Xerostomia is a common complaint of nearly half of the elderly population and about one-fifth of younger adults. It causes several signs and symptoms, and compromise oral functions and health-related quality-of-life. Multiple reasons are proposed to describe the etiology of xerostomia such as local factors, psychogenic factors, and systemic diseases. In order to manage xerostomia effectively, identification of the main causality is mandatory. The aim of this review was to present systemic diseases leading to xerostomia with their mechanisms of action. We used various general search engines and specialized databases such as Google, Google Scholar, Yahoo, PubMed, PubMed Central, MedLine Plus, Medknow, EBSCO, ScienceDirect, Scopus, WebMD, EMBASE, and authorized textbooks to find relevant topics by means of Medical Subject Headings keywords such as “xerostomia,” “hyposalivations,” “mouth dryness,” “disease,” and “systemic.” We appraised 97 English-language articles published over the last 40 years in both medical and dental journals including reviews, meta-analysis, original papers, and case reports. Upon compilation of relevant data, it was concluded that autoimmune diseases most frequently involve salivary glands and cause xerostomia followed by diabetes mellitus, renal failure, and graft-versus-host disease. Moreover, the underlying mechanisms of systemic disease-related xerostomia are: autoimmunity, infiltration of immunocompetent cells, granuloma formation, fibrosis and dehydration, deposition of proteinaceous substances, bacterial infection, and side-effects of medications.

Premedication with meloxicam and ibuprofen significantly increased the success rates of inferior alveolar nerve block anaesthesia for teeth with irreversible pulpitis; however, neither drug provided profound anaesthesia.

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Background and Objective: Inhalation of chemicals and toxins in cigarette and hookah smoke results in loss of integrity of oral cavity tissues. The objective of this study was to compare the periodontal health of hookah and cigarette smokers. Materials and Methods: In this study, 73 men at the age group of 20-35 years who smoked hookah for more than 5 years and 73 men at the same age who smoked cigarette for more than 5 years and 73 healthy men referred to the periodontal department of Mashhad dentistry school were selected and studied. Periodontal indices including pocket depth, GI, BOP, CAL were assessed in two groups. Also, using parallel periapical radiography, mesial and distal marginal bone level around the first molar tooth was measured. Finally, the data were assessed and compared using appropriate statistical analysis. Results: Pocket depth was 24.27% and 23.62%, respectively, in cigarette smokers and hookah smokers, and it was 0.96% in healthy subjects, clinical attachment level was 4.48 and 4.41 mm, respectively, in cigarette smokers and hookah smokers, and it was 0.77 mm in healthy subjects. Gingival index (GI) was 1.40 and 1.42, respectively, in cigarette smokers and hookah smokers and it was 0.52 in healthy subjects, BOP value ​​was 6.52 and 6.52%, respectively, in cigarette smokers and hookah smokers and it was 10.86% in healthy subjects. Mesial marginal bone level of first lower molar tooth was 2.27 and 2.32 mm, respectively, in cigarette smokers and hookah smokers and it was 1.74 mm in healthy subjects and distal marginal bone level of lower first molar tooth was 2.38 and 2.35 mm, respectively, in cigarette smokers and hookah smokers and it was 1.75 mm in healthy subjects. Comparison of results between the two groups of cigarette smokers and hookah smokers did not show any significant relationship in any of the variables, but there was a significant relationship between the two groups and the healthy group (P <0.001). Conclusion: Periodontal parameters in healthy individuals are significantly better than those of smokers. Also, although there is a relationship between cigarette smoking and hookah smoking and periodontal parameters, these two groups do not show a significant difference in terms of periodontal parameters.

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