Dry Mouth And Saliva Flashcards
What are the key functions of saliva?
- Acts as a buffer solution helping with remineralisation
- helps with speech
- starts digestion process
- provides lubrication
- has antimicrobial properties
Where is saliva secreted from (major + minor)
Major:
1. Parotid
2. Sublingual
3. Submandibular
Minor:
1. Labial
2. Palatal …
How is the salivary glands innervated?
- Parasympathetic increase salivation
- Sympathetic decreases salivation
- also damage to salivary gland or medication can change salivation rates
What is the tooth’s critical region?
This is the Ph at which under is dangerous for the tooth as the surfaces can be demineralised
Enamel critical value is 5.5ph - below this the tooth becomes unsaturated and the tooth starts to dissolve
What happens when saliva Ph is above critical value?
The tooth is saturated and this means there is excess minerals and these are used to repair any damaged mineral crystals - remineralisation
What is xerostomia?
This is dry mouth
This can be caused by reduced salivary flow (hyposalivation) or a change in saliva composition
What are clinical features of Xerostomia?
- Difficulty swallowing
- Difficulty wearing dentures due to lack of adherence
- No pooling of saliva at floor of mouth
- Tongue can stick to palate
- Bad breath and taste
How does hyposalivation link of caries?
Lack of saliva means less remineralisation and this can cause even good oral health patient to still develop caries cause tooth surfaces are exposed to acidic conditions for longer
How to protect against dental caries?
- Good tooth brushing to brush off plaque - twice a day with interdental cleaning
- Good diet with low sugar content
- Avoiding sticky food
- ## using fluoride toothpaste and mouthwash (8+)
What is a normal salivary flow rate (unstimulated?
0.3 - 0.4ml/min
What is considered a reduced salivary flow rate?
Less than 0.1ml/min
What is general stimulated salivary flow?
3-4 ml/min
How can a dentist control moisture in the work field?
Absorbent materials
Suctions devices
Rubber dam
What causes the work area to wet when a dentist is working!
- Patient saliva
- Water from the dental tools
Why must the work area be kept dry?
- This prevent contamination
- Fundamental of dental care - gives a better outcome
What are benefits of using a rubber dam?
- Better for patient as it’s more safe
- prevents tooth debris passing down
- more comfortable - Improves access for dentist
- Reduces risk of contamination from the oral environment
What is a fissure sealant?
A plastic coating bonds to the enamel and blacks bacteria from accessing the fissure area and this prevents caries in this region
How does fissure sealants prevent caries?
- Cuts off nutrients
- To apply FS they use an acid etchant, this initially kills of the bacteria in the area
When found fluoride be used and when is a fissure sealant used?
- Fluoride - works best if smooth surfaces but poorly on fissure and pits
- FS - works best for pits and fissures
What teeth are Fissure sealants done (FS)
- Permanent molars
- Incisors with deep palatal pits
- Teeth with early fissure caries
What are the 2 types of tooth wear?
- Physiological tooth wear
- Pathological tooth wear
What is physiological tooth wear?
This is wear and rear of the teeth and is normally expected over time
Dentists should check to see if there is excessive wear considering patient age
What is pathological wear?
Wear causes by
1. Attrition - tooth to tooth contact
2. Abrasion - by foreign bodies e.g. tooth brushing with excessive force
3. Erosion - by chemical dissolution
How is attrition tooth wear managed?
Wearing a mouth hard at night to stop crushing
Adjust bite so tooth rub on strongest parts
How is abrasion tooth wear managed?
Ensure brushing is done correctly
Avoid abrasive toothpastes
How is erosion tooth wear managed?
- Advice of reducing acid exposure
- don’t brush straight after eating (acid exposure)
- ask GP about excess vomiting, eating disorders…
Where can acids in erosion come from?
Extrinsic sources:
Sugary drinks and food
Occupational exposure
Intrinsic sources:
Acid reflux (gord)
Vomiting
- these show up of the palatal and lingual surfaces
What are the differences between dental caries and dental erosion
Caries:
- Causes by plaque metabolising sugars producing small amounts of acid in local areas
- prevented by reducing frequency and intake of sugars and better oral health care and tooth brushing (OHI AND TBI)
Erosion:
- Cause by acid but no bacteria involved
- strong acids from gut wash over a larger surfaces of teeth
- Prevented by stopping contact with gastric acids or a reduced intake of dietary acids
