Salivary gland dysfunction.

Clinically significant declines of salivary output are not a function of aging. Complaints of oral dryness (xerostomia) are common in the elderly patient, however. This complaint is most often a consequence of medications; tricyclic antidepressants, certain antihypertensives, and anticholinergics can cause marked decreases in salivary flow rates. Other medications such as diuretics may cause xerostomia without decreasing salivary output. Systemic diseases such as Sjögren's syndrome can destroy salivary glands. Specific serologic, ophthalmologic, and salivary findings are necessary for the diagnosis of Sjögren's syndrome. Radiation therapy for treatment of head and neck cancers also can damage salivary glands permanently. Infectious agents such as mycobacteria, Epstein-Barr virus, and various oral bacteria can infect human salivary glands. Diminished salivary output can lead to serious oral sequelae. Rapidly progressing dental caries and oral candidiasis are found frequently in this age group. Close supervision of the geriatric patient's oral and dental health is essential.