test 2, cariology / saliva Flashcards
low secretion rate of saliva leads to:
reduced elimination of bacteria, food retention, poor neurtralization of acids, reduction of remineralization repair, increase in caries
hyposalivation
reduction in salivary flow, patients dont really notice
xerostomia
50% or more loss of salivary function. Patients notice this one
stimulated salivary secretion rate test
Pts chew wax for 5 min and saliva is collected.
normal- 1-2 ml/min
low- below .7ml/min
severe- below .1 ml/min
unstimulated salivary secretion rate test
Pt sits in chair for 10 min and saliva is collected
normal- .3-.5ml/min
anything below is abnormal
90% of saliva is produced by what 3 glands
parotid, sublingual, submandibular
the other 10% is produced by what?
thousands of minor glands
most of saliva is produced by stimulated or unstimulated
stimulated, occurs during meal time
whats resting saliva?
occurs during the rest of the day when the mouth is bathed in saliva
when does secretion peak and virutally stop?
peaks in afternoon, stops during sleep
parotid secretion is…
watery and clear
minor gland secretions are…..
viscous and ropey
sublingual/ submandibular secretions are……
2-3X more viscous than parotid
sublingual is actually mostly (mucous/serous)?
mucous
submandibular is actually mostly ( mucous/serous)?
serous
what 2 main functions does saliva have?
aids in swallowing and digestion,
maintains integrity of teeth, tongue, mucous membranes.
how does it maintaing the integrity of teeth, tongue, and mucous membranes?
forms mucoid coating , clears food and debris, regulates pH, remineralization of Ca and P, Antimicrobial/antiviral properties from IgA, Lysozymes, lactoferrin, lactoperoxidase.
what reduces salivary flow?
radiotherapy, medications, hormonal changes, diabetes, aids, sjogrens syndrome, smoking, calculi in ducts, lupus …………….
what are some consequences of xerostomia?
ulcers, mucositis, altered taste, disguesia, disphagia, rampant caries, gingivitis
why isnt pilocarpine hydrochloride a good solution?
it increases salivary flow but causes diarrhea, sweating, nausea, slow pulse rate, reduction in blood pressure………
Radiation can cause an increase in irreversible cytotoxic damage to glands. This includes what?
xerostomia, alters the oral flora shifting to aciduric and acidogenic bacteria, increase in candida infections, mucositis
does radiation alter the composition of enamel?
no, it just favors the bad guys to destroy it.
where do radiation caries usually occur?
incisal edge of anteriors, cervical margins
when Pts have radiation what kind of daily treatment are they put on to prevent rampant careis?
applications of 1% sodium fluoride gel in custom trays, also daily daily self application of chlorhexidine (this guys stains teeth:()
