Problems with Salivation Flashcards

1
Q

what are four actions of saliva

A

acid buffering
mucosal lubrication
taste facilitation
antibacterial

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2
Q

give five examples of causes of dry mouth

A

salivary gland disease
drugs
radiotherapy and cancer treatments
anxiety disorders
medical conditions

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3
Q

what is meant by a medical condition having an indirect effect on dry mouth

A

the problem is external to the gland

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4
Q

what is meant by a medical condition having a direct effect on dry mouth

A

problem is within the gland itself

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5
Q

give 5 examples of drugs that cause the indirect effect of dry mouth

A

antimuscarinic cholinergic drugs
antihistamine
atropine
diuretics
cytotoxics

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6
Q

what are two examples of antimuscarinic cholinergic drugs

A

tricyclic antidepressants
antipsychotics

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7
Q

give four examples of medical conditions associated with causing indirect affect for dry mouth

A

diabetes
renal disease
addison’s disease
vesiculobullous disease

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8
Q

name 5 examples of conditions that affect salivary glands directly and cause dry mouth

A

aplasia
sarcoidosis
HIV
gland infiltration
cystic fibrosis

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9
Q

what is ectodermal dysplasia

A

occurs when the outer layer of tissue - the ectoderm - of the embryo does not develop normally - affects salivary glands

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10
Q

what is sarcoidosis

A

a condition that causes abnormal collection of inflammatory cells to form clumps in lungs, skin or lymph nodes

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11
Q

how is sarcoidosis linked to decreased salivary flow rate

A

causes swelling in the salivary glands

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12
Q

how is HIV linked to decreased salivary flow rate

A

HIV can present with salivary gland increased in bulk but a reduced function

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13
Q

what is amyloidosis

A

protein called amyloid builds up in the organ/ gland

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14
Q

what is haemochromatosis

A

deposition of iron in the gland (will show high Ferritin in the blood)

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15
Q

why might radiation be associated with decreased salivary flow rate

A

antineoplastic drugs and iodine can accumulate in the glands

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16
Q

what is the name of the scale used to assess mucosal dryness

A

Challacombe scale

17
Q

what would scoring 1 on the challacombe scale suggest clinically

A

mirror sticks to buccal mucosa

18
Q

what would scoring 2 on the challacombe scale suggest clinically

A

mirror sticks to the tongue

19
Q

what would scoring 3 on the challacombe scale suggest clinically

A

saliva frothy

20
Q

what are stages 1-3 on the challacombe scale managed with

A

sugar free chewing gum for 15 mins, twice daily and attention to hydration

21
Q

what would scoring 4 on the challacombe scale suggest clinically

A

no saliva pooling in the floor of the mouth

22
Q

what would scoring 5 on the challacombe scale suggest clinically

A

tongue shows generalised shortened papillae

23
Q

what would scoring 6 on the challacombe scale suggest clinically

A

altered gingival architecture (smooth)

24
Q

what are stages 4-6 of challacombe scale managed with

A

sugar free chewing gum or simple sialogogues
investigation as to why there is decreased saliva
saliva substitutes and topical fluoride

25
what would scoring 7 on the challacombe scale suggest clinically
glassy appearance of oral mucosa, especially the palate
26
what would scoring 8 on the challacombe scale suggest clinically
tongue lobulated/ fissured
27
what would scoring 9 on the challacombe scale suggest clinically
cervical caries on more than 2 teeth
28
what would scoring 10 on the challacombe scale suggest clinically
debris on palate on sticking to teeth
29
what would stages 7-10 on the challaocmbe scale be managed with
saliva substitutes and topical fluoride refer for investigation and diagnosis
30
what blood tests can be used to assess decreased salivary flow rate
FBC U&Es liver function tests C-reactive protein
31
what immunological tests can be used to assess decreased salivary flow rate
glucose anti-Ro andtibody anti-La antibody antinuclear antibody complement C3 and C4
32
what types of assay can be used to assess decrease in salivary flow rate
functional assay tissue assay
33
what types of imaging can be used to assess a decrease in salivary flow rate
plain radiographs to assess for stones sialography MR sialography with IV contrast ultrasound
34