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Xerostomia (dry mouth) that is long-standing has many causes, certain drugs being the most common. Currently, more than 500 medications are associated with xerostomia, and synergistic effects of multiple medications are increasingly common among the elderly. Drugs most commonly associated with xerostomia include tricyclic antidepressants, antipsychotics, benzodiazepines, atropinics, B-blockers, and antihistamines. Thus, xerostomia is common among patients being treated for hypertension or mental illness. Radiation is another cause of xerostomia if the salivary glands are irradiated; salivary tissue is highly vulnerable to radiation damage. Chemotherapy is another cause, with xerostomia being the fourth most common symptom reported in a study of patients with advanced cancer and xerostomia. The degree of xerostomia was related to the total number of chemotherapeutic drugs used. Xerostomia is also associated with chronic graft versus host disease, Sjogren's syndrome, sarcoidosis, HIV disease, and HCV-associated salivary gland disease. Viruses such as Epstein-Barr and human T-lymphotropic virus 1 have also been associated with dry mouth. Long-standing xerostomia can have serious oral health consequences, and management of the condition can involve topical agents, systemic agents such as pilocarpine, chewing gum, dietary supplementation, and other modalities. As new infections emerge, lifespans increase, and new drugs are developed, it is likely that more individuals will demonstrate symptoms and signs of xerostomia.

(Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, Vol. 97, No. 1, 2004)

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