clinical significance of saliva Flashcards
what processes involve saliva?
-diseases of soft and calcified tissues
-interactions with restorative procedures and materials
-interaction with prostheses and prosthetic materials
-role in surgical procedures and wound healing
-interactions with food and oral therapeutics
salivary range and mean for female
range: 0.28-0.91mL
mean: 0.59mL
salivary range and mean for male
range: 0.32-1.55mL
mean: 0.87mL
total amount saliva secreted a day
1.5L a day
where do salivary components derive from
-major glands, minor glands, GCF
the rate of saliva secretions varies with..
-time of day, age, health status, education, flow rate
-most of resting saliva contributed by
submandibular (submaxillary)
most of stimulated saliva contributed by
parotid gland
more resting/chemical saliva secreted by each gland?
Submaxillary- more resting saliva]
parotid- more chemical stimulation saliva
Sublingual- more resting saliva
Effect of diff sialagogues on salivary flow rate
-Sucrose (sugar) stimulates secretion of saliva but less extent than NaCl salt
-citrous fruit and juices highest stimulation of saliva
Salivary flow over 24hrs
-lowest salivary flow during sleep
-highest at 6pm and midday
What is xerostomia
-rapid destruction of teeth and gums
-mucosal damage
-cracking
-candida infections
-problems with taste
-difficulties with mastication
-difficulties with swallowing
-periodontal disease
What volume of saliva for xerostomia to happen
-if saliva decreases to 0.1 or less
What can xerostomia cause
-rampant caries
-glossitis(cracked tongue)
-oral thrush
-cracked lips
Systemic causes of xerostomia:
-Sjogrens syndrome (autoimmune disease)
-autoimmune disease
-dry eyes/dry mouth
-primary SS (not associated with any other autoimmune disease)
-secondary SS (associated with other autoimmune conditions such as rheumatoid arthiritis
causes of xerostomia
-systemic causes
-medications
-cancer therapies
-neurological
-undiagnosed diabetes
-sialotrophic infections
mechanical function of saliva
lubrication: mucosa, swallowing and speech
-dissolve food and aids taste
chemical function of saliva
-buffering, remineralisation
-antimicrobial effect
-protective and reparative function
salivary defence factors
anti microbial: lysosome, immunoglobulins, lactoferrin,
protection of soft tissue: growth factors, lactoperoxidase
protection of hard tissues: buffers, florid ion, pellicle membranes, other antibacterial factors, pH rise factors, calcium, phosphate
role of saliva in maintaining oral health
look at table
how can medications cause Xero
over 500 types of drugs can cause e.g. antiacne agents, anti anxiety agents, antihistamines, antidepressants etc more on pp
how can cancer therapies cause Xero
1) radiation therapy: salivary glands highly sensitive to radiation therapy used to treat head and neck cancers
-serous acinar cells more sensitive than mucous cell types
2)chemotherapy: can cause changes to salivary flow rate and composition
-immunosupression affects salivary immunoglobulin content, increasing dry mouth
other causes Xero
-undiagnosed diabetes
-neurological causes: Bell’s Palsy, cerebral palsy, trauma
-sialotrophic infections: hep C, HIV
salivary stimulation therapies
chewing sugar free gum
water based ioral gels
medication (cholinergic agonists)
artificial salivary substitutes
-Pilocarpine-used for head and neck cancer/Sjogrens syndrome
cevimeline: for sjogrens syndrome
how is oral cavity compartmentalised
-poisitoning of major glands
-oral conformation
results in: limited transfer across mouth, site-specific retention
read rest on pp
pp
