Salivary Gland Pathology. The role of saliva. Pathology detection.
The salivary glands are complex structures located deep in the bilateral lower head, with a role in maintaining a constant humidity of the oral environment through the production of saliva.
The three major groups of glands in humans are the parotid, submaxillary and sublingual glands.
What is the purpose of maintaining a moist oral environment?
Cavities prevention saliva, a product of the above-mentioned glands, is used to wash away caries-causing deposits from dental units and oral mucosa.
Digestion: through the enzymes it contains, saliva ensures the primary breakdown of food that is introduced into the oral cavity.
Deglutition: by its mucinous consistency, saliva facilitates the sliding of the food bowl to the deeper structures of the digestive system (pharynx, esophagus, stomach).
Saliva is an odorless, colorless and tasteless fluid consisting of 99% water and the remaining 1% inorganic ions, organic components such as glucose, urea, hormones and digestive enzymes.
Each day, salivary secretion is about 1 liter, more than half of which is secreted during meals. The salivary reflex is triggered by the presence of food in the oral cavity.
Salivary glands are exocrine glands because they discharge their contents into a cavity that communicates with the outside (the oral cavity).
Sometimes the flow through the salivary glands can be interrupted by stones, a relatively common condition called salivary lithiasis.
Another pathology that can affect the salivary glands is malignant impregnation of the glands, the development of primary or metastatic cancer.
The symptoms that the patient describes when presenting with salivary gland disease are as follows:
Limiting the opening of the mouth: by being located close to the muscles, the inflamed salivary glands can compress them and prevent them from achieving a wide, full opening of the mouth.
Facial asymmetry, located submandibular or genian prominence, due to inflammation.
Difficulty swallowing: due to inflammation or insufficient saliva production
Diffuse pain that may occur intraorally, in the ear or throat.
Muscle damage on the affected side: muscles lose tone or, on the contrary, remain in a state of permanent contraction, painful for the patient.
Blood impregnation of the saliva, uninfluenced by untimely brushing or hard foods that can cause bleeding gums.
Changes in vocal timbre.
Detection of salivary gland pathologies
Complementary examinations to identify salivary gland disorders include:
Ultrasound: useful in the diagnosis of salivary stones
Sialography: a contrast substance is injected beforehand to highlight salivary stones
MRI: is imperative in the detection of benign and malignant salivary gland tumors. MRI has the ability to identify pathogenic soft tissue structures.
The most commonly used method, however, is sialendoscopy, which allows direct visualization of stones in the salivary ducts.
The endoscope is small and has an optical system that penetrates the salivary ducts.
These examinations are not carried out in the dental surgery. However, the dentist has an important role in detecting salivary abnormalities and referring the patient to a specialist, as the oral cavity is the site of many manifestations indicating salivary gland damage.