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Flashcards in Saliva Deck (42)
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1

What is Saliva?

Saliva is mostly _______% water and the ____ components make up _____________.

The _____-rich secretions of the salivary glands contain a milieu of _____ _____, ______, _____, ____ elements, and usually contains incredibly high numbers of_____.  

Ironically, it is also the tooth’s _____ _____against ____ ____. 

It is a symbiotic ecology unto itself.

Saliva is mostly 99.5% water and the functional components make up only a fraction of the volume. The protein-rich secretions of the salivary glands contain a milieu of antibacterial enzymes, immunoglobulins, lubricants, inorganic elements, and usually contains incredibly high numbers of bacteria.  Ironically, it is also the tooth’s first defense against cariogenic pathogens.  It is a symbiotic ecology unto itself.

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~ The Functions of Saliva ~ Categories

_____

____ _____

_____

Protective

Food Related

Communications

3

Protective

L_____: W____, M____, ____-rich _____ coat ____ of ____ ___, ____ , and____

A____ A______ A____: Salivary ______ (e.g L____, L_____,L____, M____): H____ ,  C____, S_________,______-rich ____

M____ I___:  M____, E____ , W____

L_____,C_____:  W_____

B_____ C____:   B____ and P____, P_____

R_____:  C ____, P____, ____-rich_____

LAMB LR

I. Protective
Lubrication: Water, mucins, proline-rich glycoproteins coat   surfaces of oral mucosa, throat, and food

Antibacterial, Antifungal, Antiviral: Salivary proteins (e.g lysozyme, lactoferrin, lactoperoxidase, mucins): histatins,   cystatins, secretory IgA, proline-rich glycoproteins

Mucosal integrity:  Mucins, electrolytes, water

Lavage, cleansing:  Water

Buffering Capacity:   Bicarbonate and phosphate, proteins

Remineralization:   Calcium, phosphate, proline-rich   glycoproteins

  

4

Speaker Notes:

Specifically, this table outlines the salivary components involved in the “protective” function
of saliva. The salivary glands provide lubricatory molecules that coat food and the soft and
hard oral tissues. Lubrication allows food to travel easily through the digestive system and provides smooth tissue surfaces with minimal friction. Without lubrication, food becomes impacted around the teeth, making eating difficult and unpleasant, and increasing ___ ___. 

Saliva also contains antifungal and antiviral systems. Antibodies (like ____) can directly neutralize _____. Mucins are also effective ____molecules. 

Mucins are important in the control of ______ of the mucosal surfaces. The presence of salivary ___ can limit penetration of various potential___ and ____ in foods and beverages, as well as potentially hazardous agents from____ _____and other sources. Mucins, in combination with ____ AND ____, act as natural “____ _____” that helps maintain oral tissues in a _____ state, thus maintaining mucous membrane integrity.

Water, IgA and proline provide an oral “cleansing” and “lavage” function. This physical flow
of saliva constantly removes __________. 

Bicarbonate and phosphate ions and proteins assist in the achievement of oral ______
and maintenance of a specific pH through buffering action on strong oral acids and bases. 

Teeth are remineralized through the deposition of ___, ___ and ____. 

Speaker Notes:

Specifically, this table outlines the salivary components involved in the “protective” function
of saliva. The salivary glands provide lubricatory molecules that coat food and the soft and
hard oral tissues. Lubrication allows food to travel easily through the digestive system and provides smooth tissue surfaces with minimal friction. Without lubrication, food becomes impacted around the teeth, making eating difficult and unpleasant, and increasing plaque formation. 

Saliva also contains antifungal and antiviral systems. Antibodies (like secretory IgA) can directly neutralize viruses. Mucins are also effective antiviral molecules. 

Mucins are important in the control of permeability of the mucosal surfaces. The presence of salivary film can limit penetration of various potential irritants and toxins in foods and beverages, as well as potentially hazardous agents from tobacco smoke and other sources. Mucins, in combination with electrolytes and water, act as natural “water proofing” that
helps maintain oral tissues in a hydrated state, thus maintaining mucous membrane integrity.3

 

Water, IgA and proline provide an oral “cleansing” and “lavage” function. This physical flow
of saliva constantly removes potentially harmful bacteria. 3

Bicarbonate and phosphate ions and proteins assist in the achievement of oral homeostasis
and maintenance of a specific pH through buffering action on strong oral acids and bases. 3,4

Teeth are remineralized through the deposition of calcium, phosphorus and stathrin. 4

5

Food Related FCNS

________ for ____ : W M and -__rich

_____:  A___ R____ ,___

_____: W____ G____ (______)

Preparation for digestion  Water, mucins, proline-rich glycoproteins

Digestion  Amylase, ribonuclease, lipase

Taste  Water, gustin (zinc-binding salivary   protein)

6

Communications

____: ____, ____

Speech  Water, mucins

7

Speaker Notes

Saliva is an integral component for preparing food for digestion. Major salivary functions include ____ formation and digestion by the salivary enzymes ____, ____, and ____.

Saliva also enhances ___ and ____

 

Finally, the lubrication from water and mucins assists in the ability to speak.

Larger taste buds have _____ _____ _____

Speaker Notes:

Saliva is an integral component for preparing food for digestion. Major salivary functions include bolus formation and digestion by the salivary enzymes amylase, ribonuclease, and lipase. 4

Saliva also enhances taste and swallowing.

 

Finally, the lubrication from water and mucins assists in the ability to speak.

Larger taste buds have small salivary glands

8

The Biological Necessity of Saliva ~ LCC

SH PP STD LCC

 


•Lubricating and moistening of food for swallowing
•Temperature regulation of solid foods & liquids.
•Solubilizing material so it can be tasted
•Initiating digestion
•Preventing dental caries
•Maintaining pH of upper GI
•Maintaining health of oral mucosa
•Preventing opportunistic infections by keeping
microflora balance
•Speaking
•Cleansing of mouth and clearing the esophagus
 

 

Speaker Notes:

Long before there were toothbrushes, fluoride toothpastes and dental floss, the evolutionary process created protective mechanisms in the mouth for self-
defense against the hundreds of species of microorganisms and their 50 billion
(or more) descendants that make their home in the mouth.

The major responsibility for the defense of the mouth rests with the salivary glands.  Saliva's multi-dimensional functions include providing protection of the soft and hard oral tissues.  Saliva also plays a pivotal role in the processes of alimentation and communication, which are most often taken for granted until they are impaired. 

9

Saliva is Produced by

GLANDULAR EPITHELIUM

10

GLANDULAR EPITHELIUM

 

Glands are special types of cells, which are specialized to _____ _____ to be used _____ (where).  Glands are classified according to their ____ of ____.

Exocrine Glands – Secrete their products via ___ onto the _____ (or epithelial) surface. These glands are highly specialized ____ cells and thus are classified as ____ ____. 

 

Glands are special types of cells, which are specialized to produce products to be used elsewhere in the body.  Glands are classified according to their mechanism of secretion.

Exocrine Glands – Secrete their products via ducts onto the apical (or epithelial) surface. These glands are highly specialized epithelial cells and thus are classified as glandular epithelia. 

11

Exocrine Glands

Exocrine glands are glands whose secretions pass into a ____ of _____that lead ultimately to the ____ of the body.

So the ____ surface of the glands and the ____ that drain them are topologically _____________.

Exocrine glands are glands whose secretions pass into a system of ducts that lead ultimately to the exterior of the body. So the inner surface of the glands and the ducts that drain them are topologically continuous with the exterior of the body (the skin). 

12

Mono-Ductal Systems
____ glands - Glands of this type have an _____ duct into which the cells secrete.

Each secretory portion empties__________________.

In the oral cavity, the ______________ are a prime example of mono ductal glands.

Simple glands - Glands of this type have an unbranched duct into which the cells secrete. Each secretory portion empties separately on an epithelial surface. In the oral cavity, the minor salivary glands are a prime example of mono ductal glands.

13

Poly-Ductal Systems
 


______ glands - These glands have a ______ duct system.

Secretory portions empty into_______________, which, in turn, drain into___ ______.

Collectively these entities form the _______.

Compound glands - These glands have a highly branched duct system. Secretory portions empty into an elaborate branched duct system, which, in turn, drain into larger ducts. Collectively these entities form the major salivary glands.

 

14

Examples

Slide 13

15

These Specialized Epithelial Tissues
Combine to Form 

the Major and Minor Saliva producing Glands of the Oral Cavity

16

What Is Whole Saliva?

It is a _____ ____ secretion from the ____ and ____ salivary glands of the mouth.

Major salivary glands: Major glands ___ their secretions through a ____ ___into the mouth

Minor salivary glands: Minor glands ___ their secretions _____ (mono-ductal)

Salivary glands are classified by ___, ____, and ____. 

The major glands are ____ and alter _____-____ saliva via _____ pathways in the ____. 

Minor glands are found on the _____, _____ _____ _____ ___ _____surfaces just___  and within the ___ ____, unencapsulated and within short duct systems. 

It is a composite exocrine secretion from the major and minor salivary glands of the mouth.

Major salivary glands: Major glands push their secretions through a main duct into the mouth

Minor salivary glands: Minor glands empty their secretions directly into the mouth (mono-ductal)

Salivary glands are classified by size, location, and histology.  The major glands are paired and alter post-secretion saliva via reabsorption pathways in the ducts.  Minor glands are found on the labial, lingual, palatal, buccal, glossopalatine, and retromolar surfaces just below and within the mucous membranes, unencapsulated and within short duct systems. 

17

Other Secretory contributors to the whole Saliva

The ___ ____ glands are ____ found in the mouth.

More specifically, they are ___ salivary glands which reside within the  surrounding the circumvallate papilla in the ____  __-___ of the tongue, anterior to the ___ ___

These glands are located around _____ and ___ ____in the tongue. These glands empty their serous secretion into the ___  of the moats located around the foliate and circumvallate papillae. 

The Von Ebner's glands are exocrine found in the mouth. More specifically, they are serous salivary glands which reside within the moats surrounding the circumvallate papilla in the posterior one-third of the tongue, anterior to the terminal sulcus.

These glands are located around circumvallate and foliate papilla in the tongue. These glands empty their serous secretion into the base of the moats located around the foliate and circumvallate papillae. 

18

Generally Speaking

During the day, ___to ____ ml of saliva is produced, however only about __ml is produced during the night.  It is this nocturnal reduction in flow that makes ____________________ important component of caries management. 

During the day, 640 to 1200 ml of saliva is produced, however only about 10 ml is produced during the night.  It is this nocturnal reduction in flow that makes brushing your teeth before bed an important component of caries management. 

19

stimulated Whole Saliva

Stimulated secretion is as the name suggests; it is stimulated.  The process is extremely complex involving numerous neurological pathways. One mode of stimulation can be _____.

The term, “Stimulated Saliva” is given to those secretions produced by _____ ____ ____. 

It is thought that these secretions aid specifically in ____ and ___ as well as ___, ___, and ________ and ___________.

Stimulated secretion is as the name suggests; it is stimulated.  The process is extremely complex involving numerous neurological pathways. One mode of stimulation can be gustatory.

The term, “Stimulated Saliva” is given to those secretions produced by thinking of certain foods, tasting and chewing.  It is thought that these secretions aid specifically in digestion and taste as well as protect, buffer, and confer immune response and maintain tooth integrity.

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SPECIMEN COLLECTION

Five Minute Collection

21

Unstimulated Whole Saliva

FCN

Unstimulated secretion is defined as a resting saliva. It is the saliva that is produced while sleeping, reading, bathing, etc. It is very protective of the dentition and its supporting structures

22

Unstimulated Saliva or Resting Saliva

Always _____

____ ___ flow thru out day

Peak

Lowest

This type of saliva is always present in the mouth and plays a role in protection, buffering, antimicrobial action, and tooth integrity.


lUnstimulated saliva (Resting saliva)

Constant slow flow throughout day, peaking during afternoon and lowest

at 4:00 AM

0.3-0.5 ml per minute secretion rate

23

~ WHOLE SALIVA ~
 Left Specimen is a Resting Saliva Specimen.
Right Specimen is Paraffin Stimulated Saliva.

~ WHOLE SALIVA ~
 Left Specimen is a Resting Saliva Specimen.
Right Specimen is Paraffin Stimulated Saliva.

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~ Sialometer ~
 

Used to Collect Whole Saliva

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~ SALIVARY FLOW RATES ~

•Approximately____ Liters of saliva is secreted per day.
•The parotid contributes ___% of the unstimulated saliva while ___% comes from the submandibular salivary glands and ___% from the sublingual.
•However, during stimulation the parotid can contribute as much as __%.
 


•Approximately 1.5 liters of saliva is secreted per day.
•The parotid contributes 25% of the unstimulated saliva while 60% comes from the submandibular salivary glands and 7-8% from the sublingual.
•However, during stimulation the parotid can contribute as much as 50%.
 

26

 ~ GLANDULAR FLOW RATES ~


• Parotid Salivary flow rates for unstimulated or restng flow are _____ ml/min and ____ for stimulated flow.
• Submandibular and Sublingual gland salivary flow rates are in the range of ____ ml/min when unstimulated and ____ ml/min when stimulated, although both flow rates have wide normal ranges.

 


• Parotid Salivary flow rates for unstimulated or restng flow are 0.3-0.5 ml/min and 0.5 – 3.0 for stimulated flow.
• Submandibular and Sublingual gland salivary flow rates are in the range of 0.5 – 0.7 ml/min when unstimulated and 0.5-2.0 ml/min when stimulated, although both flow rates have wide normal ranges.

 

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28

Stimulated Saliva

One of the reasons saliva analysis is difficult is because the composition of mixed or stimulated saliva is not the _____________, as many proteins are rapidly _____ as they adhere to _____ of teeth and _____ surfaces.

~ For Example ~

The parotid contributes __% of the unstimulated saliva while __% comes from the submandibular salivary glands and ___% from the sublingual.

However, during stimulation the parotid can contribute as much as ___%.

One of the reasons saliva analysis is difficult is because the composition of mixed or stimulated saliva is not the additive sum of all salivary secretions, as many proteins are rapidly removed as they adhere to hydroxyapatite of teeth and mucousal surfaces.

~ For Example ~

The parotid contributes 25% of the unstimulated saliva while 60% comes from the submandibular salivary glands and 7-8% from the sublingual.

However, during stimulation the parotid can contribute as much as 50%.

29

~ SALIVA APPEARANCE ~
 

 Appearance should be slightly turbid (hazy)

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IN DISEASE

Saliva From a Patient with Systemic
Lupus Erythematosus

Foamy Saliva From a Patient
Sjögren’s Syndrome