Salivary Gland Diseases Overview

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Questions and Answers

What is a primary function of saliva in the oral cavity?

It provides lubrication for oral tissues. (correct)

It increases the acidity of the mouth.

It reduces sensitivity to spicy foods.

It facilitates bone growth.

What condition is characterized by increased salivary output?

Mucocele

Sialolithiasis

Sialorrhea (correct)

Xerostomia

Which medication class is commonly associated with causing dry mouth?

Analgesics

Antivirals

Antibiotics

Antidepressants (correct)

What is a common cause of salivary gland hypofunction?

Viral infections like CMV Signup and view all the answers

Which sign indicates salivary gland hypofunction?

Lipstick sign Signup and view all the answers

Which of the following may impact salivary composition and output?

Medication withdrawal Signup and view all the answers

Symptoms of salivary gland hypofunction include difficulty in which of the following activities?

Chewing and swallowing Signup and view all the answers

Which condition could lead to mechanical obstruction in the salivary glands?

Sialolithiasis Signup and view all the answers

Which autoimmune condition is known to cause salivary gland hypofunction?

Both B and C Signup and view all the answers

Which of the following is NOT a symptom of salivary gland hypofunction?

Diabetes insipidus Signup and view all the answers

What is a primary diagnostic criterion for primary SS?

Positive for 2 out of 3 objective tests Signup and view all the answers

What is the primary symptom of sialolithiasis?

Acute, painful, and intermittent swelling of the affected gland initiated by eating Signup and view all the answers

Which of the following indicates hyposalivation?

Unstimulated saliva: < 0.1 ml/min Signup and view all the answers

Which treatment option is primarily recommended for sialolithiasis?

Hydration and sialogogues Signup and view all the answers

What is NOT a sign or symptom to ask about for evaluating salivary gland dysfunction?

Experiencing frequent headaches Signup and view all the answers

Which of the following is a component of palliative therapy for salivary gland dysfunction?

Caffeine reduction Signup and view all the answers

Which of the following is a characteristic of sialosis?

Bilateral salivary gland enlargement without inflammation Signup and view all the answers

To conclusively diagnose secondary SS, which of the following must be excluded?

Use of anti-cholinergic drugs Signup and view all the answers

What is a potential complication associated with Sjögren's Syndrome?

Increased risk of developing lymphoma Signup and view all the answers

What distinguishes a ranula from other mucoceles?

It is a large mucocele located on the floor of the mouth Signup and view all the answers

Which of the following is an example of stimulated saliva measurement?

Measuring saliva in response to eating Signup and view all the answers

For which of the following conditions is surgery recommended?

Sialosis causing pain or to improve appearance Signup and view all the answers

Which serological test is important for diagnosing primary SS?

Positive anti-SS-A/B antibodies Signup and view all the answers

What type of therapy includes the use of saliva substitutes?

Palliative Therapy Signup and view all the answers

Which of the following systemic disorders is commonly associated with sialosis?

Anorexia nervosa Signup and view all the answers

What is the typical demographic for Sjögren’s Syndrome?

Older females primarily post-menopause Signup and view all the answers

What is a common presenting symptom of bacterial sialadenitis?

Purulent discharge from the ductal orifice Signup and view all the answers

Which of the following is the most common benign tumor of the salivary glands?

Pleomorphic adenoma Signup and view all the answers

Which viral infection is commonly associated with swelling of the salivary glands?

Mumps Signup and view all the answers

What is the primary treatment approach for bacterial sialadenitis?

Broad spectrum antibiotics and hydration Signup and view all the answers

Why is there a higher occurrence of sialolithiasis in the submandibular gland?

Gravity affects saliva drainage due to its position Signup and view all the answers

What is a characteristic feature of necrotizing sialometaplasia?

Erythematous nodule with a deep ulcer Signup and view all the answers

Which of these conditions involves the formation of salivary stones?

Sialolithiasis Signup and view all the answers

What is a significant clinical feature of COVID-19-associated sialadenitis?

Ear pain and parotid gland enlargement Signup and view all the answers

Study Notes

Importance of Saliva

Provides lubrication for both hard and soft oral tissues.
Vital for essential daily activities like speech, swallowing, mastication, and taste.
Plays a crucial role in the mucosal immune system, controlling bacterial and fungal populations.

Salivary Gland Dysfunction

Involves changes in salivary output (quantity) or composition (quality).
Salivary hyperfunction leads to hypersalivation (sialorrhea); hypofunction causes dry mouth (xerostomia).

Hypersalivation

Characterized by excess saliva production or reduced clearance.
Common causes include:
- Medications such as pilocarpine and cevimeline.
- Heavy metal exposure (e.g., lead, mercury).
- Neurological conditions (e.g., cerebral palsy, stroke).
- Neuromuscular diseases (e.g., Parkinson’s disease).

Medication-Induced Salivary Gland Dysfunction

Over 400 medications linked to xerostomia, especially in elderly patients.
Salivary volume and composition can be drastically reduced; withdrawal often restores function.
Common culprits include:
- Anticholinergics, antihistamines, antidepressants, and anti-anxiety medications.

Causes of Salivary Gland Hypofunction

Developmental issues (e.g., agenesis, aplasia).
Infections/inflammatory conditions (bacterial, viral like CMV and HIV, granulomatous diseases).
Iatrogenic causes from radiation or surgical interventions.
Non-neoplastic conditions such as sialolithiasis and mucocele.
Autoimmune disorders like Sjögren’s syndrome.

Symptoms of Salivary Gland Hypofunction

Oral mucosa and throat dryness.
Difficulty chewing, swallowing, and speaking.
Inability to manage dry foods; requires liquids for aid.
Sensitivity to certain foods and persistent mucosal pain.

Signs of Salivary Gland Hypofunction

'Lipstick sign': marks on labial surfaces of teeth from lipstick and epithelial cells.
Tongue appears red, fissured, with papillary atrophy.
Dehydrated buccal mucosa causing difficulty with dental instruments.

Infections/Inflammations of Salivary Glands

Bacterial sialadenitis manifests with erythema, pain, and purulent discharge.
Treatment involves broad-spectrum antibiotics and hydration.
Common viral infections include mumps (paramyxovirus), CMV, and HIV.

COVID-19-Associated Sialadenitis

Symptoms include ear pain, retromandibular edema, and parotid gland enlargement.

Neoplasms of the Salivary Glands

Most tumors occur in the parotid gland (80%).
Probability of malignancy increases in smaller glands.
Common benign tumor: pleomorphic adenoma; common malignant tumor: mucoepidermoid carcinoma.

Reactive and Metabolic Disorders

Reactive lesions include necrotizing sialometaplasia, often self-limiting.
Sialolithiasis causes salivary stones, most frequently seen in the submandibular gland.

Sialosis

Non-inflammatory, asymptomatic bilateral salivary gland enlargement.
Often associated with systemic disorders like anorexia, alcoholism, and diabetes.

Sjögren’s Syndrome (SS)

Autoimmune condition predominantly affecting women.
Increased risk of lymphoma; presents with dry mouth and eyes.
Diagnosis requires serology, ocular surface staining, and histopathology.

Evaluation of Salivary Gland Dysfunction

Saliva production characterized as unstimulated (<0.1 ml/min) or stimulated (<1.0 ml/min).

Treatment of Salivary Gland Dysfunction

Palliative therapy includes hydration, lubrication, and gustatory stimulation.
Preventive measures may involve avoiding dehydrating substances like caffeine and alcohol.

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Description

This quiz explores the importance of saliva in oral health, including its role in lubrication, speech, and taste. It also discusses salivary gland dysfunctions and their effects on salivary output and composition, underscoring the significance of saliva in the mucosal immune system.