managing problems with saliva

Question 1

What are the investigations for salivary disease?

Answer 1

Blood tests - FBC, U&Es
Salivary flow test
Labial gland biopsy
Imaging - Ultrasound, radiographs

Question 2

Name 4 frequent somatoform diseases

Answer 2

Any from:
- oral dysaesthesia (burning mouth)
- TMD
- headache
- neck/back pain
- dyspepsia
- IBS

Question 3

What is normal salivary flow?

Answer 3

0.3-0.4ml/min when resting
1-2ml/min during stimulated flow

Question 4

What is the salivary rate for hyposalivation?

Answer 4

<0.1ml/min when resting
<0.5mil/min during stimulated flow

Question 5

Name 4 treatable causes of dry mouth

Answer 5

Any from:
- dehydration
- medicines with anti-muscarinic side effects
- medicines causing dehydration
- poor diabetes control
- somatoform disorder

Question 6

What are the investigations for testing a dry mouth?

Answer 6

Salivary flow tests - less than 1.5ml unstimulated flow in 15 minutes
Blood tests - FBC, U&E, ANA, anti La, anti Ro, C3 and C4 complement
Imaging - salivary ultrasound, sialography
Dry eyes screen - Schirmer’s test - tear flow less than 5mm wetting of test paper in 15 minutes
Labial gland biopsy of lower lip

Question 7

How can a GDP manage dry mouth?

Answer 7

Prevent oral disease - prevention
Diet advice
Topical fluoride
Treatment planning for a caries risk mouth

Question 8

Name a saliva substitute

Answer 8

Saliva orthana