Managing Problems With Saliva

Question 1

how do you investigate salivary disease?

Answer 1

Blood tests (FBC, U&Es, Liver function tests, glucose, antibody)

Salivary flow rate

Gland biopsy

Imaging: radiographs, sialography, ultrasound

Question 2

whats the approximate normal & hyposalivation RESTING flow rates?

Answer 2

Normal: 0.3-0.4mL/min
Hyposalivation: <0.1mL/min

Question 3

whats the approximate normal & hyposalivation STIMULATED flow rates?

Answer 3

Normal: 1-2mL/min
Hyposalivation: <0.5mL/min

Question 4

what are the treatable causes of dry mouth?

Answer 4

• Dehydration
• Medicines with antimuscarinic side effects
• Medicines causing dehydration
• Poor diabetes control

Management of these should return the patient’s oral comfort

Question 5

what is the dentists management of dry mouth?

Answer 5

PREVENT ORAL DISEASE
- caries risk assessment
- candida/staphylococcus reduction - low sugar diet and OHI (sore tongue & angular cheilitis)

Question 6

what are some saliva substitutes?

Answer 6

glandosane (spray)
saliva orthana (lozenges)
Frequent sips of water