Dry Mouth and Sjorgren's disease

Question 1

saliva function

Answer 1

acid buffering
mucosa lubrication
- speech
- swallowing
taste facilitation
antibacterial/antifungal
digestive

Question 2

causes of dry mouth

Answer 2

dehydration
drugs
age
smoking
alcohol
radiotherapy and cancer treatment
anxiety
salivary gland disease

Question 3

describe how age affects salivary production

Answer 3

acinar tissue loss (structural)
metabolic and functional change
older glands more affected by other factors which reduce salivary production

Question 4

drugs which reduce salivary gland function

Answer 4

amphetamines
- ADHD
anticonvulsants
antidepressants
antihistamines
antineoplastic drugs
antiparkinsonian
antipsychotics
antiretrovirals
diuretics
antihypertensives
muscle relaxants
opined analgesics
benzodiazepines

Question 5

drugs which cause significant reduction in salivary production

Answer 5

amitriptyline
- 26% reduction
diuretics
lithium
- 70% have a significant reduction

Question 6

systemic diseases which can lead to dehydration

Answer 6

chronic
- diabetes mellitus
- renal failure /cardiac failure
- hypercalcaemia
- diabetes insipidus
- Addison’s disease

acute
- haemorrhage
- persistent vomiting

Question 7

Sjorgrens disease eye system

Answer 7

persistent troublesome dry eyes >3 months
recurrent sensation of sand/gravel in eyes

Question 8

Sjogrens oral symptoms

Answer 8

daily feeling of a dry mouth for > 3 months
recurrent swelling of salivary glands as an adult
difficulty eating dry foods e.g. cream crackers

Question 9

Sjogren’s disease head and neck complications

Answer 9

oral infection
caries risk
functional loss
- speech
- swelling
dentire retention
salivary lymphoma

Question 10

What is Sjorgren’s disease and what can it affect?

Answer 10

multisystem autoimmune disease
can affect
CNS
- fatigue, peripheral and CN neuropathies
skin
- xeroderma, rashes
vascular
- Raynaud’s syndrome
eyes
- corneal ulcers, keratoconjunctivitis sicca
respiratory
- chronic cough/hoarseness
GI
- dysphagia
- pancreatic insufficiency
haematological
- anaemia
muscolosketal
GU
- vaginal dryness and dyspareunia

Question 11

How to assess dry mouth

Answer 11

gland palpation
duct expression
challacombe scale

Question 12

dry mouth management

Answer 12

treat underlying cause
preventative care
symptomatic relief
artificial saliva products

Question 13

simple lifestyle measures to manage Sjogrens

Answer 13

moist, oily foods
humidify home environment
omega 3 supplements
regular exercise
glasses/goggles to reduce tear evaporation