Dry mouth Flashcards
what is the sensation of dry mouth?
xerostomia
what are causes of dry mouth?
- Medication
- Dehydration
- Mouth breathing
- Anxiety
- Diabetes
- Radiotherapy
- Systemic disease e.g., Sjogren’s syndrome
- Diurnal variation
what are symptoms of dry mouth?
- Difficulty eating, swallowing, speaking, wearing dentures.
- Mucosal surfaces stick to each other and/or to teeth.
- Bad taste/ altered taste.
- Halitosis
- Sore mouth
- Deteriorating dentition
- Salivary gland swelling persistent/ recurrent.
what is used to assess dry mouth?
Challacombe scale
what are clinical signs of dry mouth?
- Mirror sticks to buccal mucosa, tongue
- Frothy saliva
- No salvia pooling FOM
- Generalised shortened tongue papillae.
- Altered gingival architecture (smooth)
- Glossy appearance of oral mucosa especially palate.
- Lobulated/ fissures tongue
- Cervical caries (more than 2 teeth).
- Debris on palate or sticking to teeth.
what is evidence of candidiasis?
- Angular cheilitis
- Erythematous mucosa
- Thrush
- Denture stomatitis
what is score 1-3 on the challacombe scale?
mild dryness – routine check-up monitoring.
what is score 4-6 on the challacombe scale?
moderate dryness – further investigations if cause not clear.
what is score 7-10 on the challacombe scale?
severe dryness – cuase must be determined and exclude Sjogren’s – REFER
how do you test for dry mouth?
Tilt head forward and let saliva accumulate and dribble out into container.
- 15 minutes ideally, but normally 5 mins on clinic.
what is classed as a normal saliva flow rate?
0.3 to 0.4ml/min
what is classed as a reduced saliva rate?
less than 0.1ml/min
how is score 1-3 managed?
may not need treatment, sugar free chewing gum, attention to hydration.
how is score 4-6 managed?
sugar free gum or sialagogues. Consider saliva substitutes and topical fluoride.
how is score 7-10 managed?
saliva substitutes and topical fluoride
what is a good substance found in gum and sweets that helps dry mouth?
xylitol
what can be used overnight to help dry mouth?
artificial saliva gel (biotene oral balance)
BioXtra Gel
Oralieve
what are local treatments for dry mouth?
- Sugar free chewing gum/ sweets
- Artificial saliva pastilles (Salivix)
- SST (Saliva-stimulating tablets)
- Xylimelts
what is systemic therapy for dry mouth?
pilocarpine
what are carboxymethyl cellulose based treatments for dry mouth?
- Glandosane aerosol spray
- Saliveze oral spray
- Artificial saliva oral spray (Xerotin)
what are mucin based treatments for dry mouth?
AS saliva orthana
what mouthwash is advised to use for dry mouth?
sodium fluoride mouthwash 0.05%
what toothpaste is advised to use for dry mouth?
0.619%/ 1.1% (2800/ 5000ppm)
