Modulation of Salivary Gland Function Flashcards
Acute or chronic reduced salivary flow may be due to:
Mechanical blockage, dehydration, emotional stress, infection of the salivary glands, local surgery, avitaminosis, diabetes, anemia, connective tissue disease, congenital factors, radiation therapy, Sjogren’s syndrome, medications.
Drug induced xerostomia is a concern because:
- older adults take more prescription and non-prescription drugs
- Over 400 medications are implicated in causing xerostomia
- oral health impact of xerostomia is consequential
Drug categories implicated in causing xerostomia include:
sympathomimetics, diuretics, cardiovascular meds, anticholinergics, tricyclic antidepressants, antihistamines, psychotropic agents, antiparkinson agents, antineoplastic drugs, muscle relaxants.
Herbal preparations that can induce xerostomia:
St. John’s wort, Gingko Biloba
Factors contributing to increased caries susceptibility:
-decreased titers of antimicrobial substances and loss of mineralizing components and shift to more cariogenic bacteria.
Caries in xerostomic pts most likely to occur near:
gingival margins and on exposed root surfaces.
Xerostomia presents clinically with:
Periodontal problems, altered taste sensation, mouth soreness
Xerostomia is associated with:
oral pain, increased oral infections, difficulty speaking, chewing and swallowing.
Xerostomia tx is important to:
keep mouth moist, prevent caries, candida infections, and provide palliative relief.
Palliative measures for xerostomia include:
- sipping water
- avoiding mouth rinses with alcohol
- ice melting
- limit caffeine
- humidifying sleeping area
- vaseline on lips
Rx Saliva Substitute:
Sodium Carboxymethylcellulose 0.5%
- 8 fl oz
- rinse prn
Commercial saliva substitutes:
Xero-lub, Salivart, Moi-Stir, Orex
Rx fluoride therapy:
Stannous fluoride gel 0.4%
- 24 ml
- 5-10 mins/day in carrier (5-10 drops)
What should be considered if poorly tolerated taste or ceramic restorations present?
Use of neutral pH sodium fluoride gel 1%
Rx neutral sodium fluoride gel:
- 1%
- 24 ml
- 1 drop/tooth in tray, 5 mins daily
- Avoid rinsing/eating 30 mins.
No more than ____ NaF should be dispensed in one container.
264 mg
24 ml is approx:
2 week supply of gel
Antifungal Rx
Nystatin (topical) or Fluconazole (systemic)
Saliva stimulants like _____ may temporarily stimulate salivary flow.
sugarless gum or dissolving mints
Parasympatholytics
decrease saliva secretion