Clinical approach to xerostomia

1
(No Transcript)
2
Clinical approach to xerostomia

• Dr. Abbas Javadzadeh
• Dr. Atessa Pakfetrat
• Associate Professor of
• Oral medicine Department
• Mashhad Dental School

3
Xerestomia is a symptom not a diagnosis or
disease
?
4
(No Transcript)
5
(No Transcript)
6
Clinical evaluation of xerostomia

• Subjective or objective
• signs and symptom

7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
Clinical evaluation of xerostomia

• 2. Permanent or temporary?
• Acute or chronic?
• Clinical course?

11
Clinical evaluation of xerostomia

• 3. Symptoms of salivary gland dysfunction

12

• 4. Associated diseases

13
Clinical evaluation of xerostomia

• 5. History
• Review of system
• PMH, PDH

14
Etiology

• 1-Iatrogenic
• Drugs
• Radiation
• chemotherapy
• 2- Developmental
• Salivary gland agenesis

15
3- Water/metabolite loss

• Impaired fluid intake
• Hemorrhage
• Vomiting/diarrhea

16
4- Systemic disease

• Sjogren syndrome
• Renal failure
• Diabete
• Granulomatose diseases
• HIV infection
• Malnutrition
• Late stage liver disease
• GVHD
• Primary Biliary cirrhosis
• Chronic Active Hepatitis
• Vasculitis, ..

17

• 5- Psychological Factors Affective
  disorders
• 6- Local factors
• Decreased mastication Smoking Mouth
  breathing
• 7- Rarities
• Amyloidosis Bells palsy Cystic
  fibrosis hemochromatosis

18
Imaging
Serologic tests

• Para clinic

..
Sialometry
Biopsy
Salivary gland function test
19
Systemic stimulation
Symptomatic

• Treatment

Non-Drug Stimulation
Drug substitution
Treatment of associated diseases
Psychological Treatment and consult
20
??? ????? ? ??? ???? ? ??? ??????? ??? ???? ?
????? ????? ? ???????? ??? ? ??? ?????????? ???
?????? ???? ? ??? ??????? ? ???? ????????
??????? ??? ???????? ?????? ???? ????? ????
??????? ????? ?????? ??? ????? ???? ?? ?
???????? ????? ???? ?? ? ???? ????? ???? ????
??? ???? ???.....................................
...
21
(No Transcript)