Xerostomia and Associated Conditions

Questions and Answers

Which imaging technique is commonly used to diagnos xerostomia?

Positron Emission Tomography (PET) scan

Magnetic Resonance Imaging (MRI)

Computed Tomography (CT) scan

Sialography (correct)

Histopathology is used to examine which aspect of xerostomia?

Salivary flow rate

Salivary duct obstruction

Tissue changes and inflammation (correct)

Salivary gland function

What is a common complication of xerostomia?

Cavities

Gingivitis

Keratoconjunctivitis sicca

All of the above (correct)

What is the primary consequence of ionizing radiation on salivary glands?

Cell damage leading to acinar atrophy Signup and view all the answers

Which medication can help prevent mucositis in patients undergoing radiotherapy and chemotherapy?

Benzdiamine mouthwash Signup and view all the answers

What genetic influence is associated with Sjögren Syndrome?

HLA-DRw52, HLA-B8, HLA-DR3, Signup and view all the answers

What is the recommended treatment for xerostomia and radiation caries?

Sugarless candies and gum Signup and view all the answers

What is the purpose of using tongue blades in patients with trismus?

To maintain jaw opening Signup and view all the answers

What is the name of the syndrome characterized by defects of 1st/2nd branchial arch structures?

Mandibulofacial Dysostosis Signup and view all the answers

What is the mode of inheritance of Mandibulofacial Dysostosis?

Autosomal dominant Signup and view all the answers

What is the name of the syndrome characterized by asymmetric development of facial structures?

Hemifacial Microsomia Signup and view all the answers

What mutation is associated with Lacrimo-auriculo-dento-digital Syndrome?

All of the above Signup and view all the answers

What is the mode of inheritance of Lacrimo-auriculo-dento-digital Syndrome?

Autosomal dominant Signup and view all the answers

What is the treatment for severe Mandibulofacial Dysostosis?

Surgery Signup and view all the answers

What is a common feature of Mandibulofacial Dysostosis?

Hypoplastic zygomas Signup and view all the answers

What is the primary focus of sialography in Sjögren's syndrome?

To visualize the punctate sialectasia in salivary glands Signup and view all the answers

Which antibody is commonly tested in laboratory tests for Sjögren's syndrome?

All of the above Signup and view all the answers

What is the characteristic finding in a lower lip minor gland biopsy for Sjögren's syndrome?

Focal aggregates of lymphocytes Signup and view all the answers

What is the primary advantage of using imaging techniques in Sjögren's syndrome?

To monitor disease progression Signup and view all the answers

Which of the following is a feature of keratoconjunctivitis sicca in Sjögren's syndrome?

Inflammation of the eyes Signup and view all the answers

Which of the following is a characteristic finding on sialography in Sjögren's syndrome?

A 'fruit-laden, branchless tree' appearance Signup and view all the answers

What is the characteristic feature of granulomatous inflammation in Sarcoidosis?

Non-necrotizing granulomatous inflammation Signup and view all the answers

What is the initial treatment approach for Sarcoidosis?

Initial observation Signup and view all the answers

What is the proportion of HIV-infected patients affected by HIV-associated salivary gland disease?

5-10% of HIV-infected patients Signup and view all the answers

What is the treatment approach for HIV-associated salivary gland disease?

ART, sialogogues, and prednisone Signup and view all the answers

What is the prognosis of Sarcoidosis?

60% spontaneously resolve within 2 years Signup and view all the answers

What is the complication of HIV-associated salivary gland disease?

Risk of lymphoma Signup and view all the answers

Study Notes

Xerostomia

Defined as dry mouth or the sensation of dry mouth
Associated complications: dental caries, mucositis, fungal infections, and swallowing difficulties
Differential diagnosis: Sjögren syndrome, medication-induced xerostomia, HIV-associated salivary gland disease, and sarcoidosis
Management: sugar-free gum, salivary substitutes, fluoride supplements, and patient education

Salivary Glands

Major salivary glands: parotid, submandibular, and sublingual glands
Minor salivary glands: located throughout the oral cavity, except for the anterior hard palate and gingiva
Effects of radiation on salivary glands: ionizing radiation causes cell damage, leading to acinar atrophy, vascular damage, and fibrosis

Sjögren Syndrome

Chronic autoimmune disorder involving salivary and lacrimal glands
Clinical subtypes: primary and secondary
Etiology: unknown, with genetic influences (HLA-DRw52, HLA-B8, HLA-DR3)
Epidemiology: affects 0.5% of the US population
Clinical features: xerostomia, keratoconjunctivitis sicca, and parotid gland enlargement
Laboratory tests: serum IgG, RF, ANA, anti-SS-A, and anti-SS-B autoantibodies
Sialography: punctate sialectasia, giving a "fruit-laden, branchless tree" appearance
Histopathology: focal aggregates of lymphocytes in the lower lip minor gland biopsy

Salivary Gland Aplasia

Isolated or syndrome-associated (e.g., mandibulofacial dysostosis, hemifacial microsomia, LADD syndrome)
Examples: Treacher Collins syndrome, hemifacial microsomia, and Lacrimo-auriculo-dento-digital syndrome

Other Conditions

Sarcoidosis: non-necrotizing granulomatous inflammation
- Diagnosis: clinical findings, biopsy, radiographic imaging, elevated serum ACE, and minor salivary gland biopsy
- Treatment: corticosteroids, immunosuppressives, and TNF-alpha inhibitors
- Prognosis: variable, with 60% spontaneous resolution within 2 years and 4-10% mortality
HIV-associated salivary gland disease:
- Affects 5-10% of HIV-infected patients
- Bilateral parotid gland enlargement, lymphoepithelial cysts, and diffuse infiltrative lymphocytosis
- Treatment: antiretroviral therapy, sialogogues, and prednisone
- Prognosis: risk of lymphoma

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