Saliva 2 - Biochemistry of saliva (clinical significance)

Question 1

What are females salivary stats?

Answer 1

Range – 0.28 – 0.91 m L
Mean – 0.59 mL
S.D. – 0.18 mL

Question 2

What are male salivary stats?

Answer 2

Range – 0.32 – 1.55
Mean – 0.87
S.D. – 0.28

Question 3

What are the symptoms of zerostomia

Answer 3

Cracking
Problems with mastication and swallowing
Candida infections
Rapid destruction of teeth and gums

Question 4

What is

Sjorgens disease?

Answer 4

Immunological disease that attacks parotid + sub maxillary tissue
Primary saliva- not associated with other immunological disease
Secondary saliva – associated with other immunological diseases (lupus/rheumatoid arthritis)
Symptoms include:
- Dry eyes
- Dry mouth

Question 5

What medication causes zerostomia?

Answer 5

Muscle relaxants
Anti inflammatory analgesics
Anti histamines
Diuretics

In elderly synergism of medication is the most common cause due to side effects

Question 6

How does radiation therapy affect radiation therapy?

Answer 6

Serous cells contain heavy metal ions that absorb energy and release free radicals
Amifostine scavenges for heavy metal ions that may cause damage to tissues
Parotid gland should be covered during radiation
After radiation the other glands become more active to compensate for damaged
Saliva becomes more viscous and a yellow brown colour & buffering capacity reduced

Question 7

How does chemotherapy affect radiation therapy?

Answer 7

Complete immunosuppression which increases immunoglobulins
Results in:
- Caries
- Opportunistic infections
- Perio disease
Many cancer inhibiting drugs cause xerostomia
Amifostine is also used to detoxify metabolites of cis-platin

Question 8

What causes salivary stimulation?

Answer 8

Chewing gum
Artificial salivary substitutes (Oralube + Xerolube) Carboxymethylcellulose
- Water based gel
Medication
- Pilocarpine – used for SS patients + H/N cancer
- Cevimeline – used for SS
Side effects 
- excess sweating

Question 9

What does saliva contribution from each gland affected by?

Answer 9

Time of day
Age
Health status
Medication
Circadian rhythm

Nature of salivary simulant has an effect on the saliva (sweet/salty)

Oral cavity is compartmentalised (due to positioning of glands) limited transfer across mouth

Question 10

Describe site specific clearance

Answer 10

More fluoride is retained in upper sulcus
Sugars also prone to be greater at certain sites Inc. caries susceptibility at certain sites
Carcinogen exposure will be greater at certain sites
Release of fluoride from glass ionomers wont protect whole mouth limited transfer

Question 11

What information is key when analysing saliva?

Answer 11

Must know time of day/nature of sample/ how saliva was collected/ flow rate
Best to analyse saliva straight away loss of enzyme activity/ protein denaturation pH changes