TABLE 2 Causes of Dry Mouth

Mouth breathing

Continuous positive airway pressure for sleep apnea Use of systemic anticholinergic medication Dehydration

Congenitally missing salivary glands Acute bacterial/viral illnesses affecting the salivary glands Radiation therapy to the head and neck Bell's palsy

Excessive thirst (i.e., diabetes) Anxiety/depression/stress Past treatment with I131

component, while others also use subjective criteria. As a result of these differing criteria, the prevalence estimates of SS have ranged from 2 to 10 million persons in the United States, and it has remained undiagnosed in many. The disease affects primarily peri- or postmenopausal women, at a ratio of nine females to one male; however, it is being diagnosed with increased frequency in younger individuals. SS has also been described in a cohort of young persons under the age of 16 who presented with salivary gland swelling, positive antinuclear antibody, and an indolent course over a seven-year follow-up period (3).

Among individuals with rheumatoid arthritis, the prevalence of secondary SS is 30% to 50%. In patients with systemic lupus erythematosus (SLE), the prevalence has been estimated between 8% and 30%.

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