Saliva I Flashcards

1
Q

What are the functions of saliva and what is it?

A
Saliva is quite complex as a fluid
Dilute aqueous solution of organic and inorganic compounds
Numerous functions (Box 9.1) :
	- bolus formation, lubricant
	- buffer, solvent, minerals
	- enzymes, anti-bacterials 
	- physiologically active substances

digestion
antifungal action
temperature regulation

Saliva is protective, the first barrier to what the oral cavity perceives as a hostile environment. Ppl with low salivary flow rates lose their dentition very quickly.
It’s hard to swallow something that is dry. It has glycoproteins that suck up water.
As flow rates decrease, buffer capacity decreases, and these are critical for integrity of your teeth.
There are growth factors in saliva.

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2
Q

How much saliva is secreted/day and what happens to most of it and what makes the saliva? How does it alter its composition?

A

~ 0.75L/ day (1/5 total plasma volume)
Most saliva is swallowed and reabsorbed by the gut
Saliva comprised of the exudate of all salivary glands (esp. major s.g.: parotid, submandibular, and sublingual glands)
Therefore, it alters its composition depending on whether saliva is analyzed at resting flow rates or at stimulated flow rates

salivary flow is lowest when you’re sleeping

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3
Q

What is one of the most important statements of saliva in regards to the acidity of the oral cavity?

A

WHEN YOU INCREASE THE FLOW RATE YOU DECREASE THE ACID!!!!!! THINK OF WHAT THIS WILL DO TO THE ORAL CAVITY!!!!!

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4
Q

What creates viscosity in the saliva?

A

1) Lubrication: What creates viscosity?

The major proteins that are manufactured in the salivary glands are glycoproteins (mucins)
	- viscous
	- polypeptide helix
	- carbohydrate side chain
	- large #’s of GP’s. are produced
Sublingual - sulphur, sialate
Submandibular - neutral, acidic
  DON’T NEED TO KNOW EXACTLY WHAT IT IS BUT IT IS A PROTEIN CARBOHYDRATE CHAIN – KNOW THIS. THEY SOAK UP WATER. 

Don’t need to know these other names for like the sublingual and submandibular.

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5
Q

What is the function of most of the other proteins in saliva?

A

1) Lubrication:

The other proteins in salivary do impart some viscosity, but none are as effective as glycoprts in lubricating
- resist the action of proteolytic enzymes
- protect the epithelial wall of GI tract
Without these proteins, formation of bolus, swallowing and speech become very difficult

Resist the action of proteolytic enzymes, enzymes that like to break down tissues.

XEROSTOMIA!!!!!!!! its dry mouth

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6
Q

How does saliva aid in digestion?

A

Many of the proteins (enzymes) that give saliva its viscosity are also important in digestion of food particles

- Salivary amylase
- Salivary Lipase
- Peroxidase

Salivary amylase, breakdown carbohydrates
Lipase for fats
Peroxidase is antibacterial.

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7
Q

Are there more than one form s of salivay amylase (ptyalin)? What does it do?

A

Salivary amylase (ptyalin)

Enzyme responsible for breaking down starch, esp. in foods that have been degraded by cooking

Comes in two forms
a - amylase (a-1,4, glucan-4-glucanohydrolase)
b - amylase (found mainly in plants, bact.)

How does it work?
Starch is made up of 2 polysacharrides
amylose (this is 1-4 carbon linked)

amylopectin is the same as amylos except it has a 1-6 carbon linked part

a - amylase attacks the starch at the 1 - 4 carbon bonds between each glucose molecule

The end products of this digestion are glucose & maltose molecules and residual complexes of 1-6 carbon linked molecules - limit dextrans

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8
Q

What are the breakdown products of starch?

A

glucose, limit dextrans, maltose (2 glucose linked 1-4)

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9
Q

What is the optimal working pH of salivary amylase? how does this effect it and what does this mean for digestion?

A

Salivary amylase is a slow working enzyme that works at optimal pH of 6.8

Amylase become inactivated when in contact with stomach contents

Most carbohydrate degradation will take place in the stomach/ small intestine (pepsin)

So what is it more probable function?

Likely role of salivary amylase is break down residual food trapped in between teeth

Would expect that persons with higher levels of amylase would have higher incidence of caries

Why?

But compounded by other factors such as
Flow rate of saliva
Presence of acid producing bacteria

When you increase flow rate you increase amylase and you wash everything else.

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10
Q

What is one antibacterial action of saliva with mechanical action?

A

Mechanical actions of cheeks & tongue remove some adherent bacteria
Lack of this activity is most noticable first thing in the morning (oral horribilis)

The bacteria are suspended in the saliva and are generally swallowed/expectorated

Many surfaces are not cleansed by this action
That’s why tooth brushing is important.

What else is there about saliva that helps control bacteria?

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11
Q

What is another antibacterial function of saliva with mixture of all three glands?

A

When saliva becomes mixed (from all 3 glands) it develops “Leucotactic activity factor”

This factor helps attract polymorphonuclear leukocytes (PMN’s) to the saliva.

Strangely, the factor “Leucotaxin” is formed as a result of the action of bacterial proteolytic enzymes on the salivary proteins

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12
Q

What other antibacterial action does the saliva have in regards to immunoglobulins?

A

There are also immunoglobulins released from the capillary bed that permeate into the saliva

IgA > IgM > IgG

Form Opsonins that attach to bacteria surface membranes so that PMN’s can recognize as foreign and attack

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13
Q

what is an antibacterial action of saliva that involved bacterial cell walls?

A

There are enzymes in saliva that attack bacteria

Lysozyme (muramidase) dramatically attacks and dissolves certain bacterial cell walls - esp. those with polysacharrides

Depends on amount of mucin present as to effectiveness

Kills Micrococcus lysodeikticus well
Works more slowly against others - both cariogenic and non-cariogenic

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14
Q

What is an antibacterial action of saliva in regards to salivary bacteria?

A

Salivary bacteria also produce anti-bacterials

Why?

To antagonize/prevent colonization by other species

Produce hydrogen peroxide as well as lactic acid

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15
Q

What is an example of the antibacterial action of saliva in regards to hydrogen peroxide?

A

Another example
Salivary bacteria produce hydrogen peroxide

This combines with thiocyanate, present in small amounts in saliva

End result is formation of very effective but unstable bacteriocidal

Cyanosulphurous (ic) acid

HO2SCN		HO3SCN
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16
Q

What is an example of antibacterial action of saliva in regards to how well it performs as an antibacterial?

A

How well saliva performs as an antibacterial depends on many factors

Once bacterial species take hold, often the end result is an increase in cariogenic activity
This is due to production of acid

Streptococcus mutans, Actinomyces, Lactobacillus acidophillus

So what property does saliva have to combat this?

Flow rate and buffers is how it will combat this.

17
Q

Why do we need a buffering capacity in our mouths?

A

Bacterial by-products are for the most part acidic

Many of the foods we eat are also acidic (drink)

High - fluctuations in pH would be detrimental to the health of the oral epithelium (as seen in xerostomic patients)

18
Q

What are the 3 main buffering systems in saliva? Which is the most important?

A

There are 3 main buffering systems in saliva

Bicarbonate > phosphate > proteins

(proteins more involved in pH control in plaque)

Bicarbonate is the most important. This is why those with xerostomia end up with caries, it’s because of their lack of bicarbonate.

19
Q

Why is bicarbonate buffering the most important? What is the reaction that takes place?

A

Bicarbonate Buffering - most important
Operates over a greater physiological range than other two

Saliva is saturated with bicarbonate ions

 HCO3- 

These are actively secreted in the saliva so as flow rates increase, so do amounts of HCO3- in saliva.

Combines with H+ to form weak carbonic acid

HCO3 + H –> H2CO3 —> H20 + CO2

bicarbonate to carbonic acid which is a buffer because it’s a weak acid.

20
Q

What is the enzyme that helps bicarbonate HC03 to go to H2CO3 ?

A

HCO3- + H+ H2CO3

This reaction is assisted by an enzyme carbonic anhydrase and is driven further to form

H2CO3  		H2O + CO2

End up with water & CO2 in the oral cavity - complete removal of acid - Resting pH of 6-7

Ratio of HCO3- /H2CO3 is 4.5 : 1

21
Q

What does phosphate buffering do for the teeth?

A

Phosphate buffering
- not as critical for buffering as HCO3- but it is important physiologically for healthy teeth
The rate at which hydroxyapatite crystals of teeth dissolve depends on
1) the pH of the solution
2) levels of [PO43-] and [Ca2+] in solutn
At neutral pH, saliva is saturated with [PO43-] and [Ca2+]

Phosphate mops up excess hydrogen (acid)

As acid levels increase in saliva the following reaction occurs

Phosphate ion is the first part. PO4 + H –> HPO4 + H –> H2PO4

As [HPO42-] is formed, it complexes with free [Ca2+] ions to form brushite - precursor to calculus

An offshoot to the above formula is the one that goes to brushite.

Phosphate ion is the first part. PO4 + H –> HPO4 + Ca + H20 –> brushite CaHPO4 . 2H20

22
Q

What does brushite do and what happens to levels of phosphate and calcium ? What happens when you don’t have enough phosphate ion or calcium ion in the saliva when the pH gets low?

A

Brushite - CaHPO4 . 2 H2O is insoluble and therefore precipitates onto tooth surface

What has happened to the levels of [PO43-] and [Ca2+] in the saliva though?

Where are these ionic levels replenished from?
- newly added saliva
As pH continues to decrease, get to acid level where [PO43-] and [Ca2+] removed from teeth

The pH level where [PO43-] and [Ca2+] removed from teeth is called the “critical pH” - usually about pH 5.5 (can be as high as 6.5)

At this point the inorganic material of the teeth is dissolved to provide enough [PO43-] to counteract the H+ ions in the acid

Calcium hydroxyapatite - Ca10(PO4) 6OH2 - in enamel and dentine is attacked