and dietary assessment | ||
History findings | Cancer related
| General advice Oral hygiene: refer to dentist/oral hygienist. Use fluoridated toothpaste—all dentate patients should use toothpaste with at least 1000 ppm fluoride, while dentate patients with radiation-induced salivary gland dysfunction should use specialist toothpaste with 5000 ppm fluoride. Limit acidic and sugary drinks/foods/medication and rinse mouth after these products.Symptomatic management4
|
Oral infection | Treat according to local guidelines. | |
Inadequate fluid intake/dehydration | Encourage oral fluid intake and oral hygiene. | |
Decreased mastication (liquid/soft diet) | Refer for dietetic assessment and advice. Refer to a speech and language therapist. | |
Diabetes mellitus6 | Refer to a GP. | |
Sjögren's syndrome | Refer to the rheumatology team. | |
Medication findings4 | Antidepressants:
| Many other medications can cause dry mouth. Check, if any doubt, using an Electronic Medicines Compendium7. |
First line | ||
If no improvement | Psychological issues | Refer for psychological support. |
Missed organic cause | Refer to oral surgery. |
GP, general practitioner; SSRI, selective serotonin reuptake inhibitor; SST, saliva stimulating tablet.