Xerostomia Revision PDF

Xerostomia Xerostomia = a persistent or temporary reduction or absence of saliva due to factors that may alter or May cause low self- Be aware it damage the flow of saliva in the oral cavity esteem, lack of may not be predisp...

Xerostomia Xerostomia = a persistent or temporary reduction or absence of saliva due to factors that may alter or May cause low self- Be aware it damage the flow of saliva in the oral cavity esteem, lack of may not be predisposing to certain oral conditions. confidence, problems patients main (Dry mouth) speaking and eating concern. No natural cleansing or buffering effect May also be Sugar, bacteria, food, discoloured and/or plaque stagnation Increased caries and coated periodontal risk Fissured tongue Halitosis Sore throat - Lack of Clinical signs and symptoms bathing Lack of Oral from saliva cleansing - Ulcerations from saliva candida Thick saliva Affected taste Dry mucosa Not very lubricating Dental mirror will stick In order to taste, Issues talking to cheeks and tongue food needs to be in solution Persistent causes of xerostomia Temporary causes of xerostomia HIV Duct obstruction Sjorgrens syndrome Infection/inflammation of the glands Irradiation Psychogenic disorders Diabetes Mouth breathing Sarcoidosis Prescription drugs (anti-depressants) Amyloidosis Alcoholism Age changes Smoking Kidney disease Dehydration Absent salivary gland Not exhaustive list of causes.  The non-responder The responder No salivary gland activity Still have some salivary gland activity. Not possible to stimulate salivary flow. May be possible to stimulate salivary flow Alternative methods of lubricating mouth — Mastication stimuli (chewing gum) need to be found. — Chemical stimuli (citric acid) — Oralieve mouth gel — Taking of evening primrose oil — Oralieve moisturising mouth spray — Electronic devices — Biotene toothpaste & mouthwash — Medication — BioXtra oral gel — Acupuncture — Act chewing gum — Olive oil on lips at night Fluoriguard separate time to Challacombe brushing Fluoride varnish scale Fluoride treatment Duraphat Increased caries/periodontal risk Spit don’t toothpaste Regular examinations Dental therapist role · rinse Twice daily Remove plaque/food Oral hygiene brushing Disclosing instruction stagnation tablets Regular debridment Interdental cleaning Avoiding sodium Introduce oxygen with lauryl sulfate Remove dentures power driven scaler at night and Tongue cleaning cleaned Causes more Reduce problems Dietary advice Regular water sugar/acids Smoking/alcohol cessation Avoid spicy Diet analysis Recommend foods, excess Dries tissues out alternatives alcohol Challacombe scale Produces clinical oral dryness score (CODS). Allows for monitoring and correct treatment. Scores of >7 required further referral and assessment. Enables clinician to The following factors are used to evaluate dryness of quantify severity of mouth; xerostomia 1. Mirror sticks to buccal mucosa 2. Mirror sticks to tongue 3. Saliva frothy 4. No salivary gland activity pooling in the floor of the mouth 5. Tongue showed generalised shortened papillae 6. Altered gingival architecture The presence of each 7. Glassy appearance of oral mucosa especially palate accrues one point 8. Tongue lobulated/fissured 9. Cervical cavitation on more than two teeth 10. Debris on palate or sticking to teeth Score Severity and management Mild dryness — regular monitoring 1—3 Medication history may reveal cause Recommend twice daily chewing of sugar free chewing gum and keep hydrated. Moderate dryness — regular monitoring Sugar free chewing gum or simple sialogogues 4—6 Further investigation required Possible saliva substitutes and topical fluoride Severe dryness — referral required 7 — 10 Saliva substitutes and topical fluoride Causes need assessment  Lasts 2-5 Oralieve, amazon, pharmacy Works day and hours during Neutral night Lasts between day & up to 8 taste hours at night 1-2 hours Designed to replicate same natural enzyme system as saliva Oralieve Oralieve moisturising dry Oralieves longest moisturising mouth relief spray lasting product mouth gel Works immediately Pleasant taste EBay & Exploring xerostomia iHerb (Products) Sugar-free Gluten-free Suitable Up to 8hours Act chewing gum for vegans Slow release & Stimulates flow of long lasting Good taste saliva Small discs Xylimelts Moisturises mouth placed on Stimulate oral mucosa saliva flow Use day & night Alcohol & Amazon & sugar free Even when sleeping Dent-O-Care Biotene toothpaste & ph balanced Soothes and mouthwash protects oral Boots, pharmacies & tissues amazon Can use mouthwash up to 5 times a day Amitriptyline Morphine (pain) Medications likely to cause Xerostomia; Lisinopril (hypertension) Antidepressants Sertraline (anti-depressant) Antihistamines Fluoxetine (anti-depressant) Antihypertensive Citalopram (anti-depressant) Antipsychotics Chlorphenamine meleate (anti-histamine) Diuretics Promethazine hydrochloride (anti-histamine)