Oral Care

Question 1

Amosan

Answer 1

sodium perborate - a bleach type mouth rinse for canker sores

Question 2

Amosan should be avoided because

Answer 2

contains boron which is toxic

Question 3

Zilactin

Answer 3

hydroxycellulose - protectant that coats and soothes ulcers

Question 4

Which form of canker sore has high recurrence?

Answer 4

Major form

Question 5

What are some distinguishing features of chancre sore?

Answer 5

they’re red and painless; usually resolve on its own in 2 months; highly infectious

Question 6

How long does it take to see a response with vitamin B therapy for canker sores?

Answer 6

after 4 months

Question 7

Cold sores are caused by _______ virus which resides in latent state in the ________ for lifetime.

Answer 7

HSV-1; trigeminal ganglion

Question 8

How long does it take for a healthy person to heal from cold sore?

Answer 8

2 weeks

Question 9

What are the prodromal signs of a cold sore?

Answer 9

tingling and burning up to 48 hours before recurrent outbreak

Question 10

What is considered excessive recurrence and should be referred?

Answer 10

more than 6 times per year

Question 11

First time oral lesions do not need referral. T or F

Answer 11

False

Question 12

What are some risk factors for cold sores?

Answer 12

Sun exposure, physical trauma in oral cavity, stress, illness, malnutrition, fatigue, menstruation, immunosuppression

Question 13

Topical barrier products such as petroleum jelly, _____, ______ have been shown to reduce pain from cold sores in peer reviewed RCTs. T or F

Answer 13

Zilactin, Lipactin

False

Question 14

What are the 3 topical anesthetics that have been studied for cold sores?

Answer 14

Tetracaine 1.8%; Lidocaine 2.5%; Prilocaine 2.5%

Question 15

Topical barrier products such as petroleum jelly, _____, ______ have been shown to reduce pain in peer reviewed RCTs. T or F

Answer 15

Zilactin, Lipactin

False

Question 16

How would you counsel a patient on the use of zinc for recurrent cold sores?

Answer 16

Apply within 1 hour of first symptom then q2h until crust forms or 5 days if using zinc sulfate

Question 17

What benefits can a patient with cold sore expect from topical antivirals such as acyclovir 5% cream?

Answer 17

decrease in pain duration or severity but it does not prevent lesions forming

Question 18

Bee propolis 3% ointment has been studied and it may reduce duration of cold sores. T or F

Answer 18

True

Question 19

What is the medicinal name of Abbreva?

Answer 19

Docosanol

Question 20

How do you counsel a patient on docosanol use?

Answer 20

Treatment must begin before lesion formation - within 12 hours of prodrome signs onset

Question 21

If you apply docosanol early enough you can prevent lesions formation. T or F

Answer 21

False, lesions can still occur but may reduce severity of symptoms

Question 22

What is the dosing of valacyclovir for cold sore?

Answer 22

1500mg single dose or 2g BID x 1 day or 750mg BID x 1 day

Question 23

What preventative treatment may cause nitrogen build up in liver/kidney failure?

Answer 23

Lysine

Question 24

Lysine also causes an electrolyte disturbance which is…

Answer 24

hypercalcemia

Question 25

What is the dosing of valacyclovir for preventing cold sores?

Answer 25

500mg daily x 4 months

Question 26

Top medications that induce xerostomia

Answer 26

antidepressants, antihistamines, anticholinergics, antipsychotics, BDZs, diuretics, antispasmodics, cannabis

Question 27

Dose of pilocarpine/Salagen to treat dry mouth?

Answer 27

5mg TID to QID

Question 28

Saliva output is higher during the day or at night?

Answer 28

higher during the day so you want to take drugs that are xerostomic during the day

Question 29

Pilocarpine is CI in which patients?

Answer 29

asthmatics, heart disease, GI disorders, narrow angle glaucoma, acute iritis

Question 30

Anetholtrithione is used to increase saliva flow rate and they should be taken

Answer 30

25mg tabs 1 to 2 TID

Question 31

Yohimbine MOA

Answer 31

alpha 2 blocker with cholinergic effect

Question 32

What drug is a bile-secreting stimulating agent that increase ACh and stimulates PNS?

Answer 32

Anetholtrithione

Question 33

Anetholtrithione should be taken

Answer 33

25mg tabs 1 to 2 TID

Question 34

Volatile sulphur compounds are produced by

Answer 34

bacteria breakdown of epithelial cells, saliva, serum proteins and food debris

Question 35

What is the concern with the use of topical anesthetics?

Answer 35

methemoglobinemia - hemoglobin converted to methemoglobin due to oxidative stress - can cause cyanosis, agitation, dyspnea

Question 36

A prescription medication indicated for dry mouth in Sjorgren’s and radiotherapy patients

Answer 36

Pilocarpine

Question 37

5% citric acid in glycerine drops or lemon glycerine swab sticks are not effective and should not be recommended.

Answer 37

effective but controversial

Question 38

What does saliva substitutes contain?

Answer 38

carboxymethylcellulose, calcium and phosphate ions, lactoferrin, lactoperoxidase, glucose oxidase, lysozyme