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IOE > Saliva > Flashcards

Saliva Flashcards

1
Q

what is dry mouth called?

A

xerostomia

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2
Q

what are the effects of having a lack of saliva?

A
  • rampant caries
  • no buffering
  • no control of caries
  • oral thrush (candida infection)
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3
Q

what are the main causes of xerostomia?

A
  • disease of the salivary glands
  • medications
  • cancer therapies
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4
Q

what diseases can cause xerostonia?

A
  • Sjogrens syndrome (autoimmune disease causing parotid and submandibular gland dysfunction)
  • undiagnosed diabetes
  • neurological sialotrophic infections (eg HIV and Hep C)
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5
Q

how can can cancer therapies cause xerostonia?

A
  • radiation can damage cells, Serous acinar cells are the most sensitive.
  • chemo can change flow rate + composition. Immunosuppression affects salivary immunoglobulin content.
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6
Q

How can saliva be stimulated/replaced topically?

A
  • sugar-free gum/sweets.
  • artificial salivary substitutes
  • water-based gels
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7
Q

How can saliva be stimulated/replaced systemically?

A

-medications (cholinergic agonists providing parasympathetic stimulation)

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8
Q

what components does saliva have that gives it antimicrobial factors?

A
  • Lysozymes
  • Immunoglobulins
  • Lactoferrin
  • Complement Factors
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9
Q

what components does saliva have that enables it to protect soft tissues?

A
  • growth factors

- lactoperoxidase

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10
Q

what components does saliva have that enables it to protect hard tissues?

A
  • buffers
  • fluoride ions
  • pellicle proteins
  • other antibacterial factors
  • pH rise factors (Sialin)
  • Calcium
  • phosphate
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11
Q

what is saliva derived from?

A
  • major glands
  • minor glands
  • crevicular fluid exudate
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12
Q

the contribution of saliva for each is source is dependent on what different factors?

A
  • time of day
  • age
  • health status
  • medication
  • flow rate
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13
Q

which gland contributes the most saliva?

A

submandibular

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14
Q

what happens to flow rate at night?

A

decreases

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15
Q

why does saliva clear the lower teeth more than upper teeth?

A

due to submandibular gland ducts positioning.

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16
Q

what are buffers?

A

molecules that resist (slow down) pH changes.

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17
Q

what needs to bind to an acid in saliva to prevent a pH change creating a weak acid?

A

conjugate base.

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18
Q

why can buffering only work to an extent?

A

becuase there is only so many ions available in saliva that can bind to the acid.

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19
Q

within how much pH units and buffering work of the pKa number?

A

1 - buffering can only work to within 1pH unit o the pKa value of the buffering agent.

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20
Q

what does the midpoint describe when looking at buffers?

A

equal amounts of buffer and conjuent base - this is the best place.

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21
Q

how many times can phosphoric acid (H3PO4) be buffered and how many midpoints will there be?

A

3 times due to having 3 protons that can be dissociated.

3 midpoints

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22
Q

How many times can actate acid (CH3COOH) be buffered and how many midpoints will there be?

A

Once due to only having the one proton available .

one midpoint.

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23
Q

what would a higher acid buffer component that conjugate base component mean for saliva?

A

more effective buffering added bases.

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24
Q

what would a higher conjugate base component that acid buffer component mean for saliva?

A

more effective at buffering added acids.

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25
Q

how can pH of a buffer be worked out?

A

using Henderson-Hasselbalch equation.

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26
Q

what is the ideal pH for animals?

A

7.4pH

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27
Q

why is acidosis more of a threat to animal life compared to alkalosis?

A

because we produce more acids through metabolic processes.

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28
Q

what is different about histidine?

A

only amino acid with a pKa value close to physiological pH - so only amino acid with buffering potential.

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29
Q

How does buffering maintain tooth structures?

A
  • prevents dissolution of the tooth surfaces.
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30
Q

why are buffers needed to protect hard tissues?

A
  • enamel is composed of HAP so will start to dissolve when acid is in the mouth to created an equilibrium with its constituent ions in saliva.
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31
Q

what are the buffering systems in saliva?

A
  • bicarbonate
  • phosphate
  • proteins
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32
Q

what enzyme does saliva contain that catalyses the uptake of the protons to bicarbonate which increases the efficiency of the buffering system?

A

carbonic anhydrase

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33
Q

what is the produce after bicarbonate has buffered an acid?

A
  • water

- co2 (which is removed into the atmosphere)

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34
Q

why is saliva stimulated due to mastication and chemicalstimulation of taste buds?

A

to increase flow rate - creating a washing action, moving fermentable food and acidic food/drink away quickly.

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35
Q

what is plaque acid?

A

bacterial fermenting dietry carbs.

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36
Q

does pH increase or decrease with flow rate?

A

increase.

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37
Q

what happens to bicarbonate concentration with an increase in flow rate?

A

increases.

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38
Q

what components of saliva maintains oral hygiene?

A
  • lysozymes

- peroxidase

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39
Q

what components of saliva maintains mineralisation of teeth?

A
  • Calcium
  • pH rise factors

preventing xerostomia

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40
Q

what components of saliva maintains lubrication?

A
  • mucin
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41
Q

what components of saliva aids in digestive functioning?

A
  • amylase

- lipase

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42
Q

what cells enable control of how much saliva is flowing at once and how?

A

myopeitherial cells as they contain smooth muscle.

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43
Q

compared to plasma does saliva have a higher concentration of potassium (K) and bicarbonate (HCO3)?

A

Yes

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44
Q

compared to plasma does saliva have a higher concentration of sodium (Na+) and Chlorine (Cl-) ?

A

No

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45
Q

what is primary secretion of saliva?

A
  • secretion into the acini
  • contains amylase, mucous, electrolytes.
  • isotonic
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46
Q

what is secondary secretion of saliva?

A
  • striated ducts
  • Na + Cl reabsorbed from duct
  • K + HCO3 secreted
  • hypertonic
  • no movement of water.
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47
Q

what channels are in the cell wall of the striated ducts allowing movement across?

A
  • sodium channel
  • sodium-hydrogen exchanger
  • sodium-potassium pump
  • chlorine-bicarbonate exchanger
  • chlorine channel
48
Q

why does composition of saliva depend on flow rate?

A

more time saliva spends in the secondary ductal system more time for modification.

49
Q

what nervous system stimulates secretion?

A

both parasympathetic and sympathetic.

50
Q

how does the parasympathetic nervous system stimulate secretion?

A
  • copious flow of watery saliva

- contracts smooth muscle cells around acinus and vasodilatation

51
Q

how does the sympathetic nervous system stimulate secretion?

A
  • small amount of salvia rich in enzymes (flight or flight)
52
Q

what happens to sodium in saliva if aldosterone increases?

A

reduces as it prevents stimulation by mineralocorticoids.

53
Q

what are the main inorganic components of saliva?

A
  • Hydrogen ions
  • Bicarbonate ions
  • Sodium and Potassium ions
  • Calcium and Magnesium ions
  • Phosphate ions
  • Hydroxyapatite
  • Fluoride.
54
Q

what are the main organic components of saliva?

A
  • Mucins
  • Statherine
  • proline-rich proteins
  • histatines
  • immunoglobulines
  • enzymes (amylase, lysozymes, peroxidase)
  • lactoferrin
  • cystatins
  • pH rise factors
55
Q

what is the purpose of hydrogen ions (H) in saliva?

A
  • determines pH
  • remineralisation
  • determines solubility of other salivary proteins.
56
Q

what is the purpose of bicarbonate ions (HCO3) in saliva?

A
  • buffer
57
Q

what happens to the concentration of bicarbonate ions (HCO3) in saliva when flow rate increases?

A

concentration increases

58
Q

why does bicarbonate make a good buffer?

A

Ka value is 6.1 - so when pH is 6.1 there will be an equal concentration of carbonic acid and bicarbonate ions.

59
Q

how is carbonic acid generated?

A

by the actions of carbonic anhydrase present in the salivary glands,

60
Q

what are sodium and potassium present in saliva?

A

as counter ions to prevent electrical neutrality.

61
Q

what ion does sodium counter act?

A

bicarbonate.

62
Q

what ion does potassium counter act?

A

phosphate.

63
Q

what happens to the concentration of sodium ions (Na) in saliva when flow rate increases? and why?

A

increases - as saliva spends less time is striated ducts so isn’t removed.

64
Q

what happens to the concentration of potassium ions (K) in saliva when flow rate increases? and why?

A

stays constant as it is added to the ductal fluid through the duct.

65
Q

what happens to the concentration of Magnesium ions (Mg) in saliva when flow rate increases?

A

concentration decreases - dilution effect.

66
Q

what happens to the concentration of calcium ions (Ca) in saliva when flow rate increases?

A

stays constant.

67
Q

what is the purpose of calcium in saliva?

A
  • forms complexes with calcium-binding salivary proteins

- maintains ionic product for HAP, through inhibiting dissolution and bringing about repair of tooth mineral.

68
Q

what happens to the concentration of phosphate ions (HPO) in saliva when flow rate increases?

A

concentration decreases - dilution effect.

69
Q

what is the purpose of phosphate in saliva?

A
  • buffer (esp in unstimulated saliva)

- - maintains ionic product for HAP, through inhibiting dissolution and bringing about repair of tooth mineral.

70
Q

what will happen to the tooth mineral if there is not enough calcium and phosphate in saliva?

A

hydroxyapatite will dissolve trying to create an equilibrium.

71
Q

what will happen if there is too much calcium and phosphate in saliva? (super saturated)

A

encourage recipitation of minerals resulting in calculus or salivary stones.

72
Q

why is saliva super saturated with HAP?

A

so that repair is favoured.

73
Q

what is the chemical formula for hydroxyapatite?

A

Ca10 (PO4)6 (OH)2

74
Q

why would fluoride ion concentration in saliva change?

A

in areas of water fluoridation.

75
Q

what is the function of fluoride in saliva?

A
  • increases stability of HAP structure and inhibits acid dissolution through replacing OP in the HAP structure.
  • promotes repair of tooth structure - through favouring repecipitation of HAP.
76
Q

Is hydrogen an inorganic or organic component of saliva?

A

inorganic

77
Q

Is bicarbonate an inorganic or organic component of saliva?

A

inorganic

78
Q

Is sodium an inorganic or organic component of saliva?

A

inorganic

79
Q

Is potassium an inorganic or organic component of saliva?

A

inorganic

80
Q

Is calcium an inorganic or organic component of saliva?

A

inorganic

81
Q

Is magnesium an inorganic or organic component of saliva?

A

inorganic

82
Q

Is phosphate an inorganic or organic component of saliva?

A

inorganic

83
Q

Is fluoride an inorganic or organic component of saliva?

A

inorganic

84
Q

Is hydroxyapatite an inorganic or organic component of saliva?

A

inorganic

85
Q

is mucin an inorganic or organic component of saliva?

A

organic

86
Q

Is statherine an inorganic or organic component of saliva?

A

organic

87
Q

Is proline-rich protein an inorganic or organic component of saliva?

A

organic

88
Q

Is histatin an inorganic or organic component of saliva?

A

organic

89
Q

are immunoglobulins an inorganic or organic component of saliva?

A

organic

90
Q

Is amylase an inorganic or organic component of saliva?

A

organic

91
Q

Is lysozyme an inorganic or organic component of saliva?

A

organic

92
Q

Is salivary peroxidase an inorganic or organic component of saliva?

A

organic

93
Q

Is lactoferrin an inorganic or organic component of saliva?

A

organic

94
Q

Is cystatins an inorganic or organic component of saliva?

A

organic

95
Q

are pH rise factors an inorganic or organic component of saliva?

A

organic

96
Q

what is the purpose of salivary mucins?

A
  • lubricate the mouth and protect hard and soft tissue surfaces from damage and removal of water.
  • barrier to microbial colonisation
  • aid regulation of other salivary proteins and peptides.
  • antimicrobial and anti-fungal.
97
Q

what are the different types of mucins?

A

-MG1 and MG2

98
Q

what is the different between MG1 and MG2?

A

mg1=

  • 3 different gene products)
  • oligomeric structure.
  • forms complexed with other salivary components.

mg2=

  • single gene product
  • binds oral pathogens and yeast (candida)
99
Q

what is the purpose of statherine in saliva?

A
  • portion can bind to calcium and prevent spontaneous precipitation of HAP from saliva.
  • binds to existing HAP minerals, inhibiting further crystal growth.
100
Q

what cells produces statherine?

A

acinar cells.

101
Q

what is the purpose of proline-rich proteins in saliva?

A

binds to HAP - inhibits growth - they are the most common in saliva.

102
Q

what organic components of saliva are components of the salivary pellicle?

A
  • Proline-rich proteins.
  • Histatins.
  • Amylase
  • Cystatins
103
Q

what is the purpose of histatins in saliva?

A
  • inhibitor of candida.
  • some activity against streptococcus mutans.
  • binds calcium- preventing HAP precipitation.
  • low concentration in saliva
104
Q

what is the purpose of immunoglobulins in saliva? and how do they carry out this function?

A
  • defence against pathogens.

- recognises very specific pathogens, binds to them, swallows then then removes it from the body.

105
Q

what is the main type of immunoglobulin in the body? and how is it secreted?

A

IgA

  • secreted into salive via epitherlia cells of the gland - picks up additional polypeptide chains which offer protection in the mouth.
  • is also called sIgA (secreted IgA)
106
Q

what are the main different enzymes found in saliva?

A
  • Amylase
  • Lysozyme
  • Salivary peroxidase
107
Q

what is the purpose of amylase in saliva?

A
  • digests carbs - catalyses the hydrolysis of a-1-4 glycosidic bond between glucose molecules.
108
Q

what other ion activated amylase?

A

chloride ions.

109
Q

which gland is amylase mostly secreted from?

A

parotid gland

110
Q

what is the purpose of lysozyme in saliva?

A
  • anti-microbial
  • catalyses the hydrolysis between the bonds of the bacterial cell wall causing lysis and death.
    (BUT some because have a protective coating around it preventing lysozyme attacks)
    -acts copperatively with sIgA
  • binds to HAP
111
Q

what is the purpose of salivary peroxidase in saliva?

A
  • toxic to baceria - inhibits bacterial metabolic enzymes used in energy production.
  • removes hydrogen peroxide (which is damaging to soft tissues)
  • anti-microbia.
112
Q

what could be a result in low levels of salivary peroxidase in saliva?

A

more susceptible to periodontal breakdown.

113
Q

what is the purpose of lactoferrin in saliva?

A
  • antimicrobial
  • -binds to ferric ions reducing the number available so bacteria cannot use them for nutrients.
  • (BUT can be degradable by some bacteria’s and used as nutrition for them)
114
Q

what is the purpose of cystatins in saliva?

A
  • bind to and inhibit enzymes that break down proteins,
  • inhibit bacterial protease protecting the soft tissues.
  • bind to HAP
115
Q

what is the purpose of pH rise factors in saliva?

A
  • acid neutralisers.

- can produce ammonia which neutralises plaque and (but this can produce putrescine, which causes halitosis)

IOE (5 decks)

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