ppt on salivary glands and saliva

1. Salivary glands
and
saliva
Presented by
Dr.M.Manasa
I MDS

2. Contents:
• Introduction
• Embryology and development of salivary glands
• Salivary glands
• Structure
• Classification
• Saliva
• Formation of saliva
• Composition
• Functions
• Regulation of salivary secretions
• Saliva collection methods
• Clinical considerations of saliva
• Role of saliva in prosthodontics
• Conclusion
• References
2

3. WHY WE NEED TO KNOW
ABOUT SALIVA???
3

4. Introduction:
• Salivary glands are compound tubuloacinar
exocrine glands found in oral cavity, that secrete
complex watery fluid known as saliva.
• Saliva is important for several physiological
functions, it is critical in preservation and
maintenance of oral health.
4

5. Embryology and development:
• The embryologic development of salivary glands is
the result of a highly complex interaction between
the oral epithelium and underlying mesenchyme.
• All the salivary glands share a common path of
growth.
• Epithelial cells-carry information for type of
salivary secretions.
• Mesenchymal cells- carry information of pattern of
branching that eventually will be the morphologic
signature of the glands.
5

6. • Cranial neural crest cells- stroma, compresses the
capsule as well as the septa, develops form the
cranial neural crest cells.
Gland Location IU life
Parotid Gland Corner of
the
stomodeum
6th week
Submandibular
salivary gland
Floor of the
mouth
7th week
Sublingual
salivary gland
Lateral to
mandibular
primordium
8th week
Minor salivary
glands
Buccal
epithelium
After 12th
week
6

7. Stages of salivary gland development:
Pre bud stage
Initial bud stage
Early pseudo glandular
stage
Late psudo glandular stage
Canalicular stage
Terminal differntiation stage
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8. Pre bud stage Initial bud stage Early pseudoglandular
stage
Late pseudoglandular
stage
Canalicular stage
Terminal differentiation
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9. SALIVARY GLANDS
STRUCTURE:
9

10. CLASSIFICATION:
1.Based on Anatomic size:
Salivary glands
Major
Parotids
Sub mandibular
Sub lingual
Minor
Buccal
Labial
Palatine
Glossopalatine
Von ebner’s
Gland of blandin and nuhn
10

11. 2. Based on histochemical nature of secretions:
Salivary glands
Serous
Parotid
Von ebner
Mucous
Palatine
Glossopalatine
Posterior part of tongue
Mixed
Sublingual
Submandibular
labial
buccal
anterior lingual
11

12. PAROTID GLAND:
 Provides 60-65% of total salivary volume.
 Shape – pyramidal.
 Parotid duct- Stensen’s duct.
12

13. SUBMANDIBULAR GLAND:
 Provides 20-30% of total salivary volume
 Shape – walnut.
 Submandibular duct-Wharton’s duct
SUBLINGUAL GLAND:
 Provides 2-5% of total salivary
volume.
 Shape – almond
 Sublingual ducts- Bartholin’s ducts.
13

14. MINOR SALIVARY GLANDS:
 Located beneath the epithelium in almost all parts of oral
cavity.
 Types:
Labial
Buccal
Palatine
Glossopalatine
Lingual
14

15. TUBARIAL GLANDS:
 Location- around the torus tubaris , stretching from the base
of skull of the fossa of rosenmuller extending to
nasopharyngeal wall.
 Shown to contain acini producing mucous secretions
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16. BLOOD SUPPLY OF SALIVARY GLANDS:
16

17. NERVE SUPPLY OF SALIVARY GLANDS:
17

18. SALIVA
FORMATION OF SALIVA:
- Salivary secretions takes place in two stage process:
(i) Initial formation stage
(ii) Modification stage
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19. COMPOSITION OF SALIVA:
19

20. FUNCTIONS OF SALIVA:
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21. (I)Lubrication and Protection:
o As a seromucous coating, it lubricates & protects oral tissues
acting as a barrier against irritants.
o Mucins – best lubricating component of saliva.
o Lysozyme- kills the bacteria.
(II)Buffering and Clearance:
o Bicarbonates ,Phosphates ,Urea
o Diffuse into plaque and act as a buffer by neutralizing acids ,
preventing the enamel demineralization.
21

22. (III)Maintenance of tooth integrity:
oCalcium and phosphate ions.
oThe solubility of these ions is maintained by several
calcium-binding proteins, especially the acidic proline-
rich proteins and statherin.
oFluoride works to inhibit dissolution of apatite crystals.
(IV)Antimicrobial action:
osaliva has a major ecologic influence on the microorganisms
that colonize oral tissues.
o It contains a spectrum of proteins with antimicrobial activity
such as –Lysozyme, lactoferrin, peroxidase
oIgA causes agglutination of specific microorganisms,
preventing their adherence to oral tissues.
22

23. (V)Digestive function:
o Saliva has 3 digestive enzymes namely salivary amylase ,
maltase and lingual lipase.
o Salivary amylase - Converts cooked starch into maltose
o Maltase- Coverts maltose into glucose
o Lingual lipase- Converts triglycerides into fatty acids and
diacylglycerol
(VI)Excretory functions:
oMercury, Potassium, Iodide, Lead, Alkaloids are excreted by
saliva.
23

24. REGULATION OF SALIVARY
SECRETION:
• Salivary secretion is regulated by nervous mechanism
and it is a reflex phenomenon.
• Salivary reflexes are of two types:
1.Uncoditional reflex: Secretions of saliva when any
substances is placed in the mouth
- It is due to the stimulation of nerve endings in the
mucous membrane of the oral cavity.
- Also called as Inborn reflex.
2.Conditional reflex: Secretion of saliva by the sight ,
smell or thought of food .
- Due to impulses arising from the eyes , ears etc
-Also called as Acquired reflex.
24

25. SALIVA COLLECTING METHODS:
• Whole saliva
• Parotid secretions
Draining method Suction method Swab method
Carison – Crittenden device
25

26. • Submandibular and Sublingual secretions:
• Minor salivary secretions:
Micropipette
Micropipette Sialopaper
26

27. CLINICAL CONSIDERATION OF SALIVA:
Hyposalivation Hypersalivation
Xerostomia Ptyalism
27

28. XEROSTOMIA:
- Dryness of the mouth from the lack of normal
secretion.(GPT9)
Etiology:
• Aging
• Drugs with anticholinergic actions
• Psychiatric comorbidities
• Medical comorbidities
• Alcoholism
• Radiation to head and neck
28

29. Signs and symptoms:
• Dysphagia
• Dysguesia
• Halitosis
• Burning sensation of tongue associated with fissuring
• Tongue tends to stick to the palate
• Reduced denture retention
Diagnosis:
 History taking
 Symptoms and clinical examination
 Saxon test
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30. MANAGEMENT
Symptomatic
treatment
Address
Underlying
causes
Saliva
stimulation
Saliva
substitutes
Optimise
Oral hygiene
30

31. 1. Symptomatic treatment:
- More fluid intake should be advised.
- Alcohol consumption and tobacco smoking should be
avoided.
2. Addressing the underlying cause:
- Drug dosage to be altered(if taking any) after consulting
Physician
- Controling the systemic disorder.
-Substituting the medications causing xerostomia
31

32. 3. Saliva stimulation:
- The use of sugar free gum, lemon drops or mints are
conservative methods for temporarily stimulation.
- Using drugs for saliva stimulation:
(i) Bromohexidine—4-8mg tds
(ii) Pilocarpine hcl-----5-7mg tds
(iii) Cevimeline hcl (evoxac)
- Salivary Pacemakers
(i)First generation
(ii)Second generation
(iii)Third generation
32

33. (i)First generation
33

34. (ii)Second generation:
34

35. (iii)Third generation
35

36. 4. Saliva substitutes:
-Sodium carboxymethyl cellulose(0.5% aqueous solution)
-Commercial oral moisturizing gels include
Oral balance
GC dry mouth
Xerostom
Biotene
5. Optimizing oral hygiene:
- Alcohol free antimicrobial mouthwashes
- Biotene dry mouth toothpaste
36

37. Prosthodontic Management:
(I) In fixed partial denture:
- FPD’S should have full coverage retainers and easily
cleansing pontic and connectors
- Margins of retainer should be supragingival
(II) In removable partial denture:
- Use of gingivally approaching clasp should be avoided
- Tooth supported denture with minimal tissue coverage.
37

38. (III) In complete denture
- Use dentures with metal bases
- Use of soft liners to improve comfort
- Fabrication of intraoral artificial saliva reservoirs
38

39. PTYALISM:
• Is a condition that causes overproduction of saliva
• Causes:
- Anxiety
- Oral infections
- Neuromuscular diseases
- Gastroesophageal reflux disease
• MANAGEMENT:
- Irrigating with astringents
- Anti sialagogues to be administered 1 to 2 days before
the treatment
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40. Prosthodontic management:
(I) In removable partial denture
- Mouth washed prior to investing impression material
- Fast setting impression material is to be used
- Careful cleaning of alginate impression
(II) In fixed partial denture
- the dryness of the oral cavity is achieved by Rubber dam,
high volume saliva ejector , anti sialagogues.
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41. ROLE OF SALIVA IN
PROSTHODONTICS:
o From a Prosthodontist point of view, salivary glands and
saliva are of great importance anatomically and
physiologically
o Consistency of saliva:
- Best to work with a serous type of saliva.
- Presence of thick saliva creates problem for maxillary
denture retention
- Thick saliva also complicates impression making
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42. o Amount of saliva:
- Excess saliva: complicates impression making and denture
construction
- Less saliva: retention of denture is affected and increased
potential for soreness
oSaliva is considered as a major factor in evaluating the
physical agent in the retention of complete denture. The
physical forces in which saliva is involved are:
(I) Adhesion
(II)Cohesion
(III)Interfacial surface tension
(IV)Capillarity
(V)Atmospheric pressure
42

43. I. ADHESION:
The physical attraction of unlike molecules to one another
II. COHESION:
The physical attraction of like molecules to each other
43

44. (III)INTERFACIAL SURFACE TENSION:
The resistance to separation possessed by a film of liquid
between two well adapted surfaces
44

45. (IV)CAPILLARY ATTRACTION:
It is the force that causes the surface of liquid to
become elevated or depressed when it is in contact
with a solid.
45

46. (V)ATMOSPHERIC PRESSURE:
Dislodging forces applied on denture
Negative pressure under the denture
Force created by difference in the pressure
Denture retention
46

47. USE OF SALIVAAS A INVESTIGATING
AID IN DISEASES:
• Several diseases and disorders are reflected by the variations
in the saliva composition.
• Cystic fibrosis
• Sjogren’s syndrome
• Cancer’s
• Endocrine function’s
• Viral diseases
• SARS-CoV-2
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48. CONCLUSION:
The components of saliva acts as a mirror of the
body’s health. The knowledge of normal salivary
composition , flow and functions is extremely
important on daily basis when treating the patients
and recognition should be given to saliva for the
many contributions it makes to the preservation and
maintenance of oral and systemic health.
48

49. REFERENCES:
 Richard L Drake. Grays anatomy. 4th edition 2020, Elsevier
Inc;p. 1091-1094.
Chaurasia’s. Human Anatomy head and neck.2nd edition
1992,New Delhi ,CBS ; p. 252-255.
 Mincy C, Eapen A. Salivary Glands and Its Myriad Forms
of Cancers–Diagnosis And Therapy. World Journal of
Research and Review.;2(6):262947.
Rajesh E, Masthan KM. Embryology and development of
salivary gland. European Journal of Molecular & Clinical
Medicine. 2020 Dec 16;7(10):764-70.
 Sainudeen S, Sabujan A. Minor salivary glands and
‘Tubarial Glands’-Anatomy, physiology, and pathology
relevant to radiology. Journal of Radiology and Clinical
Imaging. 2021;4(1):1-4.
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50. Tango RN, Arata A, Borges AL, Costa AK, Pereira LJ,
Kaminagakura E. The role of new removable complete
dentures in stimulated salivary flow and taste perception.
Journal of Prosthodontics. 2018 Apr;27(4):335-9.
 Bellagambi FG, Lomonaco T, Salvo P, Vivaldi F, Hangouët
M, Ghimenti S, Biagini D, Di Francesco F, Fuoco R,
Errachid A. Saliva sampling: Methods and devices. An
overview. TrAC Trends in Analytical Chemistry. 2020 Mar
1;124:115781.
 Jacob SA, Gopalakrishnan A. Saliva in prosthodontic
therapy-all you need to know. J Dent Sci. 2013;1(1):13-25.
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