DTUK1910

For more information contact your Dealer or call SHOFU today on 01732 783580 SuperBuff Paste-impregnated felt disk for high gloss composite polishing, ideal for difficult areas Brownie & Greenie Fast results on precious metals and amalgam Super-Snap Simple, quick and reliable contouring, finishing, polishing and super-polishing of composites One Gloss Allows finishing and polishing of composite with the same instrument – just alter the contact pressure Dura-Green & Dura-White Speedy, chip-free contouring and finishing of porcelain, composites and other materials Brilliance at every turn! The SHOFU range of finishers and polishers give you the high-qulaity finish you demand for every indication - quickly and easily. Take a look at the choice! SHOFU UK Riverside House, River Lawn Road, Tonbridge, Kent TN9 1EP UK Tel: 01732 783580 Fax: 01732 783581 Email: sales@shofu.co.uk Web: www.shofu.co.uk © 2006 SHOFU Dental Products Ltd. E & OE A4 - Pdf Ripper.qxd:Text pasting Document.qxd 13/04/2010 11:26 of taste; difficulty in swallowing; increased effort when speaking. As clinicians, immediate signs manifesting in the mouth include no saliva pooling in the mouth; frothy or cloudy saliva; sticky/ erythematous mucosa; atrophic tongue dorsum; candidosis; an- gular cheilitis. One big marker for xerostomia, explained Prof Lewis, is the occurrence of cervi- cal caries and failed restorations. Xerostomia is often a com- plaint from patients with under- lying causes, including: Drugs: many prescribed medi- cations have dry mouth as a side effect. Drug categories including tricyclic antidepressants, antihis- tamines, diuretics and sedatives are all associated with causing dry mouth. Sjögren’s Syndrome: This im- munological condition is char- acterised by the destruction of glandular acini, part of the sali- vary production process. Radiotherapy: Salivary tissue is extremely sensitive to radiation, so patients receiving radiothera- py for malignant disease can find their salivary flow compromised. Undiagnosed or poorly con- trolled diabetes: dry mouth is an often forgotten marker for diabetes, caused by increased blood sugar levels resulting in fluid loss. Dehydration: reduction in gen- eral fluid level will naturally de- crease salivary flow – after all, saliva is made of 99.4 per cent water! Absence of salivary glands: this has been reported but is an ex- tremely rare condition. Investigating xerostomia Moving from the theoretical, Prof Lewis then discussed what clinicians can do for patients presenting with dry mouth in their surgeries. He stressed the importance of investigation into the causes of dry mouth for that patient, to ensure any under- lying condition has been identi- fied or particular medication use is explored. Means of investigation can include clinical exam (discus- sion with patient, appearance of patient (ie face, hands, gait), appearance of saliva, ‘mirror sticks test’ (a dental mirror will often stick to the buccal mucosa if there is reduced saliva) etc); salivary flow rate tests; haema- tological tests (especially im- portant for diabetes diagnosis); sialography (the infusion of a ra- dio-opaque contrast fluid into the gland which will the reveal any defects in a radiograph); labial gland biopsy (very effective in diagnosing Sjögren’s Syndrome). Managing xerostomia Once the cause of the condition has been indentified it can then focus the minds of both clinician and patient on how to manage it, commented Prof Lewis. For ex- ample, it may be possible to sug- gest a change in medication to one that does not list dry mouth as a side effect; or a diagnosis of diabetes should see improved glycaemic control on behalf of the patient and a resolution of dry mouth symptoms. There are many salivary substitutes which can be rec- ommended, many of which are listed in the British National For- mulary and so can be prescribed. Prof Lewis described a few of them, plus the benefits and dis- advantages of using them. The most graphic disadvantage was for Salinum, which was de- scribed as ‘like licking a cricket bat’! Oral care systems such as the Biotène range has proved very popular with patients due to its formulation and ease of use. Prof Lewis also discussed other helpful measures such as chewing sugar-free gum, use of systemic salivary stimulants, fre- quent sips of water to maintain hydration levels, oral health re- gime including the use of a daily fluoride rinse and twice daily brushes and the limitation of the intake of alcohol and coffee. One anecdotal measure he men- tioned was a daily one gram dose of evening primrose. Conclusion Professor Lewis’ easy delivery style and obvious enthusiasm for the subject matter made this lecture a resounding success for me. It was both informative and practical, allowing delegates to really think about the diagnosis and management of xerostomia in patients as well as highlight- ing once more how the oral cavi- ty can be a window into the over- all health of the human body. Also congratulations to the British Society of Dental Hygiene and Therapy, who in association with the International Federa- tion of Dental Hygienists put on a fantastic conference. Every del- egate I spoke to over the two days I attended were full of praise for both the scientific programme and the social programme, and are already looking forward to the next ISDH in two year’s time in Cape Town, South Africa. DTDiagram illustrating location of the major salivary glands. Image courtesy of Professor MAO Lewis, Cardiff University Failing restorations and dental caries are often seen in patients suffering from dry mouth. Image courtesy of Professor MAO Lewis, Cardiff University Collecting saliva. Image courtesy of Professor MAO Lewis, Cardiff University 7Event ReviewJuly 12-21, 2010United Kingdom Edition July 19-25, 2010United Kingdom Edition