Dry mouth and salivary gland disease

Question 1

What is the causes of dry mouth?

Answer 1

• Dehydration
• Drugs
• Age , smoking , alcohol
• Radiotherapy and cancer treatment
• Anxiety and somatisation disorders
• Salivary gland disease - Sjogren’s

Question 2

What are some complications associated with dry mouth?

Answer 2

• Discomfort/pain
• Increased caries risk
• Candidal infection
• Swallowing problems

Question 3

What are the worse medications that can cause dry mouth?

Answer 3

• Antimuscarinic
• Diuretics
• Lithium

Question 4

Chronic systemic diseases causing dry mouth

Answer 4

• Diabetes
• Renal and cardiac failure
• Hypercalcaemia

Question 5

Acute conditions causing dry mouth

Answer 5

• Haemorrhage
• Persistent vomiting

Question 6

How to assess dry mouth?

Answer 6

• Glan palpation
• Duct expression
• Challacombe scale
• Discriminating DISH from Sjogren’s - can you eat without a drink

Question 7

Management of Dry mouth

Answer 7

1. Investigate
   - Bloods - HbA1c / UE / ANA
2. treat underlying cause
   - Correct hydration
   - Avoid caffeine , smoking and alcohol
   - modify drug regime
   - Control diabetes
   - Treat somatoform disorder
3. Preventative care
   - Caries prevention
   - candida
   - angular cheilitis
   - sore tongue - SLS free TP
4. Symptomatic relief
   - Sprays - saliva prthana
   - lozenges - Salivax
   - Salivary stimulants - pilocarpine
   - oral care systems - biotene oralbalance

Question 8

What are some simple lifestyle measure than can help with dry mouth?

Answer 8

• moist and oily foods
• Humidify home environment
• Regular exercise
• Omega 3 supplements
• Glasses / goggles to reduce tear evaporation
• Warm eye compresses 10 min daily