Salivary Flow pt 2

Question 1

what is the normal unstimulated flow of saliva

Answer 1

0.2-0.4ml/min

Question 2

what is the normal stimulated flow of saliva

Answer 2

1-5ml/min

Question 3

what is the unstimulated flow of saliva in patients with xerostomia

Answer 3

less than 0.1ml/min

Question 4

what is the stimulated flow of saliva in patients with xerostomia

Answer 4

less than 0.5ml/min

Question 5

for saliva flow to fall below 50% of the normal levels, what must happen

Answer 5

there must be loss of function of more than one major salivary gland

Question 6

what are some general conditions that could affect the salivary glands

Answer 6

fluid and electrolyte loss

Question 7

how many drugs cause dry mouth

Answer 7

over 400

Question 8

what is the BNF

Answer 8

british national formulary

Question 9

what is smooth surface caries related to

Answer 9

reduced salivary flow and clearance

Question 10

what are the oral functions that become impaired by xerostomia

Answer 10

chewing
swallowing
speaking
diminished taste perception

Question 11

what are some protective components that are lost due to decreased salivary flow

Answer 11

• antimicrobial agents
• less buffering
• mucins and other proteins
• gustin

Question 12

are the absolute flow rates set

Answer 12

no they can vary - consider the functional aspects

Question 13

which questions, when answered with yes, suggest hypofunction of the salivary glands

Answer 13

• does your mouth feel dry when eating a meal
• do you have difficulty swallowing any foods
• do you sip liquids to help swallow dry food
• does the amount of saliva in your mouth feel too little

Question 14

how can you manage xerostomia if there is still a functional salivary gland

Answer 14

chewing or through drugs

Question 15

which drugs stimulate saliva flow

Answer 15

sialogogues

Question 16

when there is no functioning gland tissue remaining in someones mouth, what can be used to manage the xerostomia

Answer 16

• taking saliva substites that are either mucin or cellulose based.
• water alone is not effective

Question 17

is the saliva flow static

Answer 17

no

Question 18

where is salivary flow higher in the mouth

Answer 18

in lower lingual regions

Question 19

where is salivary flow lower in the mouth

Answer 19

labial and buccal regions

Question 20

where are cariogenic sugars retained longer in the mouth

Answer 20

in regions where the flow is slowest

Question 21

how does saliva flow in the mouth

Answer 21

horizontally, it moves toward the back of the mouth if it is from the sublingual gland
submandibular saliva washes over the anterior teeth with aid from minor mucous secretions
parotid washes over the posterior teeth

Question 22

which factors affect clearance

Answer 22

salivary film velocity and location in the mouth

Question 23

what are the important oral health aspects of clearance in the mouth

Answer 23

• removal of harmful materials
• retention of beneficial materials

Question 24

what is dawes rule

Answer 24

stimulus leads to salivary flow, making the residual volume accumulate and trigger swallowing, and the residual is then returned

Question 25

how is clearance of harmful substances increased

Answer 25

by high salivary flow

Question 26

how is retention of beneficial substances improved

Answer 26

by reduced salivary flow rates

Question 27

what are the beneficial substances that we do not want to be cleared from the mouth

Answer 27

fluoride and chlorhexidine

Question 28

why should fluoride tablets be sucked on rather than chewed

Answer 28

to prevent stimulation of saliva flow, and keep clearance to a minimum

Question 29

what is the stephan curve

Answer 29

a graph of the plaque pH change over time

Question 30

how do plaque microorganisms generate acid

Answer 30

by metabolising sugars like sucrose

Question 31

how does gum stimulation affect pH

Answer 31

it rises by 0.5 pH unit and this persists for a long time

Question 32

what type of gum increases salivary pH to above 1 pH unit

Answer 32

bicarbonate containing gum

Question 33

does gum chewing remove plaque

Answer 33

no

Question 34

what are the types of alternative sweeteners

Answer 34

• bulk caloric, low caloric
• non calory, high intensity

Question 35

what are the bulk, cariogenic sweeteners

Answer 35

sucrose
fructose
glucose
lactose

Question 36

what are the low caloric sweetenders

Answer 36

mannitol
sorbitol
xylitol

Question 37

what are the non caloric sweeteners

Answer 37

aspartame
cyclamates
saccharin
sucralose

Question 38

which sweetenders are non cariogenic relative to sucrose

Answer 38

the low caloric and non caloric sweeteners

Question 39

at what flow rate will patients begin to complain of dry mouth

Answer 39

50%

Question 40

name the stimulants that go to the salivary centres to increase saliva flow

Answer 40

• higher centres
• masticatory afferents
• gustatory afferents

Question 41

what does sympathetic effect of salivary flow lead to

Answer 41

constriction, greater flow

Question 42

what does parasympathetic effect of salivary flow lead to

Answer 42

dilation, greater flow

Question 43

describe the two stage mechanism of ductal modification

Answer 43

• primary saliva is modified as it passes through striated ducts
• reabsorption of sodium and chlorine
• secretion of potassium and bicarbonate
• final saliva hypotonic to plasma
• some proteins secreted by ducts