Overview of oral medicine part 2

Question 1

Investigations for xerostomia

Answer 1

sialometry
challacombe scale
special investigations

Question 2

xerostomia

Answer 2

dry mouth
subjective sense of dryness
- reduced salivary flow
- changes salivary composition

Question 3

xerostomia aetiology

Answer 3

mouth breathing
mucosal disease
psychological
drugs
irradiation
neurological

Question 4

xerostomia management

Answer 4

correct underlying cause e.g., diabetes/alter medication
avoid contributing factors e.g., dry foods/alcohol mouthwashes/smoking/diuresis producing drinks/dry hot environments e.g., central heating

Question 5

sprays/gels

Answer 5

dont stimulate salivary glands
mimic saliva

Question 6

sialogues

Answer 6

chewing gum
SST
diabetic sweets
pilocarpine

Question 7

Trigeminal Neuralgia pharmacological management

Answer 7

LA
- trigger area
- short/long acting LA

Carbamazepine
- first line
- effective
- dose
- side effects: blood dyscrasias/hyponatremia/stevens-johnson

Question 8

Trigeminal Neuralgia surgical management

Answer 8

peripheral techniques
- cryotherapy
- radiofrequency thermocoagulation
- alcohol injections

Gasserian ganglion level
- GA/Sedation
- Cannula into trigeminal ganglion
- glycerol injection
- 50% pain free within 5 years

Gamma knife
- cobalt-60 gamma emission
- 52% pain free at 3yr follow up

Microvascular decompression
- 73% pain free after 5 years
- mortality 0.2-0.5%

Question 9

BMS Epidemiology

Answer 9

0.7-15% population
1/3 post menopause women
3F:M