Dry Mouth And Saliva

Question 1

What are the key functions of saliva?

Answer 1

• Acts as a buffer solution helping with remineralisation
• helps with speech
• starts digestion process
• provides lubrication
• has antimicrobial properties

Question 2

Where is saliva secreted from (major + minor)

Answer 2

Major:
1. Parotid
2. Sublingual
3. Submandibular

Minor:
1. Labial
2. Palatal …

Question 3

How is the salivary glands innervated?

Answer 3

1. Parasympathetic increase salivation
2. Sympathetic decreases salivation
   - also damage to salivary gland or medication can change salivation rates

Question 4

What is the tooth’s critical region?

Answer 4

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

Question 5

What happens when saliva Ph is above critical value?

Answer 5

The tooth is saturated and this means there is excess minerals and these are used to repair any damaged mineral crystals - remineralisation

Question 6

What is xerostomia?

Answer 6

This is dry mouth
This can be caused by reduced salivary flow (hyposalivation) or a change in saliva composition

Question 7

What are clinical features of Xerostomia?

Answer 7

• 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

Question 8

How does hyposalivation link of caries?

Answer 8

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

Question 9

How to protect against dental caries?

Answer 9

• 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+)

Question 10

What is a normal salivary flow rate (unstimulated?

Answer 10

0.3 - 0.4ml/min

Question 11

What is considered a reduced salivary flow rate?

Answer 11

Less than 0.1ml/min

Question 12

What is general stimulated salivary flow?

Answer 12

3-4 ml/min

Question 13

How can a dentist control moisture in the work field?

Answer 13

Absorbent materials
Suctions devices
Rubber dam

Question 14

What causes the work area to wet when a dentist is working!

Answer 14

1. Patient saliva
2. Water from the dental tools

Question 15

Why must the work area be kept dry?

Answer 15

1. This prevent contamination
2. Fundamental of dental care - gives a better outcome

Question 16

What are benefits of using a rubber dam?

Answer 16

1. Better for patient as it’s more safe
   - prevents tooth debris passing down
   - more comfortable
2. Improves access for dentist
3. Reduces risk of contamination from the oral environment

Question 17

What is a fissure sealant?

Answer 17

A plastic coating bonds to the enamel and blacks bacteria from accessing the fissure area and this prevents caries in this region

Question 18

How does fissure sealants prevent caries?

Answer 18

1. Cuts off nutrients
2. To apply FS they use an acid etchant, this initially kills of the bacteria in the area

Question 19

When found fluoride be used and when is a fissure sealant used?

Answer 19

1. Fluoride - works best if smooth surfaces but poorly on fissure and pits
2. FS - works best for pits and fissures

Question 20

What teeth are Fissure sealants done (FS)

Answer 20

1. Permanent molars
2. Incisors with deep palatal pits
3. Teeth with early fissure caries

Question 21

What are the 2 types of tooth wear?

Answer 21

1. Physiological tooth wear
2. Pathological tooth wear

Question 22

What is physiological tooth wear?

Answer 22

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

Question 23

What is pathological wear?

Answer 23

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

Question 24

How is attrition tooth wear managed?

Answer 24

Wearing a mouth hard at night to stop crushing
Adjust bite so tooth rub on strongest parts

Question 25

How is abrasion tooth wear managed?

Answer 25

Ensure brushing is done correctly
Avoid abrasive toothpastes

Question 26

How is erosion tooth wear managed?

Answer 26

• Advice of reducing acid exposure
• don’t brush straight after eating (acid exposure)
• ask GP about excess vomiting, eating disorders…

Question 27

Where can acids in erosion come from?

Answer 27

Extrinsic sources:
Sugary drinks and food
Occupational exposure

Intrinsic sources:
Acid reflux (gord)
Vomiting
- these show up of the palatal and lingual surfaces

Question 28

What are the differences between dental caries and dental erosion

Answer 28

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