Intro to Oral Med Flashcards
What are the functions of saliva?
- Acid buffering
- Mucosal lubrication (speech, swallowing)
- Taste facilitation
- Antibacterial
- Digestive
What are the causes of xerostomia (dry mouth)?
- Salivary gland disease
- Age, smoking, alcohol
- Medication
- Medical conditions (diabetes, stroke etc) & dehydration (renal)
- Radiotherapy
- Anxiety/ somatisation disorders
What diseases/ conditions can directly cause salivary gland disease?
- Aplasia (e.g. ectodermal dysplasia)
- HIV (lympho-epithelial cysts, focal lymphocytic sialadenitis- focal collection of lymphocytes)
- Gland infiltrations (e.g. sarcoidosis- granulomas, amyloidosis- protein, haemochromatosis- iron)
- Cystic fibrosis (autosomal recessive inheritance)- ALL exocrine glands affected
What are some medications that can induce xerostomia (dry mouth)?
- Anti-depressants = amitriptyline- tricyclic, citalopram- SSRI
- Antipsychotics
- Antihistamines
- Anticonvulsants = carbamazepine, gabapentin
- Diuretics (dehydration)
Which chronic medical problems cause dry mouth?
- Diabetes (insipidus & mellitus)
- Renal disease
- Stroke (medications)
- Addison’s disease
- Persistent vomiting
Which acute conditions cause dry mouth?
- Vesicullobullous diseases
- Shock (haemorrhage, burns)
What is primary Sjogren’s syndrome?
Just gland problems, not CT disease
What is secondary Sjogren’s syndrome?
Gland problems with CT disease (e.g. SLE, RA, scleroderma)
Name a criteria used to diagnose Sjogren’s?
Modified American-European Criteria
What are the criteria for the MAEC of Sjogren’s?
- Subjective dry eyes (“gravel in eyes”)
- Objective dry eyes (Schirmer test <5mm in 5 mins)
- Subjective dry mouth (>3 months, Shallacom scale)
- Objective dry mouth (<1.5ml in 15mins)
- Auto-antibody findings (anti-Ro/La)
- Histopathological findings (+ve labial gland biopsy)
Describe a classic appearance of Sjogren’s seen on a sialography
- ‘Leopard-spots appearance’
- ‘Snow-storm appearance’
==> appearance of punctate sialectasis
What are the treatment options for dry mouth?
- Identify and treat underlying cause
- -> correct hydration, modify drug regime, control diabetes, somatoform disorders
- Prevent progression of oral disease
- -> caries mamagement, F regime, diet mod
- Saliva substitutes (sprays, lozenges, salivary stimulants, oral car systems)
What are the two categories that hypersalivation can be divided into?
- True (stroke, degenerative disease- CJD, Ms, Alzheimer’s)
- Perceived (swallowing reflex inhibited, anxiety disorders)
What is a mucocele?
- Traumatic lesion to minor salivary gland
- Causing a swelling containing saliva
- Commonly seen in the lower lip
- 2 types = extravasation or retention
What is a ranula?
- Descriptive term for mucocele seen on FOM
- Commonly sublingual extravasation