18 - Problems with salivation Flashcards
What is the function of saliva?
- acid buffering
- mucosal lubrication
- taste facilitation
- antibacterial
What are common causes of xerostomia?
- salivary gland disease
- drugs
- medical conditions
- dehydration
- cancer treatments
- anxiety and somatoform disorders
What drugs commonly cause xerostomia?
- anti-cholinergic drugs
- tricyclic antidepressants
- antipsychotics
- antihistamines
- atropine
- diuretics
- cytotoxics
What chronic medical problems induce dehydration and therefore xerostomia?
- diabetes (mellitus and insipidus)
- renal disease
- stroke
- Addison’s disease
- persistant vomiting
What acute medical problems induce dehydration and therefore xerostomia?
- acute oral mucosal diseases
- burns
- vesiculobullous diseases
- haemorrhage
What conditions directly affect the salivary glands causing xerostomia?
- ectodermal dysplasia (gland not formed properly)
- sarcoidosis
- HIV
- amyloidosis
- haemochromatosis
- CF
What is ectodermal dysplasia?
- hair, nails, teeth, salivary and sweat glands development affected
- hearing and vision may also b affected
What is sarcoidosis?
Enlargement of glands
How does HIV affect the salivary glands?
- lymphoproliferative changes
- increased size but function reduced
- can often be first sign of infection
What is amyloidosis?
Deposition of protein in the salivary gland
What is haemochromatosis?
- excess iron in the gland
- high ferritin in a blood test
What is the challacombe scale?
Scale of oral dryness to assess caries risk and treatment options
What is the management of challacombe scores 1-3?
- sips of water
- sugar free chewing gum
What is the management of challacombe scores 4-6?
- higher caries risk
- OH, diet advice and additional fluoride
- may require saliva substitute
What is the management of challacombe scores 7-10?
Referral to specialist
