SALIVA

DATE: 6.07.18
Definition

 Saliva is a complex fluid, produced by the

salivary glands, maintain the well-being of
oral cavity.
 The watery, slightly alkaline secreted
into mouth through salivary glands
and mucous membrane that lines the
mouth.
 (BRITISH MEDICAL ASSOCIATION)
Composition:

 Unique mixture of highly complex

substances

 Volume: 600-1000ml/day
 Electrolytes: Na,K,Cl,HCO,Mg,HPO and F.
 Salivary proteins: Amylase, Proline, Mucins,
Histatin, Lysozyme, Lactoferrin.
 Immunoglobulin: IgA, IgG and IgM.

 Small organic: Glucose, Aminoacids, urea.

 Other components: Epidermal growth

factor, cyclic adenosine monophosphate.
 Functions of saliva
 1: Protection:
 lubricant (glycoproteins)
 Barrier against noxious stimuli
 Washing a cellular debris
 Prevent desiccation
 2: Buffering:
 Bicarbonate and phosphate ions protect
teeth from demineralization.

 It diffuses into plaque

 And acts as a buffer by neutralizing acids.
 3: Pellicle formation:
 Salivary proteins thin film (Ca binding
proteins) (plaque= pellicle+organisms)
 Maintains tooth integrity

 7: Taste
 Taste receptors in circumvallate papilla
 : Tissue repair:

 Nerve growth factor

 wound healing
 Epidermal growth factor

 Speed up the coagulation properties

 Dilutes anti-thrombin factor in traumatic area

 4: Antimicrobial activity:
 Mucins and enzymes and immunoglobulins.
 6: Digestion:
 Amylase
 Calcium dependent digestive enzyme
 pH=6.8
 Lipase
 Von ebner gland
 Fat digestion
 Antifungal activity:
 Histatin peptide (prevents oral infections)

 Hormonal function:
 Parotin: deposition of Ca on tooth
 Nerve growth factor: growth of sympathetic
ganglia
Formation and secretion of
saliva
 Primary saliva: (secretory end pieces and
intercalated ducts) isotonic

 Secondary saliva: (striated and excretory

ducts) reabsorption and secretion of
electrolytes. (hypotonic)
Mechanism of Salivary secretion

 Salivary secretion can be defined as a

unidirectional movement of fluid electrolytes
and macromolecules into saliva in response
to appropriate stimulation.

 Active transport process under neuronal

control
 Osmotic process
Acinar cells K and HCO by active transport

Along with Cl
electrical
neutrality

Simultaneous
Primary isotonic saliva secretion of water
into acinar lumen
 Salivary ductal cells
Actively reabsorbs Na and Cl and
transfer K and HCO into saliva

Impermeable to water

Hypotonic saliva
Primary Saliva
Reflex regulation of saliva

 Food Dehydration
 Nausea Fear
 Smell Sleep
 Parasymapthetic
 Acetylecholine Muscarinic receptors
 IP3 and Ca
 Sympathetic

 Nor-epinephrine

 Beta adrenergic receptors

 cAmps
Control of salivary
secretion
 Parasympathetic stimulation
 Release of proteolytic enzyme, Kallikerin

 Aplha 2 globulins into the interstitial fluid

 Vasodilation of blood vessesls

 Stimulates secretion through acini

 Sympathetic stimulation:

 Release of saliva rich in organic substances

Ductal modification

 Autonomic nervous system

 Striated and terminal ducts
Reabsorption of Na+ and Cl-, secrete K+ and
HCO3
 Final product is hypotonic
 Rate of salivary flow
 High: Sodium and chlorine up; potassium
down
Age changes

 Fibrosis and fatty degenerative changes

(30%-60% acinar cells)

 Presence of oncocytes (eosinophilic cells

containing many mitochondria)
Clinical consideration

 Obstruction (Sialoliths/stones most common

I submandibular)
 Role of drugs (Chemotherapy and
Radiotherapy)
 Systemic disorders (Diabetus Mellitus)
 Bacterial or viral infections (cytomegalovirus,
Epstein Barr virus and human herpes virus 6
and 7)
Dry mouth (Xerostomia)
 A loss of salivary function or reduction in
salivary secretion volume lead to dry mouth.
 Causes:
 Radiotherapy and chemotherapy (atrophy of
salivary glands)
 Autoimmune diseases (Sjorgen syndrome)
Clinical Appearance

 Oral mucosa appears dry, pale or atrophic.

 Tongue may be devoid of papillae with
fissured and inflammed appearances.
 Dental caries
 Difficulty with chewing, swallowing and taste
disturbance.
 Fungal infections are common.
Management

 Palliative treatment for the relief of

symptoms and prevention of oral
complications.