Oral medicine: 4. dry mouth and disorders of salivation

From Volume 39, Issue 10, December 2012 | Pages 738-743

Authors

David H Felix

BDS, MB ChB, FDS RCS(Eng), FDS RCPS(Glasg), FDS RCS(Ed), FRCPE

Postgraduate Dental Dean, NHS Education for Scotland

Articles by David H Felix

Jane Luker

BDS, PhD, FDS RCS, DDR RCR

Consultant and Senior Lecturer, University Hospitals Bristol NHS Foundation Trust, Bristol

Articles by Jane Luker

Crispian Scully

CBE, DSc, DChD, DMed (HC), Dhc(multi), MD, PhD, PhD (HC), FMedSci, MDS, MRCS, BSc, FDS RCS, FDS RCPS, FFD RCSI, FDS RCSEd, FRCPath, FHEA

Bristol Dental Hospital, Lower Maudlin Street, Bristol BS1 2LY, UK

Articles by Crispian Scully

Article

Specialist referral may be indicated if the Practitioner feels:

Saliva is essential to oral health. The most obvious and important function of saliva is in eating, for taste and to lubricate food, as well as protecting the mucosa and teeth (Table 1). The water, mucins and proline-rich glycoproteins lubricate food and help swallowing. Importantly, saliva is essential for normal taste perception. Saliva is protective via the washing action, via various antimicrobial components such as mucin, histatins, lysozyme and lactoferrin, and via specific antibodies to a range of micro-organisms that the host has encountered.

Salivary gland secretion from the major (parotid, submandibular and sublingual) and minor glands (multiple mucous glands scattered throughout the mouth – especially the lips and soft palate), is mainly under neural control, under the influence of the autonomic nervous system, although various hormones may also modulate its composition. In general, parasympathetic stimulation increases salivation, while sympathetic stimulation produces more viscous saliva and therefore appears to depress salivation.

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