The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Antiseptics, astringents and sialogoguesbibi umeza
overview of antiseptics, antringents and sialogogues with detailed information on pharmacological action, mechanism, use and adverse effect for both dental and medical students
A number of theories have been put forward for impressions. each having its own advantage and disadvantage.
Different spacers guide and aid in in making the desired impression with adequate pressure in the desired region of the arch in maxilla and mandible. different materials are used for spacers depending on the need.
Antiseptics, astringents and sialogoguesbibi umeza
overview of antiseptics, antringents and sialogogues with detailed information on pharmacological action, mechanism, use and adverse effect for both dental and medical students
A number of theories have been put forward for impressions. each having its own advantage and disadvantage.
Different spacers guide and aid in in making the desired impression with adequate pressure in the desired region of the arch in maxilla and mandible. different materials are used for spacers depending on the need.
Speech consideration in complete dentureethan1hunt
Definition
History
Mechanism of sound production
Types/Classification of speech sounds
S sounds and their prosthodontic considerations
Prosthodontic implication in denture design affecting speech
Speech tests
This fresh lecture explain the basics of antibiotic prescription, and common interactions, clinical use, and dosages. It is written to level of undergraduate mind
This presentation features the various measures which can be undertaken to prevent pit and fissure caries to develop i an otherwise healthy oral environment. The use of pit and fissure sealants is emphasised in case of deep pits and fissures.
Speech consideration in complete dentureethan1hunt
Definition
History
Mechanism of sound production
Types/Classification of speech sounds
S sounds and their prosthodontic considerations
Prosthodontic implication in denture design affecting speech
Speech tests
This fresh lecture explain the basics of antibiotic prescription, and common interactions, clinical use, and dosages. It is written to level of undergraduate mind
This presentation features the various measures which can be undertaken to prevent pit and fissure caries to develop i an otherwise healthy oral environment. The use of pit and fissure sealants is emphasised in case of deep pits and fissures.
Xerostomia is the diesease in which their is absence of saliva in mouth. The slide inlcudes all the helpful subjects about the topic. graphical representation for ease of understanding
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Definition
General properties
Composition
Function of saliva
Formation of saliva
Method for collecting saliva
Advantages
Limitations
Analysis of saliva done for the diagnosis of systemic disease
Definition:
by Stedmann’s & Lipincott medical dictionary.
A clear, tasteless, odourless, slightly acidic (pH 6.8) viscous fluid, consisting of the secretion from the parotid, sublingual, submandibular salivary glands and the mucous glands of the oral cavity.
General properties
Volume: 1000 to 1500 mL of saliva is secreted per day and, it is approximately about 1 ml/ minute.
Contribution by each major salivary gland is:
i. Parotid glands: 25%
ii. Submandibular glands: 70%
iii. Sublingual glands: 5%.
Reaction: Mixed saliva from all the glands is slightly acidic with pH of 6.35 to 6.85.
Specific gravity: It ranges between 1.002 and 1.012.
Tonicity: Saliva is hypotonSalivary flow
The average person produces approximately 0.5 L – 1.5 L per day
Unstimulated Flow (resting salivary flow―no external stimulus)
Typically 0.2 mL – 0.3 mL per minute
Stimulated Flow (response to a stimulus, usually taste, chewing, or medication [eg, at mealtime])
Typically 1.5 mL – 2 mL per minute
Development & growth of salivary glands /certified fixed orthodontic courses ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
topic includes salivary glands, structure & duct system of salivary glands, properties & composition of saliva, functions of saliva, regulation of salivary secretion, effect of drugs & chemicals on salivary secretion, saliva & oral biofilm, applied physiology.
Definition:
by Stedmann’s & Lipincott medical dictionary.
A clear, tasteless, odourless, slightly acidic (pH 6.8) viscous fluid, consisting of the secretion from the parotid, sublingual, submandibular salivary glands and the mucous glands of the oral cavity.
General properties
Volume: 1000 to 1500 mL of saliva is secreted per day and, it is approximately about 1 ml/ minute.
Contribution by each major salivary gland is:
i. Parotid glands: 25%
ii. Submandibular glands: 70%
iii. Sublingual glands: 5%.
Reaction: Mixed saliva from all the glands is slightly acidic with pH of 6.35 to 6.85.
Specific gravity: It ranges between 1.002 and 1.012.
Tonicity: Saliva is hypotonic.
Saliva - applied physiology and its role in dental cariesKarishma Sirimulla
this seminar includes formation of saliva,factors effecting salivary flow,various conditions associated with flow of saliva and most importantly role of saliva in dental caries.remineralization and demineralization balance maintained by saliva
Opportunity for Dentists (BDS/MDS )to relocate to United kingdom -Register as a DENTAL HYGIENIST/ DENTAL THERAPIST without Board exams and after approval you can register in GDC as a DH/DT and start working as a DH/DT Immediately and get paid.
You can complete the whole process in 3-4 months.Salary range for DH/DT is around 2500-3500 Pounds per month.
Eligibility / requirements-
1. An International English Language Testing System (IELTS) certificate
at the appropriate level.(Within 2 yrs of application date )
2: A recent primary dental qualification that has been taught and examined in English..(Within 2 yrs of application date )
3: A recent pass in a language test for registration with a regulatory authority in a country where the first language is English.
If you are interested Please contact us for more details.
1ST, 2ND AND 3RD ORDER BENDS IN STANDARD EDGEWISE APPLIANCE SYSTEM /Fixed ort...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals
who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry,
Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
I –Aligners are made with FDA approved transparent thermoplastic materials using 3D scanning, 3D Printing and finally Trays with Pressure vacuum formers.
Dear Doctor,
Indian Dental Academy Now offers comprehensive online Orthodontics course.
Course includes:
1.whiteboard lecture presentations
2.Case Discussions
3.with hundreds of pictures.
4.Demo on Models
5.Demo on Patients
6. subtitles in your own language
12 months unlimited access and support @350 USD only.
For Demo please visit :www.idalectures.com/preview/
For more details visit: www.idalectures.com
Please contact us for any clarifications:
idalectures@gmail.com
indiandentalacademy@gmail.com
Thanks & Regards
Indian Dental Academy
--
Indian Dental Academy
Leader in continuing dental education
www.indiandentalacademy.com
skype:indiandentalacademy
+919248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Cytotoxicity of silicone materials used in maxillofacial prosthesis / dental ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Diagnosis and treatment planning in completely endntulous arches/dental coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Properties of Denture base materials /rotary endodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Use of modified tooth forms in complete denture occlusion / dental implant...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
MATATAG CURRICULUM: ASSESSING THE READINESS OF ELEM. PUBLIC SCHOOL TEACHERS I...NelTorrente
In this research, it concludes that while the readiness of teachers in Caloocan City to implement the MATATAG Curriculum is generally positive, targeted efforts in professional development, resource distribution, support networks, and comprehensive preparation can address the existing gaps and ensure successful curriculum implementation.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
2. Contents
Introduction
Formation of saliva
Salivary secretion control
Functions of saliva
Affect of drugs on salivary function
Mechanism of action
References
www.indiandentalacademy.com
3. Salivary glands are specialized secretory
apparatus.
They show varying differentiation, structure
& arrangement in different species.
In human beings, all salivary glands arise
from the ectoderm of the oral cavity.
www.indiandentalacademy.com
4. Based on size; salivary glands divided into 2
types
1. Major salivary glands
2. Minor salivary glands: 600-1000 minor salivary
glands present throughout oral cavity and
oropharynx.
Salivary glands produce 1-1.5 lit. of saliva per day.
In total saliva 60% by submandibular, 35% by
parotid, 4% by sublingual, 1% by minor salivary
glands
www.indiandentalacademy.com
6. Based on type of secretion; – 2 types
1. Serous
2. Mucous
Parotid is pure serous.
Submandibular is mixed but predominately
serous.
Sublingual also mixed but predominately mucous.
www.indiandentalacademy.com
7. Minor salivary glands classified according to
their anatomical location.
Labial & Buccal glands — mixed in nature
Glassopalatine — pure mucous in nature
Palatine — pure mucous in nature
Lingual – Anterior — chiefly mucous in
nature
Posterior — pure mucous in nature
Post. Lingual serous — pure serous
www.indiandentalacademy.com
8. Definition
Saliva is complex fluid composed of a wide
variety of organic and inorganic constituents
that collectively act to modulate the oral
environment
Edger WM 1992
www.indiandentalacademy.com
9. Formation of saliva occurs in 2 stages
The basic functional unit of salivary gland is terminal
secretory unit called “acini” / “secretory end piece”
First stage – Primary saliva – produced by cells of
secretory end pieces & intercalated ducts
It is isotonic fluid containing most of the organic
components & water.
Second stage – primary saliva is modified as it
passes through the striated & excretory ducts,
mainly by reabsorption & secretion of electrolytes
The final saliva that reaches the oral cavity is
hypotonic.
www.indiandentalacademy.com
11. Saliva secretion control
The physiologic control is mediated through
ANS; particularly parasympathetic nervous
system.
The control of secretion is also linked to
changing taste & smell.
Each of these is capable of modifying the
amount & consistency of saliva though
gustatory stimulus is more important than
masticatory stimulus.www.indiandentalacademy.com
12. Postganglionic fibers of both sympathetic
and parasympathetic divisions innervate
the secretory cells.
Myoepithelial, arteriolar smooth muscle cells,
intercalated & striated duct cells also receive
direct innervation.
Unmylinated nerve invested by cytoplasmic
processes of Schwann, forms a plexus in the
connective tissue surrounding the terminal
secretory units.
www.indiandentalacademy.com
13. Cortex
Fear Anticipation of feeding
Hypothalamu
s
Salivary Nuclei
Superior Inferior
(Pons ) (Medulla)
Vomiting
Center
(Medulla
)
Trigeminal
Nuclei
TMJ
Periodontiu
m Muscles
Mastication
Submandibul
ar
Sublingual
Parotid
Gland
Smel
l
Nu.of
Tractus
Solitarius
Taste
-
-
VII IX
IXVII
+ +
+
+
www.indiandentalacademy.com
14. Composition
Saliva is made up of approximately 99% water
& 1% inorganic ions, secretory proteins & other
components
Secretory proteins- α-Amylase, ribonulease,
kallikrein, histatin, cystatin, sialoperoxidase,
lysozyme, lactoferin, mucins.
Organic components like glucose, amino acids,
urea, uric acid & lipid molecules
www.indiandentalacademy.com
23. Benzodiazepine Alprazolam
Anti-Arrhythmic drug Amiodarone
Anti -Anxiety drugs Buspirone
Anti-Depressants Venlafaxine
Anti-Epileptic drug Lamotrigine
Anti-Psychotic drugs Risperidone
Mood stabilizers Lithium
Demulcents Methylcellulose,
Propylene glycolwww.indiandentalacademy.com
24. Ofloxacin inhibits rat salivary gland
functions, which might be observed as a
side-effect in humans.
Properties of fluoroquinolones to alter
intracellular cAMP & calcium levels and their
ability to suppress DNA, RNA and protein
synthesis of acinar cells might be possible
reasons for the observed changes
Fundam Clin Pharmacol. 2001;15:307-11
www.indiandentalacademy.com
25. Atropine competitively blocks the
acetylcholine action ( M3 blockade) thereby
decrease the salivary flow.
Anti Histamines – Antagonize muscarinic
actions of acetylcholine; which decrease the
salivary flow.
Anti Cholinesterases like Tacrine,
Edrophonium increases the salivary flow by
increasing brain acetylcholine levels.
www.indiandentalacademy.com
26. Omeprazole causes reduction of plasma
secretin and cholecystokinin levels
recognised inhibitors of salivation
Omeprazole may convert acidic
gastro- esophageal reflux into alkaline reflux
thus reducing the volume of saliva stimulated
by the esophago -salivary reflex
www.indiandentalacademy.com
27. The mechanism of hyposalivation by
psychotrophic drugs is not yet clear.
They have many endogenous substance
receptors in the salivary glands that mediate
the salivary flow rate, such as substance P &
vasoactive intestinal peptide receptors.
The blocking of α-adrenergic receptors can also
lead to decrease in salivary flow rate and
alterations in the saliva composition.
www.indiandentalacademy.com
28. Antidepressants block the effects of
acetylcholine on the muscarinic M3
receptors, resulting in a decreased salivary
flow rate.
Antidepressants mainly TCAs modify the
salivary component concentration, e.g. total
proteins, α -amylase, glycoproteins,
calcium & potassium.
The benzodiazepines [BZD] decreases the
salivary flow rate through the BZD receptors
in the salivary glands & by indirect action on
the salivary glands through the central BZD
receptors. www.indiandentalacademy.com
29. Clozapine is have potent anticholinergic
effects
Development of transient salivary gland
swelling on clozapine therapy
Salivary gland swelling may be a possible
cause for the inhibition saliva flow
J clinical psychiatry 1995, vol. 56;11:511-
513
www.indiandentalacademy.com
30. Theophylline, a phosphodiesterase inhibitor,
is known to induce enlargement of the
salivary glands.
This enlargement has been thought to be
associated with enhanced cellular levels of
cyclic AMP as a result of inhibition of
phosphodiesterase, finally increase the
saliva flow
J Toxicologic Pathology Vol. 16 (2003)
;4: 215 www.indiandentalacademy.com
34. XEROSTOMIA
Xerostomia is defined as subjective
feeling of oral dryness resulting
from decreased salivary flow.
BURKET’S
www.indiandentalacademy.com
35. 1. Iatrogenic causes:
Drugs;
Anti Cholinergics ( Atropine, Hyoscine)
Anti Depressants (TCA’s, SSRI, Lithium. )
Anti Hypertensives
Anti Histamines
Anti Emetics
Phenothiazines
Proton pump inhibitors
Cytotoxic drugs
Opioids
BZD s
Diuretics
Decongestants
www.indiandentalacademy.com
36. 2. Salivary Gland Disorders
A. Damage to salivary glands
Auto immune diseases
a. SjŐgren’s syndrome
b. SLE
c. Scleroderma
d. Sarcoidosis
B. Infections ( HIV, HCV, HTLV-1)
C. Obstructive salivary glandwww.indiandentalacademy.com
37. 3. Therapeutic irradiation
4. Dehydration:
Decreased water intake
Water loss thro’ skin (Burns)
Diarrhoea
Blood loss
Emesis
5. Ageing
6. Diabetes
7. Vitamin deficiency
www.indiandentalacademy.com
38. 8. Interference with Neural
transmission:
Psychological disorders
Alzheimer’s disease
Paralysis of facial nerve
9. Decrease in mastication
10. Depression
www.indiandentalacademy.com
43. Pilocarpine Hydrochloride
Obtained from Pilocarpus Jaborandi plant
Fox et al (1998), reported a clinical trial in
primary Sjögren’s syndrome patients with
pilocarpine
1. Subjective improvement of xerostomia
2. Improvement of parotid & submandibular flow
rates
First medication approved by Food & Drug
Administration for the treatment of xerostomia in
patients with SS
www.indiandentalacademy.com
44. Parasympathetic Agent
Muscarinic Agonist
Causes pharmacological stimulation of
Exocrine glands
Acts by stimulating functional salivary gland
tissue
Hence not much effective in patients with
little remaining functional gland tissue
www.indiandentalacademy.com
45. Indications:
Mainly causes pupillary constriction & reduction of
IOP
Hence used in:
Primary open angle glaucoma
Angle closure glaucoma
Oral dose: 5-10 mg 1 hr before eating
Onset of action is 30 min
Duration of action: 2-3 hrs
www.indiandentalacademy.com
46. Contraindicated in patients:
Gall bladder disease
Narrow angle glaucoma
Acute iritis
Renal colic
SIDE EFFECTS
Sweating
GI upset
Bradycardia
Increased pulmonary secretions
Increased smooth muscle tone
Blurred vision
Risk to individuals
with:
Heart disease
Asthma
Angina pectoris
Chronic bronchitis
COPD
History of MI
www.indiandentalacademy.com
47. Cevimeline hydrochloride
Cholinergic agonist
Binds to Muscarinic receptors
Stimulates remaining functional salivary
gland tissue
Binds more specifically to M3 receptors than
to M1 & M2
Because it specifically targets the salivary
glands, side effects are less severe
Hence better tolerated than Pilocarpine
Approved by FDA for treatment of
xerostomia in SS patientswww.indiandentalacademy.com
49. Bethanechol chloride
Cholinergic drug
Used for: Urinary retention
Neurogenic atony of bladder
Stimulates Parasympathetic nervous
system
Everett (1975), published a study in which
Bethanechol was given to alleviate the
Anticholinergic side effects of TCA &
reported symptomatic improvement
www.indiandentalacademy.com
51. Dose: 10-25 mg 3-4 times daily
Onset of action of GI effects is 30 min
Duration of action is 1hr
Tab. Urotone – 25mg
Tab. Urotonin - 25mg
Common cholinergic side effects:
Sweating, GI upset, Miosis
Decreased BP & reflex tachycardia
Bronchial obstruction & Asthmatic attacks
www.indiandentalacademy.com
52. Bromhexine
Alkaloid derived from Adhatoda vasica
Mucolytic agent
Used for treatment of chronic bronchitis & COPD
Acts by increasing quantity of secretions while
decreasing their viscosity
Does not appear to be an effective treatment for
xerostomia (In clinical trials)
www.indiandentalacademy.com
53. Mucolytic Agents
Guaifensin & Potassium iodide
Used to treat respiratory infections
Decrease the viscosity of saliva
Improve the symptoms of oral dryness by
improving flow through salivary ducts
No controlled clinical trials have been
demonstrated
Dosage; Acolyt syrup, Acocotin-7.5mg
www.indiandentalacademy.com
55. Alpha interferon
Alteration in salivary cytokines are seen in
SS
These abnormal salivary cytokine levels
may contribute to progressive destruction
of salivary gland tissue in SS
Recombinant human alpha interferon may
function as a Biological response modifier
Improves salivary gland function in Auto
immune related xerostomia
Clinical trials with weekly IM injections of
alpha interferon demonstratedwww.indiandentalacademy.com
57. Causes for sialorrhea
1. Medication
2. Infant teething
3. The secretory phase of menstruation
4. Heavy metal poisoning
5. Oraganophosphorous poisoning
6. Nausea
7. Gastro Esophageal Reflux Disease
8. Obstructive esophagitis
9. Neurologic & neuromuscular diseases
www.indiandentalacademy.com
58. Management
Depending upon etiology of sialorrhea 3
treatment modalities are present;
1. Physical therapy
2. Medications
3. Surgical intervention
www.indiandentalacademy.com
59. Physical therapy
It can be used to improve neuromuscular
control.
Speech & swallowing therapy should be
attempted prior to medical & surgical
intervention.
Patient cooperation is essential, so this
therapy reported very low success rate.
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60. Medications
If patient is experienced sialorrhea
secondary to pharmaceutical treatment,
alternative medications should be evaluated,
If therapeutic regimen cannot be altered,
compatible xerostomic agents should be
considered.
Cholinergic muscarinic receptor antagonists
can be used
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61. Drugs like atropine, scopolamine can be
advised.
These drugs are contraindicated when there
is H/o cardiac problem,
closure glaucoma,
prostate hypertrophy,
paralytic ileus / pyloric obstruction.
Preparations & Dosages:
Atropine sulfate – 0.6 – 2mg i.m., i.v.
( Children 10µg/ kg )www.indiandentalacademy.com
62. Sublingual administered atropine reduces
hypersalivation
Hyson et al (2002), delivered 1 drop of
atropine (1%wt / vol solution containing 0.5
mg) sublingually twice a day.
Transdermal Therapeutic System [ TTS]; It is
a self adhesive dermal patch delivering
scopolamine, usually applied to prevent
nausea. www.indiandentalacademy.com
63. Zeppetella (1999), successfully used
scopolamine via nebulization in patients who
had not improved with transdermal patch.
With nebulized delivery system scopolamine is
absorbed faster & can be used on “as required”
basis.
It is helpful in patients with problematic bronchial
secretions.
Reinish et al (1997) reported that Amisulpride
(400mg/d up-titrated from 100mg/d over week)
produced significant improvement in
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64. Minimally invasive methods
Injection of botulinum toxin A:
BTX/A (7.5-15 units) is injected in the
salivary gland it inhibit acetylcholine release
mainly at neurosecretory junctions.
It binds SNAP-25 protein forming a complex
that impairs neuronal excytosis by inhibiting
fusion of the presynaptic vesicles containing
the neurotransmitter
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65. Photocoagulation of salivary ducts
It is aimed to minimize surgical
complications.
Chang & Wong used Nd:YAG laser
(1064nm) for intraductal laser
photocoagulation of bilateral parotid ducts at
7/10 watts during 10 seconds.
Concepts of laser-tissue interaction of
intraductal laser photocoagulation are based
on partial destruction of parotid gland &
occlusion of parotid ducts.
Postoperatively transient facial swelling iswww.indiandentalacademy.com
66. Tongue acupuncture
Wong et al, hypothesized that tongue
acupuncture stimulate the rich neural network in
the tongue, which is connected to salivary
glands & tongue muscles via the cranial nerve
nuclei; & improve salivary secretion and
swallowing mechanism.
Children easily tolerated the treatment with
significant improvement of hypersalivation & no
complications
This technique may be an alternative /
adjunctive option for children with intractablewww.indiandentalacademy.com
67. Surgical methods
Neurectomy – sectioning the parasympathetic
pathway reduces the flow of saliva.
The tympanic plexus and Chorda tympanic
nerves can be sectioned unilaterally or
bilaterally, and either alone in combination with
submandibular gland removal.
Chorda tympani neurectomy reduces the
salivary flow rate of the submandibular /
sublingual complex but it seems to be poor
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68. Chorda tympani neurectomy always
produces a loss of taste in the anterior 2/3rds
of the tongue.
Contraindicated in patients who already have
hearing problems.
Hearing loss is the possible complication
Despite an initially high success rate, the
long term results of neurectomies used alone
are relatively disappointing
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69. Salivary duct and gland
procedures
One of the earliest surgical management of
sialorrhea is;
Bilateral parotid duct relocation from buccal
vestibule to tonsillar fossa or posterior part of
tonsillar pillar to initiate the swallowing reflex.
Bilateral duct ligation of parotid glands combined
with submandibular gland removal gives goodwww.indiandentalacademy.com
70. The purpose of duct ligation is to obtain
gland atrophy.
Submandibular duct relocation performed
alone or in combination gives success
rate of 75% - 89%.
Occasional post operative complications
such as ranula formation, pain &
numbness.
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71. References
The pharmacological Basis of Therapeutics
Goodman & Gilman 10th Edition
Pharmacology & Pharmacotherapeutics
Satoskar 20th
Edition
Essentials of Medical Pharmacology
KD Tripathi 6th
Edition
www.indiandentalacademy.com
72. Oral Histology & Embryology
Orban 12th
Edition
J Contemp Dent Practice 2008; 9: 001-
032
O O O E 2008;106:58-
65
British Dental Jour 1992;172:305-
312 www.indiandentalacademy.com
73. Burket's Oral Medicine 11th Edition
Salivary gland dysfunction: A review of systemic
therapies
OOOE 2001;92:56-62
An update of etiology and management of
xerostomia
OOOE 2004;97:28-46
Drooling of saliva: A review of etiology and
management options
OOOE 2006;101:48-57
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