Secretions of the Oral Cavity: Saliva

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Transcript of Secretions of the Oral Cavity: Saliva

Page 1: Secretions of the Oral Cavity: Saliva
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SALIVA

> lubricates & protects

the structure of the

mouth.

> influences the nature

of oral flora & chemical

composition of teeth.

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> it plays a major role in the

maintenance of health & in the

production of disease by permitting or

inhibiting the formation of:

- plaque

- calculus

- proliferation of selected

microorganisms.

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> It contains:

a. Immunoglobulins

b. WBC

c. Lipids

d. Electrolytes

e. Protein

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Major Salivary Glands:

- produces 95% of the total salivary flow

1. Parotid

2. Submandibular

3. Sublingual

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1. Parotid Gland

- biggest, pyramidal in shape

- literally next or anterior to the ear

- opens to the STENSEN’S duct

( opposite the maxillary 2nd molar)

- produces 60-65% of the total salivary flow

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2. Submandibular Gland

- irregular, walnut in shape

- lies posteriorly to the floor of the mouth or at the angle of the mandible

- opens to the WHARTON’S duct

(summit of the sublingual papilla at the side of the frenulum of the tongue)

- produces 20-30% of the total salivary flow

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3. Sublingual Gland

- smallest, almond in shape

- lies immediately beneath the oral mucosal lining on the anterior portion of the floor of the mouth

- opens to the BARTHOLIN’S duct

(surface of the sublingual fold on either side of the tongue)

- produces 2-5% of the total

salivary flow

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Minor Salivary Glands:

- produces 5% of the total salivary flow

1. Minor sublingual

2. Labial

3. Buccal

4. Glossopalatine

5. Palatine

6. Lingual

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> Secretion is primarily by

unconditioned reflex associated with

eating & masticatory proprioceptors of

the periodontal ligament & muscles of

mastication.

> 1,000-1,500 ml is the total salivary

fluid produced during a 24-hour

period. (1 cc/min)

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Factors Affecting Salivary Secretion:

1. Pharmacologic agents

2. Psychological

3. Size of gland

4. Interference with taste perception

5. Age changes

6. Systemic diseases

7. Disease of the salivary gland

8. Irradiation of glands.

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Most important attribute of salivary

secretions:

Protective in nature – helps maintain

integrity of teeth, tongue & mucous

membrane of oral and pharyngeal

areas.

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Role in Oral Health:

1. Lubrication & Protection

- glycoproteins & mucoids produced

by the salivary glands forms a

protective covering for the mucous

membrane against irritants.

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2. Buffering action

- because of its bicarbonate,

phosphate & amphoteric proteins.

- bacteria require specific pH

condition.

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3. Maintenance of tooth integrity

because it:

a. Provides minerals for

posteruptive maturation.

b. Provides ions to counteract tooth

dissolution.

c. Forms a film of glycoprotein that

may act as a diffusion barrier,

to prevent loss of tooth mineral.

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4. Antibacterial activity against

bacteria & viral invasion.

- Lysozyme, IgA, Sialoperoxidase

thiocynate & Lactoferin

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> Saliva plays a role in the formation

of plaque & calculus and is therefore

intimately related to caries and

periodontal disease.

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> Salivary glycoprotein + precipitation

+ pellicle + microorganisms overgrow

+ plaque + mineralization + calculus.

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Functions of Saliva: (Lavelle)

1. Digestive Function

- amylase as main digestive enzyme

2. Excretory Function

- saliva provides as important

excretory route for blood components

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3. Solvent Function

- by facilitating digestion

- dissolution of foodstuff (one of the

major salivary function)

4. Protective Function

- protects oral tissues from dehydration

- mechanical food & microbial debris

lavage

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Process of Secretion: (Ferguson)

> Stimuli to Digestive Organ has

three phases:

1. Cephalic – conditioned stimuli:

a. Psychological Phase

b. Visual Phase

c. Olfactory Phase

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a. Psychological phase

> “the thought of food

b. Visual phase

> ”the sight of food”

c. Olfactory phase

> “the smell of food”

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2. Intraorgan – within organ stimuli

(most important for salivary

secretion)

a. Mechanical stimuli – touch &

pressure on oral structures and

movements of masticatory muscles

and mandible

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b. Chemical stimuli – substances that

stimulate taste receptors

3. Interorgan – stimulatory effect on

secretion from irritation to the

esophagus

e.g. vomiting reflex

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Role in Oral Health:

1. Pellicle & plaque deposition

2. Plaque mineralization &

calculus formation

3. Dental caries

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PELLICLE

- thin, cellular &

essentially bacteria

free covering of the

tooth which consist of

various glycoprotein

derived from the

mucous salivary

gland.

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- thin deposit may form shortly after eruption on the exposed surface of the teeth.

- reformed within minutes after exposure of pumice-polished teeth to saliva.

- due to rapid formation, it precedes the first stage in plaque formation.

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PLAQUE

- localized concentration of microorganism on the tooth surface.

- accretion of necrotic debris, foodstuff substances & salivary glycoproteins.

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- contains mono & oligosaccharides

that serve as substrates for microbial

growth.

- Streptococcus mutans is the

predominant organism that

enzymatically degrade plaque.

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CALCULAR DEPOSIT

- grainy in nature & act as mechanical irritant.

- by product of calcification of organic products & microorganisms.

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- calcified bacterial plaque

- organic components consist mainly

of Calcium & Phosphate.

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- Types of Calculus:

a. Supragingival

- creamy white or

yellowish in color

- hard in consistency

- most abundantly

seen opposite the

opening of the major

salivary glands

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b. Subgingival

- dark brown to black

due to blood pigments

- hard to very hard in

consistency

- found in the

periodontal pockets of

any tooth.

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DENTAL CARIES

- is a microbial

disease of the calcified

tissues of the teeth,

characterized by

demineralization of the

inorganic portion &

destruction of the

organic substance of

the tooth.

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- Five general ways by which saliva

can affect caries:

a. to mechanically cleanse & thus

lessen plaque accumulation.

b. to reduce enamel solubility by

plaque modification through calcium,

phosphate & fluoride.

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c. buffer & neutralize the acids either

produce cariogen or introduced

directly through diet.

d. direct anti-bacterial activity.

e. by aggregation or clumping

bacteria & reducing adherence to

teeth surfaces.

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GINGIVAL FLUIDS

- Sulcular fluid

- fluid found in the gingival sulcus

which seeps through the thin sulcular

epithelium.

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