Xerostomia

Question 1

Which of the three salivary glands is the most serous?

Answer 1

Parotid gland

Question 2

Which salivary gland is more mixed with serous and mucous?

Answer 2

Submandibular gland.

Question 3

Which salivary gland is mixed but is more mucous?

Answer 3

Sublingual gland

Question 4

What are the screening questions for the subjective evaluation of xerostomia?

Answer 4

1. Do you have any difficulties swallowing?
2. Does your mouth feel dry while eating a meal?
3. Do you sip liquids to help swallow dry foods?
4. Does the amount of saliva in your mouth seem too little?

Question 5

What are the causes (aetiology) of dry mouth?

Answer 5

• Polypharmacy
• Autoimmune diseases (e.g.: Sjogren’s)
• Metabolic disorders (anorexia or diabetes - constant dehydration and malnutrition)
• Dehydration
• Psychiatric issues
• Iatrogenic issues (chemo or radio)
• Developmental salivary gland disorders (rare)

Question 6

What are the clinical features of xerostomia?

Answer 6

• Difficulty in chewing, swallowing and speech
• Loss of taste and pain
• Dry and cracked lips
• Shiny, smooth-surface tongue
• Angular cheilitis can occur from dry mouth

Question 7

What are some of the treatment options for angular cheilitis?

Answer 7

• Lip balm or thick emollient ointment, applied frequently
• Topical antiseptics
• Topical or oral antistaphylococcal antibiotic
• Topical antifungal cream
• Oral antifungal medication
• Topical steroid ointment

Question 8

How do you investigate for true xerostomia?

Answer 8

Stimulated Saliva Flow Rate test where patient chews on wax for 5mins and dribbles into a cup for 1min. Less than 0.7ml/min is xerostomia.

Question 9

What are the treatment options for dry mouth/xerostomia?

Answer 9

• Neutrafleur TP 5000ppm
• Fluoride neutral pH gels (tray)
• Curasept
• Alcohol-free fluoride mouthwash
• Dietary modifications (avoid caffeine, alcohol)
• Sialogogues
• Hydrate
• Salivary substitutes like Biotene
• Proper denture hygiene
• Routine dental reviews
• Maintain good OH