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BDS4 Oral Medicine > Problems with Salivation > Flashcards

Problems with Salivation Flashcards

1
Q

what are four actions of saliva

A

acid buffering
mucosal lubrication
taste facilitation
antibacterial

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2
Q

give five examples of causes of dry mouth

A

salivary gland disease
drugs
radiotherapy and cancer treatments
anxiety disorders
medical conditions

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3
Q

what is meant by a medical condition having an indirect effect on dry mouth

A

the problem is external to the gland

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4
Q

what is meant by a medical condition having a direct effect on dry mouth

A

problem is within the gland itself

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5
Q

give 5 examples of drugs that cause the indirect effect of dry mouth

A

antimuscarinic cholinergic drugs
antihistamine
atropine
diuretics
cytotoxics

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6
Q

what are two examples of antimuscarinic cholinergic drugs

A

tricyclic antidepressants
antipsychotics

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7
Q

give four examples of medical conditions associated with causing indirect affect for dry mouth

A

diabetes
renal disease
addison’s disease
vesiculobullous disease

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8
Q

name 5 examples of conditions that affect salivary glands directly and cause dry mouth

A

aplasia
sarcoidosis
HIV
gland infiltration
cystic fibrosis

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9
Q

what is ectodermal dysplasia

A

occurs when the outer layer of tissue - the ectoderm - of the embryo does not develop normally - affects salivary glands

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10
Q

what is sarcoidosis

A

a condition that causes abnormal collection of inflammatory cells to form clumps in lungs, skin or lymph nodes

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11
Q

how is sarcoidosis linked to decreased salivary flow rate

A

causes swelling in the salivary glands

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12
Q

how is HIV linked to decreased salivary flow rate

A

HIV can present with salivary gland increased in bulk but a reduced function

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13
Q

what is amyloidosis

A

protein called amyloid builds up in the organ/ gland

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14
Q

what is haemochromatosis

A

deposition of iron in the gland (will show high Ferritin in the blood)

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15
Q

why might radiation be associated with decreased salivary flow rate

A

antineoplastic drugs and iodine can accumulate in the glands

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16
Q

what is the name of the scale used to assess mucosal dryness

A

Challacombe scale

17
Q

what would scoring 1 on the challacombe scale suggest clinically

A

mirror sticks to buccal mucosa

18
Q

what would scoring 2 on the challacombe scale suggest clinically

A

mirror sticks to the tongue

19
Q

what would scoring 3 on the challacombe scale suggest clinically

A

saliva frothy

20
Q

what are stages 1-3 on the challacombe scale managed with

A

sugar free chewing gum for 15 mins, twice daily and attention to hydration

21
Q

what would scoring 4 on the challacombe scale suggest clinically

A

no saliva pooling in the floor of the mouth

22
Q

what would scoring 5 on the challacombe scale suggest clinically

A

tongue shows generalised shortened papillae

23
Q

what would scoring 6 on the challacombe scale suggest clinically

A

altered gingival architecture (smooth)

24
Q

what are stages 4-6 of challacombe scale managed with

A

sugar free chewing gum or simple sialogogues
investigation as to why there is decreased saliva
saliva substitutes and topical fluoride

25
Q

what would scoring 7 on the challacombe scale suggest clinically

A

glassy appearance of oral mucosa, especially the palate

26
Q

what would scoring 8 on the challacombe scale suggest clinically

A

tongue lobulated/ fissured

27
Q

what would scoring 9 on the challacombe scale suggest clinically

A

cervical caries on more than 2 teeth

28
Q

what would scoring 10 on the challacombe scale suggest clinically

A

debris on palate on sticking to teeth

29
Q

what would stages 7-10 on the challaocmbe scale be managed with

A

saliva substitutes and topical fluoride
refer for investigation and diagnosis

30
Q

what blood tests can be used to assess decreased salivary flow rate

A

FBC
U&Es
liver function tests
C-reactive protein

31
Q

what immunological tests can be used to assess decreased salivary flow rate

A

glucose
anti-Ro andtibody
anti-La antibody
antinuclear antibody
complement C3 and C4

32
Q

what types of assay can be used to assess decrease in salivary flow rate

A

functional assay
tissue assay

33
Q

what types of imaging can be used to assess a decrease in salivary flow rate

A

plain radiographs to assess for stones
sialography
MR sialography with IV contrast
ultrasound

34
Q
A

BDS4 Oral Medicine (22 decks)

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