Managing Problems with Saliva Flashcards
what resting flow does a patient with dry mouth have?
<0.1mL/min
what stimulated flow does a patient with dry mouth have?
<0.5ml/min
what resting flow does a patient with a normal mouth have?
0.3-0.4mL/min
what stimulated flow does a patient with normal mouth have?
1-2mL/min
what are some treatable causes of dry mouth?
- dehydration
- medicines with anti-muscarinic side effects
- medicines causing dehydration
- poor diabetes control
- somatoform disorder
what investigations should be carried out in patients presenting with dry mouth?
- blood tests
- imaging
- dry eyes screen
- tissue exam
what causes of dry mouth only have symptomatic treatment?
- Sjogrens Syndrome
- dry mouth from cancer treatment
- dry mouth from salivary gland disease
What blood tests should be taken when investigating dry mouth?
- Dehydration = U&Es, glucose
- Autoimmune disease = ANA, Anti-Ro, Anti-La
- Complement levels = c3 and c4
what imagine tests should be done when investigating dry mouth?
- Salivary ultrasound (looking for ‘leopard spots’)
- Sialography
what is the dentists role in management of the dry mouth?
PREVENTION!!!
- diet info
- fluoride application
- treatment planning for a high caries risk mouth
what are some examples of salivary substitues?
- glandosane
- saliva orthana
- bioxtra
what are some causes of “hypersalivation”?
Swallowing failure
- anxiety
- stroke
- motor neurone disease
- MS
Postural drooling
- babies
- cerebral palsy
What drugs can be given to reduce salivation?
- Anti-muscarinic agents
- Botox to prevent gland stimulation
How might a dentist deal with excess saliva in a patient?
- treat any anxiety disorder
- drugs (botox or anti-muscarinic agent)
- swallowing control training
- gland removal
- duct repositioning
