Sialogogue and Anti-sialogogue

SIALOGOGUE AND ANTISIALOGOGUE

DR.FOYSAL SIRAZEE BDS(DU),MS(FINAL PART), BSMMU,DHAKA.

SIALOGOGUE #Definition………….. Sialogogue are the agents or drugs which are used to increased salivation due to dryness of mouth or any other reasons.

Classification of sialogogue sialogogue

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Saliva substitute Agent which increase salivary reflex…

*Bitter food *Hot food *Spicy food *Alcohol

*Anti-bacterial agent *Complex mixture of salt *Sorbitol or sweetener *Cellulose and * Flavoring agent

Cholino-mimetic drugs

*Pilocarpin *Neostigmine *Physostigmine

HOT AND SPICY FOOD

SOUR FOODS

BITTER FOODS

Sialogogues agents

XEROSTOMIA  #Definition….. The term xerostomia or “dry mouth” refers to a subjective complaint of dryness involving the oral mucosa and oropharynx that may or may not be accompanied by salivary gland hypo function, an objective decrease in salivary flow.

Etiologic factors/Causes of  xerostomia Potential etiologic factors for Xerostomia and/or Salivary gland Hypo function……. #Mediations-----*Antihistamines *Decongestants *Antidepressants *Sedatives/ anxiolytic agent *Anti-hypertensive agent *Anti-cholinergic agent *Anti- neoplastic agent *Anti-psychotic agent #Radiation therapy

Etiologic factors/Causes of  xerostomia …..continue

#Systemic diseases----*Sjögren’s syndrome *Diabetes mellitus *Diabetes insipidus *Sarcoidosis *Human Immunodeficiency Virus *(HIV) infection *Hepatitis C infection *Graft versus host disease *Parkinson’s disease

Etiologic factors/Causes of  xerostomia …..continue

#Electrolyte loss------*Decreased fluid intake *Hemorrhage *Vomiting *Diarrhea #Local factors-----*Smoking *Excessive caffeine intake *Mouth breathing *Alcohol abuse

#Anti-Histamines….. *Diphenhydramine *Chlorpheniramine #Decongestants ….. *Pseudo ephedrine #Anti-Depressant ….. *Amitriptyline *Fluoxetine *Paroxetine *Citalopram #Sedatives/anxiolytic ….. *Diazepam *Lorazepam *Alprazolam

#Anti-Hypertensive agent ….. *Methyldopa *Chlorothiazide *Furosemide *Metoprolol *Calcium channel blockers #Anti-Cholinergic agent ….. *Atropine *Scopolamine #Anti-Psychotic agent ….. *Haloperidol * Phenothiazine derivatives

Management of Xerostomia Management of xerostomia involves…… 1.Patient education, diet, and lifestyle modifications; 2. Management of systemic diseases and medication use; 3.Prevention of dental and oral mucosal diseases; 4. Palliative management of symptoms; and 5. Sialogogues or salivary gland stimulants.

 ANTI-SIALOGOGUE #Definition ….. Anti-Sialogogues are the agents or drugs which are used to decreased salivation due to excessive salivation in mouth or any other reasons.

Classification of anti-Sialogogues  ANTI-SAIALOGOGUE LOCALLY ACTING

e.g. ASTRINGENTS

SYSTEMICALLY ACTING

CNS DEPRESSANTS

CHOLINERGIC ANTAGONIST

e.g. Morphine, Opium.

 ANTI-MUSCARINIC e.g.. Atropine, Scopolamine

 ANTI-NICOTINIC

 AUTONOMIC GANGLIONIC BLOCKER  e.g. Hexamittonium

PTYALISM #Definition …… It is a clinical condition characterized by excessive secretion of saliva from major or minor salivary glands of oral region.

CAUSES OF PTYALISMS A. Pathos-physiological causes…. a) Physiological causes…. *Pregnancy, *Malnutrition, *Menstruation, b) Pathological causes…. 1) CNS causes…. *Bell’s palsy, *Hysteria, *Rabies, *Stroke, *Parkinson’s disease.

CAUSES OF PTYALISMS 2) Endocrine causes…. *Exophthalmia goiter. 3) GIT causes…. *Nausea and vomiting, *Gastro esophageal reflex. 4) Oral causes…. *Stomatitis, *ANUG. B. Drug induced….. a)Cholinomimetic agent….. *Pilocarpine, *Neostigmine, *Physostigmine. b)Others agent…. *Mercury, *Iodine.

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MANAGEMENT OF PTYALISMS Management of ptyalism depends upon the causes…. Speech therapy Behavioral therapy Radiation therapy Medications Surgery     