Salivary Flow pt 2 Flashcards

1
Q

what is the normal unstimulated flow of saliva

A

0.2-0.4ml/min

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2
Q

what is the normal stimulated flow of saliva

A

1-5ml/min

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3
Q

what is the unstimulated flow of saliva in patients with xerostomia

A

less than 0.1ml/min

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4
Q

what is the stimulated flow of saliva in patients with xerostomia

A

less than 0.5ml/min

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5
Q

for saliva flow to fall below 50% of the normal levels, what must happen

A

there must be loss of function of more than one major salivary gland

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6
Q

what are some general conditions that could affect the salivary glands

A

fluid and electrolyte loss

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7
Q

how many drugs cause dry mouth

A

over 400

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8
Q

what is the BNF

A

british national formulary

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9
Q

what is smooth surface caries related to

A

reduced salivary flow and clearance

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10
Q

what are the oral functions that become impaired by xerostomia

A

chewing
swallowing
speaking
diminished taste perception

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11
Q

what are some protective components that are lost due to decreased salivary flow

A
  • antimicrobial agents
  • less buffering
  • mucins and other proteins
  • gustin
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12
Q

are the absolute flow rates set

A

no they can vary - consider the functional aspects

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13
Q

which questions, when answered with yes, suggest hypofunction of the salivary glands

A
  • does your mouth feel dry when eating a meal
  • do you have difficulty swallowing any foods
  • do you sip liquids to help swallow dry food
  • does the amount of saliva in your mouth feel too little
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14
Q

how can you manage xerostomia if there is still a functional salivary gland

A

chewing or through drugs

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15
Q

which drugs stimulate saliva flow

A

sialogogues

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16
Q

when there is no functioning gland tissue remaining in someones mouth, what can be used to manage the xerostomia

A
  • taking saliva substites that are either mucin or cellulose based.
  • water alone is not effective
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17
Q

is the saliva flow static

A

no

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18
Q

where is salivary flow higher in the mouth

A

in lower lingual regions

19
Q

where is salivary flow lower in the mouth

A

labial and buccal regions

20
Q

where are cariogenic sugars retained longer in the mouth

A

in regions where the flow is slowest

21
Q

how does saliva flow in the mouth

A

horizontally, it moves toward the back of the mouth if it is from the sublingual gland
submandibular saliva washes over the anterior teeth with aid from minor mucous secretions
parotid washes over the posterior teeth

22
Q

which factors affect clearance

A

salivary film velocity and location in the mouth

23
Q

what are the important oral health aspects of clearance in the mouth

A
  • removal of harmful materials
  • retention of beneficial materials
24
Q

what is dawes rule

A

stimulus leads to salivary flow, making the residual volume accumulate and trigger swallowing, and the residual is then returned

25
how is clearance of harmful substances increased
by high salivary flow
26
how is retention of beneficial substances improved
by reduced salivary flow rates
27
what are the beneficial substances that we do not want to be cleared from the mouth
fluoride and chlorhexidine
28
why should fluoride tablets be sucked on rather than chewed
to prevent stimulation of saliva flow, and keep clearance to a minimum
29
what is the stephan curve
a graph of the plaque pH change over time
30
how do plaque microorganisms generate acid
by metabolising sugars like sucrose
31
how does gum stimulation affect pH
it rises by 0.5 pH unit and this persists for a long time
32
what type of gum increases salivary pH to above 1 pH unit
bicarbonate containing gum
33
does gum chewing remove plaque
no
34
what are the types of alternative sweeteners
- bulk caloric, low caloric - non calory, high intensity
35
what are the bulk, cariogenic sweeteners
sucrose fructose glucose lactose
36
what are the low caloric sweetenders
mannitol sorbitol xylitol
37
what are the non caloric sweeteners
aspartame cyclamates saccharin sucralose
38
which sweetenders are non cariogenic relative to sucrose
the low caloric and non caloric sweeteners
39
at what flow rate will patients begin to complain of dry mouth
50%
40
name the stimulants that go to the salivary centres to increase saliva flow
- higher centres - masticatory afferents - gustatory afferents
41
what does sympathetic effect of salivary flow lead to
constriction, greater flow
42
what does parasympathetic effect of salivary flow lead to
dilation, greater flow
43
describe the two stage mechanism of ductal modification
- primary saliva is modified as it passes through striated ducts - reabsorption of sodium and chlorine - secretion of potassium and bicarbonate - final saliva hypotonic to plasma - some proteins secreted by ducts