Xerostomia and BMS Flashcards
What is xerostomia
abnormal reduction of saliva
What should saliva output be
1.5ml/15min
name 3 local factors that can cause xerostomia
tobacco, alcohol, mouth breathing
what is the most common cause of xerostomia
an adverse side effect of medications (drug-induced)
what else could xerostomia be caused by
symptom of certain diseases
what do you always ask about when a patient has xerostomia + why
eyes because this would suggest sjogren’s syndrome
Name 7 classes of medicaitons that can cause xerostomia
- Tricyclic antidepressants,
- antipsychotics,
- benzodiazepine,
- beta-blockers,
- antihistamines,
- anticholinergics
- decongestants
Which patients are more likely to experience drug-induced xerostomia?
Elderly patients and those treated for hypertension or mental illness.
How can certain medications be used to treat hyper-salivation?
Medications that induce xerostomia can be used to reduce saliva in hyper-salivating patients.
What oral condition can chemotherapy cause, apart from xerostomia?
Oral mucositis, which involves burning, inflammation, and ulceration of the mouth.
How does radiotherapy cause xerostomia?
It causes direct damage to salivary tissue, especially in the parotid glands, which are highly vulnerable to radiation.
Which symptom is xerostomia often associated with during chemotherapy?
Dysgeusia (altered taste), dysphagia (swallowing difficulties), and dysphonia (abnormal voice).
What factor determines the severity of xerostomia after radiotherapy?
The degree of exposure of the salivary tissue to radiation.
Which disease associated with xerostomia can lead to Marginal Zone B Cell Malignant Lymphoma?
Sjogren’s syndrome.
Name 5 other conditions that can cause xerostomia.
Diabetes
HIV
sarcoidosis
Chronic graft vs host disease
salivary gland agenesia (v rare)
What is sialectasis?
Sialectasis is the cystic dilation of the ducts of salivary glands.
Which routine tests are part of xerostomia investigations?
- PCO, HPC
- MH, drug history
- FBC – haematinics, LFT, U+Es
- Salivary flow rate
- Immunology
- Labial gland biopsy
- Sialography
- Ultrasound
What is a labial gland biopsy used for?
To confirm xerostomia diagnosis and assess gland health.
What is sialography?
Radiographic imaging of salivary glands, used to detect duct obstructions.
What are common symptoms of xerostomia?
Need for frequent water, dry mouth, difficulty in speech/swallowing, altered taste.
What is a common clinical sign of xerostomia on examination?
Sticky mucosa, mirror sticks to mucosa.
How does xerostomia increase caries risk?
Reduced saliva leads to less enamel protection, especially in cervical regions.
Why are xerostomic patients prone to Candida infections?
Dryness creates an environment for Candida overgrowth.
How can salivary gland infections in xerostomia be managed?
With antibiotics like amoxicillin and clindamycin.
Name two saliva substitute products for xerostomia.
BioTene, BioXtra.
What are Salivix pastilles used for?
To stimulate saliva in xerostomic patients.
When is pilocarpine hydrochloride prescribed for xerostomia?
For severe cases, typically in Sjogren’s syndrome or head/neck cancer patients.
Which blood tests are specific to Sjogren’s diagnosis?
Anti-Ro, Anti-La antibodies.
What is the prognosis concern with Sjogren’s syndrome?
Increased risk of B cell non-Hodgkin’s lymphoma.
What is burning mouth syndrome?
A burning, stinging sensation in the mouth with no local/systemic cause.
Who is typically affected by burning mouth syndrome?
Middle-aged females, often 50-60 years old.
How is burning mouth syndrome diagnosed?
By exclusion of other causes (normal oral mucosa, no systemic disease).
What are common treatments for burning mouth syndrome?
Reassurance, clonazepam, amitriptyline, CBT
What is oral malodour commonly caused by?
Oral biofilm, dry mouth, poor oral hygiene, smoking, certain foods
Which organisms are implicated in oral malodour?
P. gingivalis, Prevotella intermedia, F. nucleatum, T. denticola
What is the organoleptic method for assessing halitosis?
Smelling the patient’s breath by nose and mouth.
What are key management steps for oral malodour?
Good oral hygiene, avoiding certain foods, regular meals, using tongue scrapers.
