Salivary glands types , functions and disorders
Salivary glands
What are the benefits of saliva ?
What are salivary gland disorders?
A number of diseases can affect your salivary glands. These range from cancerous tumors to Sjögren’s syndrome. While some conditions go away with time or antibiotics, others require more serious treatments, including surgery.
Salivary gland infection
Salivary gland infection is also called sialadenitis. Most salivary gland infections occur in people who have something that blocks the flow of saliva (such as a stone) or who have very low flow of saliva. Infection is most common in the parotid gland and typically occurs in people who
Are in their 50s and 60s
Have a chronic illness and dry mouth
Have Sjögren syndrome
Have had radiation therapy to the mouth area or radioactive iodine therapy for thyroid cancer
Adolescents and young adults with anorexia are also prone to this infection. The usual infecting organism is the bacteria Staphylococcus aureus.
People with a bacterial infection of a salivary gland have fever, chills, and pain and swelling on the side of the face with the infected gland. The skin over the infected gland becomes red and swollen. Sometimes a collection of pus (abscess) forms in the gland, and a small amount of pus comes out of the duct of the gland.
Sialolithiasis and sialadenitis
Sialolithiasis occurs when stones made of calcium form in the salivary glands. These stones can block the glands, and that can partially or completely stop the flow of saliva. Most commonly affect submandibular gland as it's long and somewhat tortous duct .
A stone can form from salts contained in the saliva. Stones are particularly likely to form when people are dehydrated or take drugs that decrease saliva production. People with gout are also more likely to form stones. Salivary gland stones are most common among adults. About 25% of people with stones have more than one.
Salivary stones create problems when they block the tube (duct) that carries saliva from the gland to the mouth. Blockage makes saliva back up inside the duct, causing the salivary gland to swell painfully. A blocked duct and gland filled with stagnant saliva may become infected with bacteria.
Sialadenitis is an infection involving a salivary gland. It often results from stones blocking the gland. Staph or strep bacteria can cause this infection. Older adults and infants are most likely to develop this condition.
Sjögren’s syndrome
Sjögren’s syndrome is another common salivary gland disorder. It occurs when white blood cells target healthy cells in moisture-producing glands, such as the salivary, sweat, and oil glands. This condition most commonly affects women with autoimmune disorders, such as lupus.
Viruses
Viruses can affect the salivary glands as well. These include:
flu virus
mumps
Coxsackie virus
echovirus
cytomegalovirus
Cancerous and noncancerous tumors
Cancerous and noncancerous tumors may develop in the salivary glands as well. Cancerous tumors of the salivary glands are rare. When they do occur, it’s typically in 50- to 60-year-olds, according to Cedars-Sinai.
Noncancerous tumors that can affect the parotid glands include pleomorphic adenomas and Warthin’s tumors. Benign pleomorphic adenomas can also grow in the submandibular gland and the minor salivary glands, but this is rare.
Mumps is a viral infection that primarily affect parotid glands , along with other parts of the body. Mumps can cause swelling in one or both of these glands.
Mumps was common in the United States until mumps vaccination became routine. Since then, the number of cases has dropped dramatically.
Swelling also can result from cancerous (malignant) or noncancerous (benign) tumors in the salivary glands. Swelling resulting from a tumor is usually firmer than that caused by an infection. If the tumor is cancerous, the gland may feel stone-hard and may be fixed firmly to surrounding tissues (see Mouth and Throat Cancer ). Most noncancerous tumors are moveable.
An injury to the lower lip—for instance, from accidental biting—may harm any of the minor salivary glands found there and block the flow of saliva. As a result, an affected gland may swell and form a small, soft lump (mucocele) that appears bluish. The lump usually disappears by itself within a few weeks to months.
Dry Mouth
Many older people have a dry mouth. Although aging itself affects moisture in the mouth only slightly, it does make people more susceptible to conditions that dry the mouth, and older people are more likely to take drugs that may dry the mouth.
For many people, a dry mouth is only an occasional annoyance. For others, it is a persistent problem that interferes with tasting, chewing, swallowing, speaking, and wearing dentures. Persistent dry mouth increases the risk of tooth decay and periodontal disease. Persistent dry mouth is usually a symptom of a disorder or a side effect of a drug.
What are the symptoms of a salivary gland disorder?
The symptoms of sialolithiasis include:
painful lump under the tongue
pain that increases when eating
Sialadenitis symptoms include:
lump in your cheek or under your chin
pus that drains into your mouth
strong or foul-smelling pus
fever
Cysts that grow in your salivary glands can cause:
yellow mucus that drains when the cyst bursts
difficulty eating
difficulty speaking
difficulty swallowing
Viral infections in the salivary glands, such as mumps, can cause:
fever
muscle aches
joint pain
swelling on both sides of the face
headache
The symptoms of Sjögren’s syndrome include:
dry mouth
dry eyes
tooth decay
sores in the mouth
joint pain or swelling
dry cough
unexplained fatigue
swollen salivary glands
frequent salivary gland infections
If you have diabetes or alcoholism, you may also have swelling in the salivary glands.
Diagnosis of Salivary Gland Disorders
Biopsy
Endoscopy
Imaging studies
For infection, culture of pus from the salivary gland duct
There are no good tests to measure saliva production. However, the salivary glands can be squeezed (milked), and the ducts can be observed for saliva flow.
Swelling due to blockage of a salivary duct is diagnosed because of the relationship of pain to eating or drinking something that stimulates saliva flow. To diagnose other causes of swelling, a dentist or doctor may do a biopsy to obtain a sample of salivary gland tissue and examine it under a microscope. Other causes of blockage may be identified by newer techniques that use very small viewing tubes (endoscopes) that can be inserted into the salivary gland ducts.
If doctors are not able to make the diagnosis during the physical examination, they may do certain imaging studies, such as computed tomography (CT), ultrasonography, and sialography. Sialography is a type of x-ray that is taken after a dye that is visible on x-rays has been injected into the salivary glands and ducts.
If infection is suspected, doctors look for inflammation on imaging tests, such as a computed tomography (CT) scan, ultrasonography, or magnetic resonance imaging (MRI). If the doctor can squeeze pus from the duct of the affected gland, it is cultured (sent to the laboratory to try to grow bacteria).
Treatment of Salivary Gland Disorders
For dry mouth, good dental hygiene and sometimes drugs as pilocarpine parasympathomimetic .
For stones, pain relievers, fluids, physical measures, or sometimes removal
For infection, antibiotics and physical measures
For swelling, various treatments, possibly including surgery
For dry mouth, people should
Avoid drugs that decrease saliva production
Sip fluids throughout the day
Brush and floss regularly
Use fluoride rinses
Visit their dentist for examination and cleaning every 3 to 4 months
Sometimes a saliva substitute containing carboxymethylcellulose as a mouthwash
Sometimes chew sugarless gum or suck on xylitol lozenges
Some dentists have people wear plastic tooth covers filled with fluoride gel at night to prevent tooth decay due to dry mouth. Sometimes, drugs that increase saliva production, such as cevimeline or pilocarpine, help relieve symptoms. Such drugs may not help when the salivary glands have been damaged by radiation.
For salivary gland stones, people can take pain relievers (analgesics), drink extra fluids, massage the glands, apply warm compresses, and trigger saliva flow with lemon juice or wedges, sour candy, or a combination. If the stone does not pass on its own, a dentist can sometimes push the stone out by pressing on both sides of the duct. If that fails, a fine-wire‒like instrument can be used to pull out the stone. As a last resort, the stone can be removed surgically or through an endoscope.
For salivary gland infection, doctors give antibiotics and have people massage the glands and apply warm compresses. A salivary abscess needs to be cut open and drained. Staying hydrated, triggering saliva with lemon juice and hard candies, and having good oral hygiene are also important.
Salivary gland swelling treatment varies with the cause. A mucocele that does not disappear on its own can be removed surgically if it becomes bothersome. Similarly, both noncancerous and cancerous salivary gland tumors can usually be removed surgically.
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