Oral Medicine - Dry Mouth Disorders

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Questions and Answers

Which of the following is NOT a physiological cause of dry mouth?

  • Irradiation (correct)
  • Advanced age
  • Mouthbreathing
  • Anxiety

What is the main neural control of salivary gland secretion?

  • Peripheral nervous system
  • Autonomic nervous system (correct)
  • Somatic nervous system
  • Central nervous system

What effect does sympathetic stimulation have on saliva?

  • Decreases saliva production
  • Increases saliva viscosity (correct)
  • Increases saliva production
  • Decreases saliva viscosity

Which of the following is NOT a component of saliva that contributes to its antimicrobial action?

<p>Epinephrine (D)</p> Signup and view all the answers

What is the consequence of reduced salivary defenses?

<p>Increased risk of dental caries (A)</p> Signup and view all the answers

What is the effect of parasympathetic stimulation on salivary gland secretion?

<p>Increased saliva production (D)</p> Signup and view all the answers

Which of the following is a possible consequence of xerostomia?

<p>Increased oral malodour (D)</p> Signup and view all the answers

What is a common symptom of a dry mouth caused by anxiety?

<p>Reduced salivation (C)</p> Signup and view all the answers

Which of the following conditions is a potential complication of hyposalivation?

<p>Dental caries (C)</p> Signup and view all the answers

What is the primary method for diagnosing hyposalivation?

<p>Clinical examination and history taking (D)</p> Signup and view all the answers

What is the main characteristic of dental caries that often develops with hyposalivation?

<p>Caries on the smooth surfaces and areas not typically prone to caries (B)</p> Signup and view all the answers

Which of these is NOT a blood test specifically mentioned in the text that could be used in investigating hyposalivation?

<p>Complete blood count (B)</p> Signup and view all the answers

What might explain the situation of patients experiencing recurrent caries despite following dietary advice?

<p>Hyposalivation (D)</p> Signup and view all the answers

What is the name for the procedure used to measure salivary flow rates?

<p>Sialometry (A)</p> Signup and view all the answers

Why is hyposalivation considered a clinical diagnosis?

<p>It is predominantly diagnosed based on the history and examination. (A)</p> Signup and view all the answers

What is a keypoint for dentists regarding dry mouth, as mentioned in the text?

<p>Dry mouth can be a significant symptom of hyposalivation. (D)</p> Signup and view all the answers

What condition might cause redness in the eyes and soft crusts at the angles?

<p>Conjunctivitis sicca (A)</p> Signup and view all the answers

Which of the following is NOT recommended for managing dry mouth?

<p>Drinking sugary beverages (D)</p> Signup and view all the answers

Which salivary replacement product contains fluoride?

<p>AS Saliva Orthana (D)</p> Signup and view all the answers

What is a common component of alcohol-free mouth rinses for dry mouth management?

<p>Glycerate polymer (D)</p> Signup and view all the answers

Which of the following is a suggestion for saliva stimulation?

<p>Chewing sugar-free gum (D)</p> Signup and view all the answers

What is a potential complication of chronic B lymphocyte stimulation?

<p>B cell neoplasms (B)</p> Signup and view all the answers

Which feature is consistently present in both types of Sjögren’s syndrome?

<p>Dry eyes (C)</p> Signup and view all the answers

What is the relationship between Sjögren’s syndrome and extraglandular problems?

<p>Extraglandular problems are more common in SS-2. (B)</p> Signup and view all the answers

Which diagnostic tool may confirm a diagnosis of Sjögren’s syndrome?

<p>Sialometry (D)</p> Signup and view all the answers

Which symptom is NOT associated with Sjögren’s syndrome?

<p>Excessive sweating (A)</p> Signup and view all the answers

What confirms the diagnosis of Sjögren’s syndrome in specialist units?

<p>Use of international criteria (C)</p> Signup and view all the answers

Which connective tissue disease is associated with Sjögren’s syndrome type SS-2?

<p>Rheumatoid arthritis (A)</p> Signup and view all the answers

Chronic complications of Sjögren’s syndrome mainly affect which tissues?

<p>Exocrine glands and extraglandular tissues (A)</p> Signup and view all the answers

What is a primary approach to managing hyposalivation in patients?

<p>Using synthetic salivary substitutes (C)</p> Signup and view all the answers

Which of the following is a common symptom experienced by patients with SS?

<p>Dryness and grittiness in the eyes (A)</p> Signup and view all the answers

What role does the dental team play in the management of SS?

<p>Providing education on oral hygiene and preventive care (C)</p> Signup and view all the answers

Which dietary approach should SS patients adopt to manage their condition?

<p>Non-cariogenic diet (A)</p> Signup and view all the answers

What is the significance of the erythrocyte sedimentation rate (ESR) in SS?

<p>It is commonly raised in SS (D)</p> Signup and view all the answers

What is a recommended method to keep the mouth moist for patients experiencing xerostomia?

<p>Frequent sips of water or ice chips (B)</p> Signup and view all the answers

Which class of drugs is known to directly damage the salivary glands?

<p>Cytotoxic drugs (D)</p> Signup and view all the answers

Which of the following is a possible underlying cause of xerostomia that should be addressed?

<p>Xerostomia-producing medication (A)</p> Signup and view all the answers

What autoimmune factors are often associated with Sjögren's syndrome (SS)?

<p>Antinuclear factor (ANF) and antinuclear antibodies (B)</p> Signup and view all the answers

What is one common difficulty experienced by patients with hyposalivation?

<p>Swallowing dry foods (D)</p> Signup and view all the answers

Which of the following drug types typically shares anticholinergic activity?

<p>Antidepressants (A)</p> Signup and view all the answers

Patients with dry mouth may also experience which of the following?

<p>Dry eyes (D)</p> Signup and view all the answers

What issue may arise from the tongue sticking to the palate due to hyposalivation?

<p>Clicking speech (C)</p> Signup and view all the answers

Which of the following is a common side effect of anticholinergic drugs?

<p>Loss of taste (C)</p> Signup and view all the answers

Which group of medications includes tricyclic antidepressants?

<p>Psychoactive agents (B)</p> Signup and view all the answers

What symptom might accompany dry mouth in terms of eye issues?

<p>Burning sensation (B)</p> Signup and view all the answers

Flashcards

Conjunctivitis sica

Inflammation of the conjunctiva leading to red eyes and crusts.

Lacrimal glands

Glands that produce tears and may swell during inflammation.

Dry mouth management

A set of tips to manage insufficient saliva production.

Artificial saliva

Substitutes that replace missing saliva in dry mouth.

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Alcohol-free mouthrinse

Mouthrinse options that do not contain alcohol, beneficial for dry mouth.

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Hyposalivation

A condition characterized by reduced saliva production, leading to dry mouth.

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Cytotoxic drugs

Medications that can damage salivary glands directly, causing dry mouth.

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Anticholinergic agents

Drugs that block the action of acetylcholine, often leading to dry mouth.

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The cracker sign

Difficulty swallowing dry foods due to reduced saliva production.

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Psychoactive agents

Drugs that influence mental processes and can have anticholinergic effects, causing dry mouth.

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Tricyclic antidepressants

A class of antidepressants that can lead to dry mouth as a side effect.

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Antihistamines

Medications commonly used for allergies that can also cause dry mouth.

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Common symptoms of dry mouth

Include difficulty swallowing, speaking, bad taste, and dry eyes.

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Oral Malodour

Unpleasant smell originating from the mouth, often due to bacteria or poor hygiene.

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Xerostomia

A condition characterized by dry mouth due to reduced saliva production.

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Salivary Components

Antimicrobial agents in saliva including mucin, histatins, and lysozyme.

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Causes of Hyposalivation

Factors leading to reduced saliva, such as anxiety, medication, or aging.

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Orofacial Sensation

Nerve perception in the face and mouth, influencing taste and touch.

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Autonomic Nervous System

Part of the nervous system managing involuntary actions, including salivation.

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Parasympathetic Stimulation

Part of the nervous system that increases saliva production.

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Iatrogenic Causes

Health complications or conditions caused by medical treatments or procedures.

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Dental caries

Tooth decay that can occur on smooth surfaces not normally prone to it.

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Diagnosis of Hyposalivation

A clinical diagnosis made mainly through patient history and examination.

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Salivary function studies

Tests to measure saliva production, such as sialometry.

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Recurrent caries

Repeated occurrence of tooth decay despite preventive measures.

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Salivary flow rates

Measurements of saliva production usually assessed in sialometry.

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Sialometry

A method used to measure salivary flow.

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Management of Hyposalivation

Includes addressing underlying causes and symptomatic treatment.

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Investigation criteria

Clinical reasons for additional tests in diagnosing hyposalivation.

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Salivary Substitutes

Products used to relieve symptoms of dry mouth.

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ANF and RF

Autoantibodies often present in Sjögren's Syndrome, include antinuclear factor and rheumatoid factor.

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SS-A and SS-B

Specific autoantibodies related to Sjögren's Syndrome.

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Clinical Features of SS

Mainly includes eye complaints like dryness and sensitivity.

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Non-Cariogenic Diet

Diet that does not promote tooth decay, important for xerostomia patients.

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Sjögren’s Syndrome

A chronic autoimmune disorder that primarily affects salivary and lacrimal glands, leading to dry mouth and dry eyes.

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Dry Mouth

A common symptom of Sjögren's syndrome characterized by a lack of saliva production.

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Dry Eyes

A common symptom of Sjögren's syndrome where tear production is reduced, causing irritation.

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Extraglandular Symptoms

Symptoms of Sjögren’s syndrome that occur outside of the salivary and lacrimal glands, like fatigue and joint pain.

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B Lymphocyte Stimulation

The activation of B lymphocytes, which can lead to increased production of antibodies and potentially B cell neoplasms.

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Lymphoma Risk

Chronic stimulation of B cells in Sjögren’s syndrome can occasionally lead to the development of lymphoma.

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Autoantibody Studies

Tests conducted to detect autoantibodies, which help confirm the diagnosis of Sjögren's syndrome.

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Study Notes

Oral Medicine - Dry Mouth and Salivation Disorders

  • Saliva is crucial for oral health, aiding eating, taste, lubrication, and protection. Its composition includes water, mucins, and protective proteins.
  • Hyposalivation (reduced saliva) and altered salivary composition lead to dry mouth (xerostomia).
  • Common causes of dry mouth include inadequate fluid intake, excess fluid loss (e.g., diabetes), medications (anticholinergics, sympathomimetics, diuretics), and head/neck irradiation.
  • Reduced saliva can lead to problems like dental caries, oral infections, and difficulty with eating, swallowing, and speaking.
  • Physiological causes of hyposalivation include anxiety (sympathetic activity), mouth breathing, and advanced age.
  • Systemic diseases like Sjögren's syndrome, sarcoidosis, and HIV can cause salivary gland dysfunction.
  • Dry mouth can also have a psychogenic cause.

Causes of Dry Mouth

  • Iatrogenic: Medications are a significant cause, particularly those with anticholinergic, sympathomimetic, or diuretic effects.
  • Radiation: Radiation therapy for head and neck cancers often causes hyposalivation.
  • Dehydration: Conditions like diabetes, renal failure, and fevers can result in decreased saliva production.
  • Salivary Gland Diseases: Conditions impacting the salivary glands (e.g., Sjögren's syndrome, sarcoidosis) can disrupt saliva flow.
  • Other Medical Conditions: HIV, hepatitis C, liver diseases, and cystic fibrosis are additionally linked to hyposalivation.

Clinical Features of Hyposalivation

  • Difficulties with swallowing (particularly dry foods), controlling dentures, and speaking.
  • Unpleasant taste, sense of taste loss, or bad breath.
  • Dryness of other oral mucosa, eyes, and potentially other areas.
  • Characteristics like adhered lips, dental mirror sticking to the mucosa, missing saliva pooling, dry tongue and potential lobulation/loss of papillae.
  • Dental caries, notably in areas not usually prone to them, and recurring cavities are complications.

Dry Mouth (Xerostomia) Diagnosis

  • Diagnosis is primarily clinical, based on patient history and examination.
  • Salivary function studies like sialometry (measuring salivary flow rate) can aid in diagnosis, though it can be inaccurate.
  • Specialist investigation may be needed to assess potential underlying conditions (e.g., connective tissue disorders, systemic diseases).

Sjögren's Syndrome

  • Sjögren's syndrome (SS) is an autoimmune disease.
  • SS is frequently associated with dry mouth and dry eyes.
  • Systemic features, including joint pain, may accompany SS.
  • Diagnostic tools for SS include blood tests (autoantibodies), eye examinations (Schirmer test), salivary gland biopsies, and imaging.

Managing Hyposalivation

  • Addressing underlying causes is crucial (e.g., stopping/modifying dry mouth-inducing medications, treating other medical conditions).
  • Promoting oral hydration and avoiding stimuli that worsen symptoms.
  • Using salivary substitutes (e.g., synthetic saliva, water) and stimulating salivation through sugar-free chewing gum/sweets can be helpful.
  • Maintaining thorough oral hygiene to mitigate dental caries risk.

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