clinical significance of saliva

Question 1

what processes involve saliva?

Answer 1

-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

Question 2

salivary range and mean for female

Answer 2

range: 0.28-0.91mL
mean: 0.59mL

Question 3

salivary range and mean for male

Answer 3

range: 0.32-1.55mL
mean: 0.87mL

Question 4

total amount saliva secreted a day

Answer 4

1.5L a day

Question 5

where do salivary components derive from

Answer 5

-major glands, minor glands, GCF

Question 6

the rate of saliva secretions varies with..

Answer 6

-time of day, age, health status, education, flow rate

Question 7

-most of resting saliva contributed by

Answer 7

submandibular (submaxillary)

Question 8

most of stimulated saliva contributed by

Answer 8

parotid gland

Question 9

more resting/chemical saliva secreted by each gland?

Answer 9

Submaxillary- more resting saliva]
parotid- more chemical stimulation saliva
Sublingual- more resting saliva

Question 10

Effect of diff sialagogues on salivary flow rate

Answer 10

-Sucrose (sugar) stimulates secretion of saliva but less extent than NaCl salt
-citrous fruit and juices highest stimulation of saliva

Question 11

Salivary flow over 24hrs

Answer 11

-lowest salivary flow during sleep
-highest at 6pm and midday

Question 12

What is xerostomia

Answer 12

-rapid destruction of teeth and gums
-mucosal damage
-cracking
-candida infections
-problems with taste
-difficulties with mastication
-difficulties with swallowing
-periodontal disease

Question 13

What volume of saliva for xerostomia to happen

Answer 13

-if saliva decreases to 0.1 or less

Question 14

What can xerostomia cause

Answer 14

-rampant caries
-glossitis(cracked tongue)
-oral thrush
-cracked lips

Question 15

Systemic causes of xerostomia:

Answer 15

-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

Question 16

causes of xerostomia

Answer 16

-systemic causes
-medications
-cancer therapies
-neurological
-undiagnosed diabetes
-sialotrophic infections

Question 17

mechanical function of saliva

Answer 17

lubrication: mucosa, swallowing and speech
-dissolve food and aids taste

Question 18

chemical function of saliva

Answer 18

-buffering, remineralisation
-antimicrobial effect
-protective and reparative function

Question 19

salivary defence factors

Answer 19

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

Question 20

role of saliva in maintaining oral health

Answer 20

look at table

Question 21

how can medications cause Xero

Answer 21

over 500 types of drugs can cause e.g. antiacne agents, anti anxiety agents, antihistamines, antidepressants etc more on pp

Question 22

how can cancer therapies cause Xero

Answer 22

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

Question 23

other causes Xero

Answer 23

-undiagnosed diabetes
-neurological causes: Bell’s Palsy, cerebral palsy, trauma
-sialotrophic infections: hep C, HIV

Question 24

salivary stimulation therapies

Answer 24

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

Question 25

how is oral cavity compartmentalised

Answer 25

-poisitoning of major glands
-oral conformation
results in: limited transfer across mouth, site-specific retention

Question 26

read rest on pp

Answer 26

pp