Parotitis at the End-of-Life

Filipa Tavares Carreiro*, Rita Abril and Isabel Galriça Neto

Parotitis at the End-of-Life.

Saliva plays a key role in maintaining physiological homeostasis of the oral cavity and
its estimated daily production is of about 500-600 mL /day. Xerostomia is
defined as the subjective feeling of dry mouth caused either by changes in the saliva consistency,
or by the acute reduction of its production, by 50% or more. Its prevalence
varies among 14% and 72%, and it is most common in polymedicated elder patients, when in a state of dehydration and/or malnutrition.

It is also associated to multiple comorbidities such as renal failure, hepatic failure, hypothyroidism, diabetes mellitus and depression. The use of drugs with anticholinergic and diuretic effects can lead to dehydration and to the consequent increase of the prevalence of xerostomia.

The most commonly implicated drugs are antidepressants, anticholinergics, sedatives, antipsychotics, antiepileptic, anti-parkinson drugs and antihistamines, diuretics and antihypertensives. There are numerous secondary complications to xerostomia such as dysphagia, taste alterations, lesions of the oral mucosa, local pain and oropharyngeal infections.

Parotitis is the most common form of salivary gland infection. Parotids are the glands most often involved and its inflammation is called parotitis. The location of these gland channels, along the upper jaw, leads to salivary stasis, contrary to what occurs with sublingual and submandibular glands.

On the other hand, the saliva produced by the parotid gland is more serous in comparison to the
one produced by sublingual and submandibular glands, which consists of mucous material, rich in immunoglobulins.

Palliat Med Hosp Care Open J. 2017; 3(1): 11-13. doi: 10.17140/PMHCOJ-3-121