salivary glands Flashcards
what is seen in patients with sever hyposalivation
increased incidence of caries
hyposalivation
reduced salivary flow (2/3 typical)
symptoms of decreased salivary loss
Xerostomia Mucosal changes Enamel erosion Increased caries Difficulty swallowing changes in tatse
subjective feeling of dry mouth
Xerostomia
Genic cause of dry mouth
Rare
systemic disease for dry mouth
Mups
Sjogren’s
Diabetes mellitus
HIV
Medication causing dry mouth
Anti-cholinergic, diuretics, antidepressants, antihistamines, antihypertensives
what is largelt responsible for prevalence of dry mouth in elderly patients
age kinda, but mostly medication
mdical treatment that cuases dry mouth
Head and neck radiotherapy
efects of head and neck radiotherapy on salivation
rapid(days) and long lasting
initial effect of radiotherapy on salivation
reduced gland function
later effects of head and neck radiotherapy
cell death, primarily acinar cells
how do we try and spare salivary function from radiotherapy
newer radiation therapies for specific target tumor site
therapies to aid in saliva production
genetic modification of remaining salivary tissue
Stem cell
stem cel use for salivary flow
clauster of saliva secreting cells (Acinus-like) grown invitro from stem cells in the parotid gland
mangement of hyposalivation
frequent dental evaluation and prophylaxis due to prevalence of complication
artifical saliva
salivary stimulants
what must be checked for hyposalivation patients
caries
oral lesions
oral candidias
what are some artificial salivas
mucopolysaccharide (MouthKote) Glycerate polymer (Oral balance Hydroxyethylcellose( salivart, oralube, xerolube)
salivary stimulants
sugarless candies, chewing gum
secretatgogus (agonist for cholinergic muscarinic receptors)
Major functions of saliva
Protection Buffering Tooth integrity antimicrobial tissue repair Digestion taste
how does the saliva protect
Lubrication and protective barrier (mucins)
clearance of bacteria and sugar
how does the saliva buffer
Neutralization of acids and pH maintenanec (bicarbonate)
how does the saliva aid in tooth integrity
Enamel maturation via calcium binding proteins (proline rich proteins and statherin)
what does the saliva has as an antimicrobia
Lysozyme, peroxidase, defensins, histatins
Iga (agglutination of microorganisms, anti-viral)
what does the saliva do for tissue repair
growth factors
what does the saliva do for digestion
lubrication, swallowing: mucins
Enzyme digestions: amylase, lipase
what does the saliva do for taste
Dissolves stimuli for transport to taste recetpors: water
what kind of gland is the salivary gland
Exocrine glands
unstimulated saliva rate
.2-.4 per min
how much saliva is in the mouth
1ml as a thin film that coats everything
stimulated saliva rate
2-5 per min
saliva flow during sleep
decreases during sleep
what are the major saliva glands
Parotid gland
submandibular
sublingual
what are the minal saliva glands
Von ebners gland
Labial, palatal, buccal, lingual
what innervates the parotid
IX
what inneravtes the submandibular
VII
what innervates the sublingual
VII
what innerates von ebner glands
IX
what does the parotid gland make
serous (watery), amylase
what does the submandibular make
mixed, mostly serous
what does the sublingual make
Mixed, mostly serous
what does von ebner gland make
Lingual lipase
what does labial, palatal, buccal, lingual
Mucins
saliva flow percentatge from the major glands
60: parotid
25: submandibular
7-8: sublingual
what does the parotid have to have saliva leave
stensons duct
largest salivary gland
Paroid
GR for parotid
14-28
GR for submandibular
10-15 GR
what does the submandibular have to have saliva leave
Wharton’s duct
GR for sublinual
2 GR
ducts of sublingual
Rivinius and Bartholin’s duct
the functional component of the salivary gland
Parenchyma