Review
Published: 2020-06-15

Secretory process: the role of age, autoimmunity and endocrinopathy

Department of Biomedicine, Neurosciences and Advanced Diagnostics, Section of ENT Surgery, University of Palermo, Italy
Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy
Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy
Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy
Department of Biomedicine, Neurosciences and Advanced Diagnostics, Section of ENT Surgery, University of Palermo, Italy
Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy
xerostomia dry-mouth autoimmunity Sjögren’s syndrome diabetes oral-pharyngeal health secretory flow

Abstract

Xerostomia is a common occurrence in older people, impairing their quality of life. When salivary gland function goes below 50%, patients show oral mucosal dryness and consequent problems on speaking and eating. They present oral health impairment. Their quality of life is compromised too. The prevalence of xerostomia is reported to be approximately 30% in people over 65 years old. Drug-induced xerostomia is the most common cause of dry mouth in elderly, because many older adults are taking at least one medication that causes salivary dysfunction. Among the autoimmune disease that can cause xerostomia, Sjögren’s syndrome (SS) is the most representative one in elderly. Dryness of oral mucosa and eyes is the main symptom of the disease. The “Elderly onset primary Sjogren’s Syndrome” (EopSS) is a common disease in Caucasian population, with a global incidence of 3% but a geographic variability. Patients with SS are frequently misdiagnosed, and physicians treat each symptom individually, unaware of underlying systemic disease. The control of symptoms with substitution of saliva and tears is recommended; therapies with anti-CD20 and Interferon-α are useful in patients with residual glandular function and salivary flow. Among the endocrinopathies, diabetes mellitus (DM) is the most common cause of xerostomia in older patients. Hyposalivation increases in diabetic patients with low metabolic control, which can cause more severe side effects in relation to oral health. Xerostomia may be produced by changes in salivary composition (caused by diabetes complications such as neuropathy, angiopathy, and metabolic failure) instead of changes in salivary quantity. Treating diabetes itself, maintaining good glycaemic values, can allay xerostomia in those patients. Doctors and dentists have to be aware of the various oral manifestations of diabetes in order to make an early diagnosis and treatment, avoiding further complications.

Affiliations

Antonina Mistretta

Department of Biomedicine, Neurosciences and Advanced Diagnostics, Section of ENT Surgery, University of Palermo, Italy

Viola Pasquale

Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy

Davide Pisani

Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy

Marco Ciriolo

Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy

Riccardo Speciale

Department of Biomedicine, Neurosciences and Advanced Diagnostics, Section of ENT Surgery, University of Palermo, Italy

Giuseppe Chiarella

Department of Experimental and Clinical Medicine, Audiology and Phoniatrics Unit, Magna Graecia University, Catanzaro, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2020

How to Cite

[1]
Mistretta, A., Pasquale, V., Pisani, D., Ciriolo, M., Speciale, R. and Chiarella, G. 2020. Secretory process: the role of age, autoimmunity and endocrinopathy. JOURNAL OF GERONTOLOGY AND GERIATRICS. 68, 02 Special (Jun. 2020), 99-105. DOI:https://doi.org/10.36150/2499-6564-487.
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