Disorders of the salivary glands

Question 1

Xerostomia

Answer 1

this is the uncomfortable condition of having constantly dry mouth due to decreased production of saliva, it has several causes:

Question 2

1. Irradiation

Answer 2

of head + neck area, usually as radiotherapy trt for cancer in this area

Question 3

2. Medications

Answer 3

that affect the nerve supply to the salivary glands to reduce their salivary flow or act as a diuretic + stimulate fluid loss, as well as certain drugs such as tricyclic antidepressants which cause dry mouth as a side effect

Question 4

3. Sjögren’s syndrome

Answer 4

a syndrome that occurs in conjunction with an autoimmune disorder, such as rheumatoid arthritis, where the body’s defence system attacks itself + destroys its own glandular tissues, including the salivary glands + lacrimal glands in the eye

Question 5

Reduction in saliva will have serious oral consequences:

Answer 5

• increased incidence of dental caries, as self cleansing ability it lost
• increased risk of oral infections, as defence capability is reduced
• increased risk of oral soft tissue trauma, as the protective mechanism is reduced
• problems with speech, swallowing + chewing, as lubrication effect is reduced
• poor taste sensation + lack of food enjoyment, as the taste buds cannot function correctly in a dry field

Question 6

There is little that can be done to ease this condition

Answer 6

other than change pt’s drug regime, the use of salivary stimulants + artificial saliva sprays may help in some cases + research is currently ongoing into salivary gland tissue transplant

Question 7

Pts suffering from xerostomia should be advised:

Answer 7

• frequent recall attendance to monitor for the onset of caries + other oral problems
• use of artificial saliva sprays or constant sipping of plain water
• high standard of oral hygiene, + especially use of topical fluoride products to strengthen teeth against caries
• dietary advice to avoid cariogenic products
• avoidance of oral health products containing alcohol, as these tend to worsen drying effect

Question 8

Ptyalism

Answer 8

excessive salivation, is a symptom associated with an underlying disease rather than a disorder in its own right

Question 9

It can occur due to any of following disorders:

Answer 9

• periodontal disease
• oral soft tissue injury or trauma, including that caused by sharp edged dental appliances
• oesophagitis + other conditions causing acid reflux
• disorders affecting the nervous system, including Parkinson’s disease + mercury poisoning

Question 10

Treatment

Answer 10

is focused on the causative disease + relief of its symptoms, although some drugs may be used to reduce salivary gland secretions e.g. atropine may be used during oral + maxillofacial surgery to significantly reduce saliva flow + provide clear, dry operating field for the surgeons