0%) were diagnosed with Sjögren’s syndrome [4]. These results demonstrated http://www.selleckchem.com/products/dinaciclib-sch727965.html that the causes of dry mouth were various, and that Sjögren’s syndrome existed in less than 10% of the dry mouth cases, thus, the importance of examinations for the diagnosis was emphasized. Xerostomia is defined as a subjective complaint of dry mouth [5], and is caused by hyposalivation and/or hyper-evaporation of saliva. Hyposalivation

occurs due to various causes, such as Sjögren’s syndrome, radiation therapy to the head and neck, the use of medications, and diabetes mellitus [5]. Evaporation of saliva is mainly caused by mouth opening or mouth breathing, which often occurs during the night without an apparent decrease in the salivary flow. Evaporation occurs even in the Sjögren’s syndrome patients. Thus, for the management of xerostomina in those with Sjögren’s syndrome, it is important not only to promote saliva secretion and moisturize the oral mucosa, but also to prevent the evaporation of saliva. Saliva production and secretion is vital for the maintenance of Erastin supplier oral health and oral function. Common complications include rampant dental

caries, candidiasis, mucosal atrophy and burning, difficulty in denture retention and use, compromised speech and swallowing, and reduced or altered taste sensation [6]. The management of oral candidiasis has been recognized to be Vitamin B12 an especially important issue in patients with Sjögren’s syndrome. This will be discussed as one of the topics, in addition to the management of dry mouth, in this review. The management of dry mouth has included using air humidifiers, rinsing the mouth with water or mouthwash, the application of a salivary substitute and administration

of secretagogues. A large number of systemic agents have been proposed as secretagogues, but only a few have shown consistent salivary enhancing properties in well-designed, controlled trials [7]. There are currently three secretagogues suitable for alleviation of dry mouth in Sjögren’s syndrome patients in Japan; cevimeline hydrochloride hydrate (cevimeline), pilocarpine hydrochloride, and anetholtrithione. Recently, the usefulness of a reservoir bite guard [8] and an intraoral lubricating device [9], [10] and [11] were reported to deliver a saliva substitute to the oral cavity for hyposalivation patients. We previously applied a simple bite guard for sleep-related xerostomia [12], and based on the results of this study, the bite guard is expected to alleviate dry mouth in patients with Sjögren’s syndrome. Cevimeline, which is an agonist of muscarinic types 1 and 3 receptors [13], has shown clinical efficacy in increasing saliva production and improving the subjective perception of oral dryness in Sjögren’s syndrome patients [14] and [15].