Salivary Gland Disease

Question 1

What are the 3 main salivary glands?

Answer 1

1. Parotid gland
2. Submandibular gland
3. Sublingual gland

Question 2

How much saliva do humans produce daily?

What % of saliva do minor salivary glands produce?

Answer 2

Approximately 620ml p/d

Minor salivary glands make up approx. 10%

Question 3

List 5 functions of saliva:

Answer 3

1. Lubrication - for speech, swallowing, mastication
2. Taste
3. Buffering - pH and bicarbonate control
4. Enzymatic activity - amylase
5. Antibacterial

Question 4

What does PSA stand for and what does this help to screen for?

Answer 4

Prostrate Specific Antigen - screens for prostate cancer

Question 5

What is sialolithiasis?

What can cause this?

How is it treated?

Answer 5

Salivary gland stone (calculi - consists largely of calcium phosphate)

Causes: smoking, autoimmune diseases

Treatment: massage, heat application, surgical removal

Question 6

What is Sjogren’s syndrome?

How does it present?

How is it treated?

What is it associated with?

Answer 6

Autoimmune disease effecting fluid-producing areas of body - saliva, tears

Presents with dry eyes and dry mouth

Treatment: Saliva stimulation and topical fluoride (high caries risk)

Associated with Non-Hodgkin’s lymphoma

Question 7

How does radiation induced xerostomia happen? (Explain mechanism of action)

Answer 7

1. Direct damage caused by RT oxidative species
2. Cytotoxic damage caused by release of toxic compounds from cells
3. Radiation induced intracellular apoptosis

Question 8

List 4 ways to manage radiation induced xerostomia:

Answer 8

1. Radiation protection agents
2. Acupuncture
3. Good OH - topical NaF, removal of at risk osteoradionecrosis areas
4. Salivary substitutes

Question 9

What is Sarcoidosis?

How is it diagnosed?

How is treated?

Answer 9

Rare chronic multisystem disease that causes small patches of swollen tissues, GRANULOMAS, to develop in organs - lung involvement COMMON

Diagnosed - xerostomia present, diagnosed histologically

Treated with corticosteroids

Question 10

What is sialadentitis?

Answer 10

Sialadenitis = inflammation and enlargement of one or more salivary glands

Question 11

Embryonic development:

1. Explain the pre-bud stage
2. Explain the initial bud stage
3. Explain the Pseudo-glandular stage
4. What happens during the canalicular and terminal bud stages?
5. How does epithelial apoptosis begin?

Answer 11

1. Pre-bud stage = develops initially as a thickening of the oral epithelium
2. Initial Bud stage = Outgrowth of the 1st branchial branch
3. Pseudo-glandular Stage = SMG primordium becomes a solid, elongated epithelial stalk terminating in a bulb
4. During the canalicular and terminal bud stages = These branches and buds hollow out by epithelial cell apoptosis to form ductal system and presumptive acini
5. Epithelial apoptosis begins with the onset of lumen formation