Zusammenfassung der Ressource
Salivary Gland Disorders
- Salivary stones
= Sialoliths
- 80% in the
submandibular gland
- Symptoms
- Pain/swelling when smelling or
tasting food e.g. at mealtimes
- Pain, swelling or
infection of gland
- Adult males
- Pathology
- Deposition of calcium salts around
a nidus of organic material
- Investigations
- 1. Radiograph
- Lower occlusal
- Submandibular
- Cheek
- Parotid
- 50% radiolucent
- Sialography
- inject contrast medium through the
duct and take a lateral oblique usually
- Ultrasound
- Management
- Ultrasonic shock
wave therapy
- Surgical removal
- Xerostomia
- Management
- Saliva substitutes
- Sodium carboxymethylcellulose based
- Biotene products
- Stimulate residual
secretory capacity
- Best method = sugar free chewing gum
- Pilocarpine
- Eliminate cause if poss.
- e.g. liaise with GP to change drug
- Effects
- Reduced denture retention
- Increased risk of
- Caries & Perio
- Bacterial sialodenitis
- Candidosis
- Discomfort, difficulty eating,
swallowing, talking
- Taste disturbance
- Causes
- Sjogren's
- Drugs
- Anti-depressants
- Beta blockers, diuretics
- H&N DXT
- Diabetes
- Renal failure
- Sialadenitis
- Inflammation of
salivary glands
- Usually major glands
- Bacterial
- Acute
- Common pathogens
- Staph.Aureus
- Strep
- Presentation
- Painful swelling
with rapid onset
- Unilateral
- Discharge (pus) from gland duct
- Diagnosis
- Radiograph to see if sialolith
- Pus swab
- Treatment
- Antibiotics e.g. amoxicillin
- Chronic
- Presentation
- Unilateral
- Intermittent, recurrent swelling & pain
- Most common pathogen =
Staph. Aureus
- Treatment
- Stimulation of salivary flow
- Massage gland
- Chewing gum
- Predisposing factors
- Reduced salivary flow
- Sialolith
- Recurrent pain/swelling at mealtimes
- Dehydration
- Medications
- Radiotherapy
- Sjögren’s syndrome
- Poor oral hygiene
- General managment
- Rehydration
- Removal of sialolith
- Viral = Mumps
- Pathogen = paramyxovirus
- Mostly affects Parotid gland
- can affect submandibular
- Self-limiting
- Presentation
- Bilateral, painful swellings
- Fever, malaise
- Children & young adults
- Treatment
- Fluids, analgesics, bed rest
- Prevention = MMR
- Droplet inhalation transmission
- Sjogren's Syndrome
- = autoimmune inflammatory
disoder with dry eyes & dry
mouth +/- systemic disease
- Destruction of glandular tissue
- Primary = no systemic disease
- Inflammation seen
histopathologically
- Women
- Diagnosis
- Exclude other causes
- Drugs
- DXT
- Salivary gland tests
- Saliva flow rate
- Salivary scintography
- Parotid sialography
- Biopsy
- Clinical
- Anti-Ro or Anti-La autoabs
- Secondary = + systemic disease
- Systemic
- Rheumatoid arthritis
- Lupus erythematosus
- Scleroderma
- Diagnosis
- Clinical
- Biopsy
- Inflammation seen
histopathologically
- Anti-Ro or Anti-La or
rheumatoid factor
- Clinical features
- Eyes
- Dry, gritty
- Painful, red
- Oral
- Xerostomia
- Recurrent/persistent
gland swelling
- Painless
- 1st gland affected = Submandibular
- Systemic features (secondary)
- Increased risk of lymphoma
- Management
- Anti-fungals
- Eyes
- Eye drops
- Minimise screen time
- Avoid AC, dust, wind
- Oral
- Saliva substitues
- Chewing gum, pilocarpine
- Immune-modulatory
- Ciclosporin
- Immunosuppression