Dry Mouth Flashcards
What are the causes of dry mouth?
Dehydration
Drugs
Age
Smoking
Alcohol
Radiotherapy and cancer tx
Anxiety and somatisation disorders
Salivary gland diseases eg - Sjögren’s disease
What are the complications of dry mouth?
Discomfort and pain
Increased caries risk
Candidato infection
Swallowing problems
Give examples of drugs that can cause dry mouth
Anticonvulsants (TN)
Antidepressants
Antihistamines
Antipsychotics
Diuretics
Muscle relaxants
Opioids
Benzodiazepines
What are the worst drugs for causing dry mouth
Antimuscarinics (anticholinergic)
Diuretics - bendroflumethiazide
Lithium
Why does radiotherapy and cancer tx cause dry mouth?
Radiation effects (apoptosis then inflammation and fibrosis)
GVHD
Antineoplastic drugs
Radioiodine
What chronic diseases lead to dehydration?
Diabetes mellitus
Renal failure
Cardiac failure
Hypercalcaemia
Diabetes insipidus
Addison’s disease (hypovolaemia)
What acute diseases cause dehydration?
Haemorrhage
Persistent vomiting
How should you assess dry mouth?
Gland palpation
Duct expression
Challacombe scale
Discriminating meal time symptoms from Sjögren’s
How is dry mouth managed?
Investigations
Treat underlying cause
Preventative care
Symptomatic relief
What investigations should be carried out for dry mouth?
Bloods - HbA1c, U+E, ANA
Sialometry
Ultrasound scan of salivary glands
Which underlying causes for dry mouth can be treated?
Correct hydration
Avoid caffeine, smoking and alcohol
Modify drug regime
Control diabetes
Treat somatoform disorder
What preventative care for dry mouth can be carried out?
Caries - diet, fluoride, tx planning
Candida infections - angular cheilitis
Sore tongue - SLS free toothpaste
What can be used to treat dry mouth symptoms?
Sprays - glandosane, saliva orthana
Lozenges - saliva orthana, salivix
Saliva stimulants - pilocarpine
Oral care systems gels - biotene oral balance, bioextra gel
What simple lifestyle measures can help dry mouth?
Moist, oily foods and sauces
Humidify home environment
Regular exercise
Omega 3 supplements
Glasses/goggles to reduce tear evaporation
Warm eye compresses 10mins daily
