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
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sialogogue

Agent which increase salivary reflex *Bitter food *Hot food *Spicy food *Alcohol

Saliva substitute *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

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#Systemic diseases----*Sjgrens syndrome *Diabetes mellitus *Diabetes insipidus *Sarcoidosis *Human Immunodeficiency Virus *(HIV) infection *Hepatitis C infection *Graft versus host disease *Parkinsons disease

Etiologic factors/Causes of xerostomia

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#Electrolyte loss------*Decreased fluid intake *Hemorrhage *Vomiting *Diarrhea

#Local factors-----*Smoking *Excessive caffeine intake *Mouth breathing *Alcohol abuse

Examples of Common medications associated With Xerostomia and/or Salivary gland Hypo function
#Anti-Histamines.. *Diphenhydramine *Chlorpheniramine #Decongestants .. *Pseudo ephedrine #Anti-Depressant .. *Amitriptyline *Fluoxetine *Paroxetine *Citalopram #Sedatives/anxiolytic .. *Diazepam *Lorazepam *Alprazolam

Examples of Common medications associated With Xerostomia and/or Salivary gland Hypo function
#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 SYSTEMICALLY ACTING

e.g. ASTRINGENTS

CHOLINERGIC ANTAGONIST

CNS DEPRESSANTS
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. *Bells palsy, *Hysteria, *Rabies, *Stroke, *Parkinsons 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