Xerostomia

Question 1

Challacombe scale tests (5)

Answer 1

Mirror sticks to BM
Mirror sticks to tongue
Frothy
No pooling
Smooth tongue

Question 2

Functions of saliva (4)

Answer 2

Acid buffering
Antibacterial
Speech/swallow
Taste

Question 3

Causes of a dry mouth (5)

Answer 3

Salivary gland disease - Sjogrens (autoimmune)
Drugs
Medical conditions
Direct salivary gland issues
Anxiety/dehydration - altered saliva secretion by brain

Question 4

Drugs that can cause dry mouth examples (4)

Answer 4

Tricyclic antidepressants - Amitriptyline
Antipsychotics
Antihistamines
Diuretics

Question 5

Medical conditions that can cause dry mouth examples (4)

Answer 5

Diabetes
Stroke
Addisons - decreased cortisol
VBDs

Question 6

Direct Salivary gland issue examples (5)

Answer 6

Ectodermal dysplasia
Sarcoidosis
HIV
CF
Radiotherapy/cancer tx

Question 7

Salivary gland disease examples

Answer 7

Sjogrens
Sialolith- salivary stone
Salivary gland tumours

Question 8

List investigations for salivary disease

Answer 8

1. Bloods
   - U+Es,FBCs,LFTs,C3+C4, glucose,antiro/la
2. Functional assay
   - salivary flow <1.5ml in 15mins
3. Tissue assay
   - Labial gland biopsy
4. Imaging - US/sialography
5. Dry eyes - schemer test

Question 9

Causes of salivary gland enlargement

Answer 9

Viral inflammation - HIV/mumps
Secretion retention - mucocele/duct obstruction
Gland hyperplasia - Sialolis

Question 10

Define sialolis

Answer 10

Chronic painless bilateral swelling of parotid glands

Question 11

Symptoms of mucocele

Answer 11

Recurrent swelling bursts, salty taste, usually from trauma to lower lip

Question 12

What is dry mouth?

Answer 12

Xerostomia
Term used to describe decreased amount of saliva (sometimes normal amount)

Question 13

What are the symptoms?

Answer 13

Dry burning sensation
Difficulty swallowing, eating,talking,denture retention
Bad breath
Altered taste

Question 14

Management of dry mouth

Answer 14

Management depends on the cause
1. Liaise with GP if med related + may take bloods to rule out other causes (autoimmune disease/gland obstruction)
2. Salivary stimulation
- Sugar free gum/pastilles
- Ice chips
- Frequent sips of water
- Pilocarpine (sweating/taccychardia)

3. OH + diet
   - Important as inc risk of caries/gingivitis/infections
   - Low sugar diet + avoid acidic drinks
   - Brush 2x daily
   - Take dentures out
   - Can prescribe higher F toothpaste