PDTCP

• What is Hyposalivation?


  reduced production of saliva
• What is Xerostomia?

  dry mouth
• What is Asialism?

  Absence of saliva
• What is the usual flow rate in hyposalivation?

  <0.7ml per min stimulated flow<0.1ml per min unstimulated flow
• What are some causes of reduced salivary flow?

  Factors affecting the salivary centresFactors affecting the autonomic nerve supply to the salivary glandFactors affecting the salivary gland function directlyFactors producing changes in the fluid or electrolyte balance
• What are three major factors affecting the salivary centres?

  Emotions-anxiety, fear, excitement & depressionOrganic disease-tumoursDrugs-A wide range of drugs cause reduced salivary flow
• What factors affect the autonomic nerve supply to the salivary gland?

  Trauma-Through injury or surgeryTumoursEncephalitis - inflammation of the brain/ autoimmune response Drugs-A wide range of drugs cause reduced salivary flow
• What factors can directly affect the salivary gland function?

  Irradiation-Head & neck radiotherapyObstructions-Salivary calculi-CystInfections-MumpsAplasia-Congenital absence of salivary glandSjögrens Syndrome-Autoimmune disorderTumoursHIV
• What is Sjogrens Syndrome?

  Autoimmune disorder causing dryness of the mucous membranes, purpuric spots on the face & bilateral swelling of the parotid glandMost frequently see in menopausal womenAssociated with arthritis
• Why is Xerostomia common in HIV patients?

  - salivary gland disease- secondary to medication
• What factors produce changes in the fluid/electrolyte balance?

  Diabetes-Mellitus-InsipidusDehydration-Sweating-Diarrhoea-vomitingUraemia-Changes urea & nitrogenous waste in the bloodCardiac failure-Changes electrolyte balanceOedema-Changes electrolyte balance
• What are temporary causes of hyposalivation?

  Dehydration Mouth breathing Oxygen therapy Drugs Excessive use of diuretics Trauma Duct calculi Sialoadentis
• What are permanent causes of Hyposalivation?

  AplasiaSjögrens syndromeSystemic disorder-Lupus erythematosis-Diabetes-Reynauds syndrome-ParkinsonsHIVRadiotherapySurgery
• What medications can retard salivary flow?

  1) Diuretic e.g. Acetazolamide 2) Antihistamine3) Antidepressent e.g. Amitriptyline 4) Tranquillisers5) CNS stimulant e.g. Amphetamine 6) Appetite suppressants7) Antipsychotic e.g. Chlorpromazine 8) Antibiotic e.g. Tetracyclinee) 9) Antihypertensive e.g. Clonidine10) Anti-Parkinsonian e.g. Benapryzine
• What are the functions of saliva?


  LubricantProtectionCleansingTasteSpeechDigestionPh balance/buffering capacityRemineralisation
• What are some patient symptoms of Xerostomia?

  Feeling oral drynessBurning sensation/soreness of oral mucosa & tongueProblems wearing denturesHalitosisThirst, resulting in increased fluid intake & licking of lipsDifficulty with:-Speech-Swallowing-MasticationImpaired or altered tasteSensitivity
• What is Dysphagia?

  difficulty swallowing
• What is Dysphonia?


  difficulty speaking
• What is Dysgeusia?

  distortion of taste
• What are the oral implications of Xerostomia?

  Increased amount of plaque which may cause gingivitis & periodontitisIncreased risk of primary & secondary caries, esp. root, cervical & proximal cariesIncrease in candidal infection in denture wearersAll antibacterial properties & lubrication are reduced therefore an increased risk of trauma
• What can patients with Sjogrens syndrome suffer from?

  Cervical, proximal & incisal cariesMarginal gingivitis Gross cariesCoated tongueCandida on palateGeneral erythematous appearance of oral mucosa

  
• What can patients post radiotherapy suffer from?

  Gross primary caries & minimal secondary cariesGross caries incisal, proximal & cervicalPatient at 3 months post radiotherapy