Saliva test

tinny rasjad

Salivary glands - Anatomy

Minor salivary glands

Hundreds throughout
mouth

Major salivary glands (3

on each side of face)
Parotid Gland (cheek)
Submandibular gland
(under angle of the jaw)
Sublingual gland (under
tongue)

Physiology and Function

Saliva function
Controls oral pH
Assists with food intake

Lubricates food bolus

Contains amylase for carbohydrate
digestion

Mouth cleansing and oral hygiene

Saliva limits oral pathogen growth

Reduces oral odor (halitosis)

Saliva content
Water 99,4%
Organic compounds mucin, amylase,
lysozym, immunoglobulin A
Anorganic compounds HCO3-, K, Cl, Na,
Ca, phosphates and others.

Aplication
Molecular Diagnostic
Detection of DNA und RNA with molecular biological
methods
- Head & neck cancer
cancer diagnosis for health care

- Clinical diagnostic of infections and periodontitis

direct detection of viral and bacterial pathogens

Drug Detection (Drugs of Abuse)

The detection of narcotics e.g. cocaine,
amphetamines and psychotropic
current drug consumption.

Aplication
Hormones and Enzymes
Determination of steroid hormones, e.g.
cortisol as well as biogenic amines as
melatonin from saliva can give information on
a person's current hormone status
-amylase is a parameter to identify stress
and also used for authentification of saliva in
the drug screening area.

Aplication
Clinical chemistry parameters
Electrolytes as K+, Mg2+, Ca2+, PO4,
lipids as HDL,
salivar proteins & metabolites as albumin,
total protein and creatinine show good
correlation of saliva : serum

Testing of saliva production

Unstimulated production collection of saliva
into container during 15 min
Stimulated production collection of saliva
during 15 min of chewing parafine gum
Measuring of both amounts during 2x15 min
Normal levels: greater than 8-10 ml
Pathologic levels: under 8 ml

Xerostomia
Definition

Decreased saliva production

Physiology: Saliva plays vital role in

dental health

Re-mineralizes enamel
Buffers cariogenic acids
Removes food residue
Inhibits bacterial growth

Causes of Xerostomia

Medications (anticholinergic affect)

Tricyclic Antidepressants
Antispasmodics
Neuroleptics
MAO inhibitors
Antiparkinsonian agents
Lithium
Central Adrenergic Agonists (antihypertensives)
Diuretics
Decongestants
Antihistamines
Bronchodilators

Other causes
Radiation therapy to head and neck
Salivary Gland surgery
Sjogren's Syndrome
Amyloidosis
Human Immunodeficiency Virus (HIV Infection)
Diabetes Mellitus
Major Depression
Granulomatous Disease

Sarcoidosis
Tuberculosis
Leprosy

Ptyalism
Pathophysiology

Normal Submandibular Saliva production 0.10-0.15

ml/min
Ptyalism may result in 1-2 L/day of Saliva loss
Mechanisms of excessive Saliva
Decreased Saliva swallowing and clearance
Excessive Saliva production
Neuromuscular disease
Anatomic abnormalities

Causes
Saliva Overproduction

Pregnancy (Ptyalism Gravidarum)

Hyperemesis Gravidarum

Excessive starch intake

Gastrointestinal causes
Gastric distention or irritation
Gastroesophageal Reflux
Acute Gastritis or Gastric Ulcer
Pancreatitis
Liver disease

Stomatitis and localized oral lesions

Aphthous Ulcers
Oral chemical burns
Oral suppurative lesions
Alveolar abscess
Epulis

Oral infectious Lesions

Dental Caries
Diphtheria
Syphilis
Tuberculosis
Small Pox

Sialadenitis
Acute viral and bacterial infection
Chronic bacterial, fibroproductive, postactnic, specific (actinomycosis, syfylis,
TBC), immunosialadenitis

Acute viral sialadenitis

Parotitis acuta
Paramyxovirus
Neurotrophic effect n.VIII
Affection of gonadal tissues, pancreas,
central nervous systm
Incubation: 18 days
Whole life immunity

Acute bacterial sialadenitis

Ascendent ductal infection
Dehydratation, diabetes, renal diseases,
wrong dental hygiene, inflammation in
mouth and pharynx

Chronic bacterial parotitis

Predisposition ectasy of salivary ducts
congenital, postinfectious, obstructive,
immunopatological
Sialography

Sialolithiasis
Stones composed of Ca salts often obstruct
salivary glands, causing pain, swelling, and
sometimes infection. Diagnosis is made clinically
or with CT, ultrasound, or sialogram. Treatment
involves stone expression with saliva stimulants,
manual manipulation, a probe, or surgery.