Засоби й методи стимуляції слиновиділення (огляд літератури)

Abstract

У наш час пропонується велика кількість засобів і методів для зменшення сухості в порожнині рота й відновлення дефіциту біологічно активних речовин, що надходять у порожнину рота разом зі слиною. Стимулювати слиновиділення можна й місцевими, і системними засобами. Пацієнти потребують корекції ксеростомії, бо дефіцит ротової рідини сильно впливає на стан зубів, слизової оболонки порожнини рота і тканин пародонта й на якість життя в цілому. У зв'язку з тим, що лікування ксеростомії в низці випадків неефективне й неможливе, такі пацієнти потребують симптоматичної терапії для полегшення проявів і наслідків ксеростомії. На стоматологічному ринку представлено велику кількість засобів для симптоматичної корекції ксеростомії.

Currently, a large number of tools and methods are proposed to reduce dryness in the mouth and restore the deficiency of biologically active substances entering the mouth with saliva. Stimulation of salivation can be carried out by both local and systemic means. The aim of our study was to analyze pharmacological and systemic stimulators of salivation. Results and discussion Only three drugs were subjected to a detailed study - bromhexidine, anethole trithione and pilocarpine hydrochloride. Currently, the development of long-acting (prolonged) drugs is underway, which is a promising solution for long-term treatment of patients with dry mouth. Local stimulation of salivation is based on irritation of the nerve endings of the oral cavity, which transmit a signal to the salivary glands. Various methods are offered, it is chewing of gums, menthol-containing substances, inert means like paraffin. Chewing gum, mint or citric acid tablets (lollipops) and rinses are recommended in everyday life. Frequent use of these tools is not always effective due to various negative factors. The most important of them is short-term effect, but not the possibility of frequent use. In some patients, drugs such as citric acid can irritate the mucous membranes, especially if its content is increased due to dry mouth. Frequent use of these tools can cause demineralization of teeth. Many authors recommend so-called "saliva substitutes" or "saliva compensators". Various options of replacement therapy in the form of gels, rinses, sprays, toothpastes, etc. are offered. To prevent caries during hyposalivation, the authors propose a composition of artificial saliva with a high content of fluoride ions, with the introduction of hydroxyapatite from animal bones. Researchers offer various methods of stimulation the functional activity of the salivary glands, but the main factor in choosing the appropriate treatment is a favorable assessment of the degree of violation of the patient's salivary glands and the mechanism of violation. Conclusion. Owing to the review of the literature, we can conclude that the timely diagnosis and treatment of xerostomia is an urgent problem of modern dentistry. Patients need xerostomia correction, because the deficiency of oral fluid significantly affects the condition of teeth, mucous membranes of the mouth and periodontal tissues and the quality of life in general. Due to the fact that the treatment of xerostomia in some cases is ineffective and impossible, such patients need symptomatic therapy to alleviate the manifestations and consequences of xerostomia. The dental market offers a large number of tools for symptomatic correction of xerostomia. Many literature sources contain conflicting data on their effectiveness. Therefore, we consider it appropriate to study the comparative evaluation of tools that facilitate the manifestations of xerostomia, as well as to assess the effectiveness of correction of xerostomia depending on the causes of its development.