Salivation

Question 1

What does saliva do?

Answer 1

acid buffering
help with speech and swallowing
taste facultation
antibacterial

Question 2

Causes of dry mouth

Answer 2

degnerative disease of salivery glands
radiotherapy and cancer tx
drugs
anxiety and somtisation disorders
smoking
medical condtions

Question 3

Medical conditions that cause dry mouth

Answer 3

stroke
diabetes
addisons
presistent vomitng

Question 4

Drus which cause dry mouth

Answer 4

Anti-muscarinic drugs - tricyclic antidepressants, diuretics, antipsychiotics, antihistamines

Question 5

Xerostomia

Answer 5

Unstimulated salivia flow <0.1ml/min

Question 6

Direct salivary gland problems

Answer 6

Sarcoidosis - causes infiltrate within the glands and prevents it functioning nrormally
HIV disease
Cystic fibrosis
gland infiltration

Question 7

Challocombe scale

Answer 7

measures degree of mucosal dryness
1 = mirror sitcks to buccal mucosa, saliva frothy
4-6 = no salvia visible on floor of mouth and lost papille on tongue
7-10 = no saliva visble

Question 8

Invesitgations for dry mouth

Answer 8

FBC and U&E’s
Liver test
glucose
anti ro and anti la
antinuclear
ultrasound
functional assay - saliva flow
tissue assay - labial gland biopsy

Question 9

Management of dry mouth

Answer 9

Diet
high fluoride toothpaste
chew sugar free gum
freq sips of water

Question 10

Saliva subsititues

Answer 10

sprays = glandosane, saliva orthana, salivere
lozenges = salvia orthana saliva stimulating tablets (SST)
saliva stimulants = prilocarpine
oral care systems = biotene orobalance, bioxtra gel

Question 11

Causes of hypersalivation

Answer 11

Actual disease = drugs, dementia, stroke, CJD
Perceieved = anxiety, MS, motor neurone disease
Postural drooling = Cerebral palsy

Question 12

Management of hyprsalivation

Answer 12

treat anxiety
anti-muscarnic drugs
botox to prevent gland stimulation
swallowing training
surgery to salivary gland system (gland removal, duct repositioning)

Question 13

Changes in gland size caused by

Answer 13

Viral infeciton - mumps, HIV
Secretion retention - mucocele, duct obstruction
Gland hyperplasia - sialosis, Sjogren’s syndrome
salivary neoplasms

Question 14

Mumps

Answer 14

treat with fluid and analgesics
incubation period = 2-3weeks
commonest in childhood

Question 15

Mucocele

Answer 15

obstruction of minor salivary gland
common in lower lip or junction between HP and SP

Question 16

Subcute obstruction

Answer 16

major gland obstruction in submandibular gland
blockages - by stones, mucous plugging

Question 17

Invesitgations for salivary gland enlargement

Answer 17

plain radiography - parotid = OPT, oblique lateral, AP profile view of parotid
Sialography = constrast medium into ductal system (when infection free)
isotope scan if gladn function uncertain
ultrasound of duct assessment

Question 18

Management of salivary gland enlargement

Answer 18

surgical sialoath removal
saiolography for no stone cases = washing effect
consider gland removal if fixed swelling

Question 19

Sialosis

Answer 19

major gland enlargement - 1 or more major salivary gland
Associated with - eating disorders, drugs, alcohol abuse, cirrhosis, diabetes mellitus