Teeth and Salivary Glands

Question 1

3 major pairs of salivary glands

Answer 1

sublingual
submandibular
parotids

Question 2

Causes of acute bilateral gland Sx (5)

Answer 2

mumps-ask about vaccinations
TB
HIV
Staphs
ALL

Question 3

Causes of acute unilateral gland Sx (2)

Answer 3

mumps

ascending oral infection

Question 4

Cause of recurrent unilateral Sx and features and Rx (5)

Answer 4

stones

submandibular most common-more mucinous

presents w. red, swollen, tender gland

if pus is present near incisors this indicates secondary submandibular gland infection

Rx:removal of stones. via mouth if distal. excise if still within gland.

Question 5

Causes of chronic bilateral gland Sx (2)

Answer 5

Sjogren’s (eye/mouth dryness)

Sarcoid

Question 6

Common site and Mx of salivary gland tumours

Answer 6

mainly in parotid gland

remove any lump lasting >1mo

Question 7

Histology of salivary gland tumours (3)

Answer 7

benign pleiomorphic adenomas most common

adenolymphoma

carcinoma (mucoepidermoid, adenoid cyst):

• rapid growth
• hard, fixed mass
• painful
• facial palsy

(NB hard mass w. nerve invasion likely to be ca.)

Question 8

Presentation of dentistry dysfunction (4)

Answer 8

tooth pain

trismus-pain on opening mouth (=severe infection)

facial swelling

systemic upset

Question 9

Causes of painful teeth (3)

Answer 9

tooth alive (pulpitis):

• exacerbated by sugar/heat
• better/worse w. cold
• intermittent pain

tooth dead (osteitis/abscess)

• constant pain
• worse w. percussion

abscess:
-worse when moved between finger and thumb

Question 10

Pathology of dental caries (2)

Answer 10

tooth decay

due to bacteria (strep mutans) and sugar

Question 11

Features of rampant caries

Answer 11

seen in children exposed to excess sucrose

Question 12

Features and Rx of radiation caries (4)

Answer 12

occurs after head and neck radiotherapy
may occur w. osteonecrosis of jaw
pain>ibuprofen
infection>penicillin and metronidazole

Question 13

Vincent’s anginga; features, assoc. and Rx (6)

Answer 13

necrotising ulcerative gingivitis
assoc. w. HIV and smoking
Rx w. penicillin+metronidazole, chlorhexidine mouthwash and paracetemol

Question 14

Causes of gingival swelling (5)

Answer 14

AML/CML
HIV
pregnancy
drugs: ciclosporin, phenytoin, nifedipine
congenital fibrous hyperplasia

Question 15

Features of malocclusion

Answer 15

inappropriate positioning of teeth and jaw

Question 16

Wisdom teeth features (2)

Answer 16

can occur in early adulthood

cause problems w. impaction

Question 17

Ludwig’s angina features (3)

Answer 17

symmetrical, tender swelling of floor of mouth and upper neck
due to dental infection
life threatening