Problems with Salivation Flashcards
what are four actions of saliva
acid buffering
mucosal lubrication
taste facilitation
antibacterial
give five examples of causes of dry mouth
salivary gland disease
drugs
radiotherapy and cancer treatments
anxiety disorders
medical conditions
what is meant by a medical condition having an indirect effect on dry mouth
the problem is external to the gland
what is meant by a medical condition having a direct effect on dry mouth
problem is within the gland itself
give 5 examples of drugs that cause the indirect effect of dry mouth
antimuscarinic cholinergic drugs
antihistamine
atropine
diuretics
cytotoxics
what are two examples of antimuscarinic cholinergic drugs
tricyclic antidepressants
antipsychotics
give four examples of medical conditions associated with causing indirect affect for dry mouth
diabetes
renal disease
addison’s disease
vesiculobullous disease
name 5 examples of conditions that affect salivary glands directly and cause dry mouth
aplasia
sarcoidosis
HIV
gland infiltration
cystic fibrosis
what is ectodermal dysplasia
occurs when the outer layer of tissue - the ectoderm - of the embryo does not develop normally - affects salivary glands
what is sarcoidosis
a condition that causes abnormal collection of inflammatory cells to form clumps in lungs, skin or lymph nodes
how is sarcoidosis linked to decreased salivary flow rate
causes swelling in the salivary glands
how is HIV linked to decreased salivary flow rate
HIV can present with salivary gland increased in bulk but a reduced function
what is amyloidosis
protein called amyloid builds up in the organ/ gland
what is haemochromatosis
deposition of iron in the gland (will show high Ferritin in the blood)
why might radiation be associated with decreased salivary flow rate
antineoplastic drugs and iodine can accumulate in the glands
what is the name of the scale used to assess mucosal dryness
Challacombe scale
what would scoring 1 on the challacombe scale suggest clinically
mirror sticks to buccal mucosa
what would scoring 2 on the challacombe scale suggest clinically
mirror sticks to the tongue
what would scoring 3 on the challacombe scale suggest clinically
saliva frothy
what are stages 1-3 on the challacombe scale managed with
sugar free chewing gum for 15 mins, twice daily and attention to hydration
what would scoring 4 on the challacombe scale suggest clinically
no saliva pooling in the floor of the mouth
what would scoring 5 on the challacombe scale suggest clinically
tongue shows generalised shortened papillae
what would scoring 6 on the challacombe scale suggest clinically
altered gingival architecture (smooth)
what are stages 4-6 of challacombe scale managed with
sugar free chewing gum or simple sialogogues
investigation as to why there is decreased saliva
saliva substitutes and topical fluoride
what would scoring 7 on the challacombe scale suggest clinically
glassy appearance of oral mucosa, especially the palate
what would scoring 8 on the challacombe scale suggest clinically
tongue lobulated/ fissured
what would scoring 9 on the challacombe scale suggest clinically
cervical caries on more than 2 teeth
what would scoring 10 on the challacombe scale suggest clinically
debris on palate on sticking to teeth
what would stages 7-10 on the challaocmbe scale be managed with
saliva substitutes and topical fluoride
refer for investigation and diagnosis
what blood tests can be used to assess decreased salivary flow rate
FBC
U&Es
liver function tests
C-reactive protein
what immunological tests can be used to assess decreased salivary flow rate
glucose
anti-Ro andtibody
anti-La antibody
antinuclear antibody
complement C3 and C4
what types of assay can be used to assess decrease in salivary flow rate
functional assay
tissue assay
what types of imaging can be used to assess a decrease in salivary flow rate
plain radiographs to assess for stones
sialography
MR sialography with IV contrast
ultrasound
