Term
| What medications cause dry mouth? |
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Definition
- anticholinergics
- antidepressants/antipsychotics
- NSAIDs, opioids, muscle relaxants, BZDs, antihistamines
- HTN: clonidine, alpha/beta blockers, calcium channel blockers, diuretics, AceI |
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Term
| What are therapies for dry mouth? |
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Definition
- Candy, sugar free sucking gum
- carboxy/hydroxymethylcellulose, including Mouth Kote, Biotene, Moi-stir spray. Caphosol is expensive, a medical device
- Pilocarpine/salagen and Cevilemine/Evoxac |
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Term
| What can be used to treat sensitive teeth? |
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Definition
KNO - in sensodyne
**Caused by bulimia, GERD, teeth grinding, excessing carbonated beverages. Aggressive brushing |
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Term
| What is another name for canker sores? |
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Definition
Recurrent Aphthous Stomatitis - noninfectious, onset more common in teen years. Overproduction of inflammation - stress, food allergy, can run in the family. Smoking!
**Occur on inside of the mouth, heal in 1-2 weeks. |
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Term
| How are canker sores treated? |
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Definition
Evidence is limited:
- Amlexanox/aphthasol - only FDA approved, has best evidence. Can stop in prodromal phase. Apply QID
- Topical steroids reduce pain
- Topical tetracycline
- Sucralfate susp - reduce pain as a protectant
- Chlorhexadine - speeds healing |
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Term
| What nonprescription medications can be used for canker sores? |
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Definition
- Benzocaine/anbesol - reduces pain. Avoid use in kids under 2!
- Canker cover - citrus oils/menthol
- Carbamide or H2O2 to debride - only use for 7 days
- Salt water/baking soda pastes to reduce discomfort, listerine to reduce healing |
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Term
| What supplements can be used for canker sores? |
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Definition
- Vitamin B12 1000 mcg QD for prophylaxis
- Propolis - antimicrobial/anti-inflammatory |
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Term
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Definition
herpes simplex I - recurrent outbreaks in 1/3 of adults. Occur on the lip, or around the mouth. Heals in 10 days
**Herpes Simplex Labialis. Can see a fever, unlike canker sores |
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Term
| How are recurrent cold sores treated? |
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Definition
- Acyclovir 400 5x/day x5 days
- Valtrex 2g BID
- Famciclovir 1500 mg single dose
**Heals faster, does not cure. |
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Term
| How are topical antivirals used for cold sores? |
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Definition
- less effective and convenient than oral antivirals:
- Acyclovir 5% cream 5x daily
- penciclovir/denavir - every 2 hours
- Xerese: acyclovir + hydrocortisone 1% cream 5x/day for five days |
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Term
| What is suppression treatments for cold sores? |
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Definition
- For frequent outbreaks that affect quality of life
- Acyclovir 400 BID
- valacyclovir 500 QD-BID (HIV), or 1g QD
- Famciclovir 500 mg BID |
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Term
| What non-prescriptions are used to treat cold sores? |
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Definition
- Docosanol/Abreva - the only FDA approved OTC for cold sores. Apply 5x daily until sores heal, max 10 days. Blocks herpes virus from entering cells. Only for age>12
- Topical anesthetics - camphor, benzyl alcohol, pramoxine, phenol, menthol, benzocaine (20% in Anbesol)
- Protectants relieve dryness - allantoin, petrolatum, calamine
**Do not use salicylic acid |
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Term
| What supplements can be used for cold sores? |
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Definition
- Lysine 1000 mg - may reduce recurrence, severity, healing time. high arginine intake affects lysine efficiency - nuts have high arginine
- lemon balm/propolis |
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Term
| What are the phases of canker sores? |
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Definition
- Prodromal phase - tingling/burning up to two days prior to ulcer appearance
- Painful sore 3-15 mm. No fever, white/yellow center. |
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Term
| What are nonpharmacologic txs for canker sores? |
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Definition
- Diet - avoid caffeine, spices, citrus, nuts, chocolate
- ICE application
- home remedies: mouth rinse/mylanta |
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Term
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Definition
Carbamide peroxide 10% to debride canker sores: up to QID for 7 days. DO NOT SWALLOW.
**For ages 2+ years, for direct application, do not dilute. Expectorate! |
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Term
| What are OTC products for canker sores? |
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Definition
- Rinses - soothe with water, glycerin, bicarb, Rincinol
- Oral anesthetics - benzocaine 20%
- Canker cover - citrus oils and menthol |
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Term
| What is the problem with benzocaine in children < 2? |
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Definition
| May cause methemoglobinemia - pale, gray/blue skin, lips, nail beds. Considered a medical emergency! |
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Term
| How is herpes labialis spread? |
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Definition
- Direct skin or mucous contact or sharing of utensils/drinks
- transmission can occur from the first tingle until healed |
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Term
| What are triggers for cold sores? |
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Definition
- Stress!
- Cold weather
- Staying out in the sun |
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Term
| What are non-pharmacologic treatments for cold sores? |
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Definition
- Avoid triggers
- Diet: avoid acidic foods, pickles
- Keep lips moist
- Sunscreen
- Change toothbrush |
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