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Oral Med > Xerostomia and BMS > Flashcards

Xerostomia and BMS Flashcards

1
Q

What is xerostomia

A

abnormal reduction of saliva

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2
Q

What should saliva output be

A

1.5ml/15min

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3
Q

name 3 local factors that can cause xerostomia

A

tobacco, alcohol, mouth breathing

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4
Q

what is the most common cause of xerostomia

A

an adverse side effect of medications (drug-induced)

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5
Q

what else could xerostomia be caused by

A

symptom of certain diseases

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6
Q

what do you always ask about when a patient has xerostomia + why

A

eyes because this would suggest sjogren’s syndrome

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7
Q

Name 7 classes of medicaitons that can cause xerostomia

A
  • Tricyclic antidepressants,
  • antipsychotics,
  • benzodiazepine,
  • beta-blockers,
  • antihistamines,
  • anticholinergics
  • decongestants
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8
Q

Which patients are more likely to experience drug-induced xerostomia?

A

Elderly patients and those treated for hypertension or mental illness.

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9
Q

How can certain medications be used to treat hyper-salivation?

A

Medications that induce xerostomia can be used to reduce saliva in hyper-salivating patients.

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10
Q

What oral condition can chemotherapy cause, apart from xerostomia?

A

Oral mucositis, which involves burning, inflammation, and ulceration of the mouth.

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11
Q

How does radiotherapy cause xerostomia?

A

It causes direct damage to salivary tissue, especially in the parotid glands, which are highly vulnerable to radiation.

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12
Q

Which symptom is xerostomia often associated with during chemotherapy?

A

Dysgeusia (altered taste), dysphagia (swallowing difficulties), and dysphonia (abnormal voice).

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13
Q

What factor determines the severity of xerostomia after radiotherapy?

A

The degree of exposure of the salivary tissue to radiation.

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14
Q

Which disease associated with xerostomia can lead to Marginal Zone B Cell Malignant Lymphoma?

A

Sjogren’s syndrome.

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15
Q

Name 5 other conditions that can cause xerostomia.

A

Diabetes
HIV
sarcoidosis
Chronic graft vs host disease
salivary gland agenesia (v rare)

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16
Q

What is sialectasis?

A

Sialectasis is the cystic dilation of the ducts of salivary glands.

17
Q

Which routine tests are part of xerostomia investigations?

A
  • PCO, HPC
  • MH, drug history
  • FBC – haematinics, LFT, U+Es
  • Salivary flow rate
  • Immunology
  • Labial gland biopsy
  • Sialography
  • Ultrasound
18
Q

What is a labial gland biopsy used for?

A

To confirm xerostomia diagnosis and assess gland health.

19
Q

What is sialography?

A

Radiographic imaging of salivary glands, used to detect duct obstructions.

20
Q

What are common symptoms of xerostomia?

A

Need for frequent water, dry mouth, difficulty in speech/swallowing, altered taste.

21
Q

What is a common clinical sign of xerostomia on examination?

A

Sticky mucosa, mirror sticks to mucosa.

22
Q

How does xerostomia increase caries risk?

A

Reduced saliva leads to less enamel protection, especially in cervical regions.

23
Q

Why are xerostomic patients prone to Candida infections?

A

Dryness creates an environment for Candida overgrowth.

24
Q

How can salivary gland infections in xerostomia be managed?

A

With antibiotics like amoxicillin and clindamycin.

25
Q

Name two saliva substitute products for xerostomia.

A

BioTene, BioXtra.

26
Q

What are Salivix pastilles used for?

A

To stimulate saliva in xerostomic patients.

27
Q

When is pilocarpine hydrochloride prescribed for xerostomia?

A

For severe cases, typically in Sjogren’s syndrome or head/neck cancer patients.

28
Q
A
29
Q

Which blood tests are specific to Sjogren’s diagnosis?

A

Anti-Ro, Anti-La antibodies.

30
Q

What is the prognosis concern with Sjogren’s syndrome?

A

Increased risk of B cell non-Hodgkin’s lymphoma.

31
Q

What is burning mouth syndrome?

A

A burning, stinging sensation in the mouth with no local/systemic cause.

32
Q

Who is typically affected by burning mouth syndrome?

A

Middle-aged females, often 50-60 years old.

33
Q

How is burning mouth syndrome diagnosed?

A

By exclusion of other causes (normal oral mucosa, no systemic disease).

34
Q

What are common treatments for burning mouth syndrome?

A

Reassurance, clonazepam, amitriptyline, CBT

35
Q

What is oral malodour commonly caused by?

A

Oral biofilm, dry mouth, poor oral hygiene, smoking, certain foods

36
Q

Which organisms are implicated in oral malodour?

A

P. gingivalis, Prevotella intermedia, F. nucleatum, T. denticola

37
Q

What is the organoleptic method for assessing halitosis?

A

Smelling the patient’s breath by nose and mouth.

38
Q

What are key management steps for oral malodour?

A

Good oral hygiene, avoiding certain foods, regular meals, using tongue scrapers.

Oral Med (10 decks)

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