saliva a clear slightly acidic viscid mixture of secretions of the salivary glands

1. Goodmorning

2. SALIVA AND IT’S ROLE IN
PROSTHODONTICS
Ashitha Dominic
1st year PG
Dept. of Prosthodontics

3. CONTENTS
• Introduction
• Classification
• Anatomy of salivary glands
• Development of salivary gland
• Composition of saliva
• Functions of saliva

4. • Collection of saliva
• Saliva & forensic odontology
• Saliva as diagnostic aids
• Biomarkers

5. • Saliva as a transport medium
• Role Of Saliva In Prosthodontics
• Conclusion
• References

6. Clear, slightly acid, sometimes viscid
mixture of secretions of the salivary glands and
gingival fluid exudates.

7. CLASSIFICATION
.

8. According to size
major salivary glands - parotid
- submandibular
- sublingual
minor salivary glands – von ebner’s glands, labial,
buccal, palatal , lingual, glossopalatine & retromolar
glands

9. According to secretions
Serous – the parotid and glands of von
ebner
Mucous- lingual buccal & palatine glands
Mixed – submandibular & sublingual

10. ANATOMY

11. THE PAROTID
GLAND
• Largest among the
salivary glands
• 15 g
• Below the external
acoustic meatus,
between ramus of the
mandible and the
sternocleidomastoid
• Purely serous
secretions

12. Capusle – investing layer of deep cervical fascia
Duct – stenson’s duct opens inside the cheek against the
upper 2nd molar tooth.
Blood supply – external carotid artery
Nerve supply – parasympathetic: auriculotemporal
nerve
- sympathetic : plexus around ECA
Lymphatic drainage – parotid nodes & to the upper
deep cervical lympnodes

14. THE SUBMANDIBULAR GLAND
Situated in the anterior part of the digastric triangle ,
size of a walnut.
‘J’ shaped gland
Indented to the posterior part of mylohyoid which
divides the gland into larger superficial & smaller deep.
Duct – wharton’s duct
opens on the floor of the mouth
Blood supply – facial artery
Lymphatic drainage – submandibular nodes
Nerve supply – branches from submandibular
ganglion.

15. THE SUBLIGUAL GLAND
Almond shaped
3 – 4 g
above the mylohyoid & below the floor of the mouth
6-8 ducts open from the gland which directly opens
to the floor of the mouth
Main duct – Bartholin’s duct
Blood supply – lingual & submental arteries

16. MINOR SALIVARY GLANDS
• Lingual mucous glands – situated on the post 1/3rd of the
tongue behind circumvallate papillae. tip & margins of the
tongue
• Posterior Lingual serous glands – near circumvallate
papillae & filiform papillae
• Buccal glands - between mucous membrane & buccinator
muscle
• Labial glands
• Palatal glands
imp role in taste perception.

17. DEVELOPMENT OF
SALIVARY GLAND
Glands Origin Intrauterine life
parotid corners of the 6th week
stomodeum
submandibular floor of the end of 6th week
mouth
Sublingual lateral to submandibular 8th week
primordium
Minor salivary buccal epithelium 12th week

18. GENERAL PROPERTIES
• Total amount : - 1,200 – 1500 ml in 24 hrs . 0.3 ml/min when
unstimulated& 1.5ml/min when stimulated.
parotid gland – 25 %
submandibular gland – 70 %
sublingual – 5 %
• Consistency – slightly cloudy because of the presence of cells and
mucin.
• Reaction – usually slightly acidic (PH 6.02 – 7.05)
• Specific gravity – 1.002 –1.0061
• Freezing point – 0.07 – 0.340C

19. COMPOSITION
ORGANIC
LIPIDS
PROTEINS
SALIVARY AMYLASE IMMUNOGLOBULINS
PROTEINS
SYNTHESIZED WITHIN
GLANDS
GLYCOPROTEINS
BLOOD GROUP HORMONES CARBOHYDRATES
ALPHA AMYLASE
KALLIKERIN
DEXTRANASES
ALPHA PHOSPHATASE
LIPASE
IgA
IgM
IgG
Factor VII
Factor VIII
Factor IX
Platelet
factor

20. INORGANIC
Sodium Potassium Calcium Phosphorus Chloride bicarbonate
Cells
yeast
bacteria
protozoa
pmnl
Gases
oxygen
nitrogen
Carbondioxide

21. Composition
Electrolytes – Calcium, Sodium, Magnesium,
Potassium, Bicarbonates & Phosphates
Saliva also constitutes immunoglobulins, proteins,
enzymes, mucins, and nitrogenous products ( urea & ammonia).
Bicarbonates, phosphates, and urea act to modulate
pH and the buffering capacity of saliva.
Proteins and mucins serve to cleanse, aggregate, or
attach oral microorganisms and contribute to dental plaque
metabolism.
Calcium, phosphate, and proteins work together as
an antisolubility factor and modulate demineralization and
remineralization.

22. Immunoglobulins, proteins, and enzymes
provide antibacterial action.

24. FUNCTIONS OF
SALIVA
• Digestive
• Protective
• Taste
• Excretion
• Water balance
• Oral hygiene

25. • 1) DIGESTIVE FUNCTION
alpha-amylase(ptyalin)
- It is a calcium dependent digestive enzyme
- activated by Cl.
- acts on cooked starch
Lingual lipase
- von ebner gland
- responsible for the first phase of fat digestion
BOLUS FORMATION
- Moistening of food
- Mucin – lubricating material, makes the food slippery, facilitates
swallowing

26. • 2 Soft tissue repair
Although bacteria are always present, wounds
in the mouth rarely become infected.
The presence of nerve growth factor &
epidermal growth factor in the submandibular saliva
may accelerate wound healing.
Epidermal growth factor is present in human
saliva at lower rates and the wound healing in the
mouth remains to be established.

27. • 4 Mastication and deglutition
Saliva moistens the food and helps its
breakdown into smaller particles to initiate
digestion. The moistening and lubricating
properties of saliva allow the formation of bolus
and facilitate deglutition. Saliva not only moistens
the dry food but also reduces the temperature of
the hot foods.
• 5 Taste perception
The food taken into the oral cavity is
emulsified in saliva and dissolved. This process is a
prerequisite for the sense or perception of taste. This
is due to the presence of water and lipocalins in
saliva. It also helps in maintaining taste receptors.

28. • 6 Speech
Saliva keeps the oral tissue moist and well
lubricated which facilitates speech. It helps in
vocalization and communication.
• 7 Excretory Function
Many substances both organic & inorganic,
are excreted through saliva. It also excretes lead,
mercury etc. In some pathological conditions saliva
excretes certain substances like glucose in diabetic
mellitus .

29. • 8 Regulation of water balance
When the water content of the body
decreases the salivary secretion also get reduced and
causes dryness of the mouth and induces thirst. When
water is taken it quenches the thirst and restore the
body water content.
• 9 Lubrication and demulcent properties
The oldest function of salivary glands is to supply
lubricating molecules , not only to coat the food but
the oral tissue as well. The lubrication function helps
in phonation as well as smooth swallowing without
friction.

30. • 10 ANTIBACTERIAL FUNCTION OF SALIVA
Salivary lysozyme can cause lysis
of bacterial cells especially streptococcus mutans. The
antimicrobial effect of salivary peroxidase against S.
mutans is significantly enhanced by interaction with
secretory IgA.
A group of salivary proteins lysozyme,
lactoferrin, and lactoperoxidase working in conjunction
with other components of saliva can have an immediate
effect on oral bacteria, interfering with their ability to
multiply or killing them directly.

31. • Salivary peroxidase is part of an antibacterial system
which involves the oxidation of salivary thiocyanate by
hydrogen peroxide (generated by oral bacteria) to
hypothiocyanite and hypothiocyanous acid.
• 11 Maintenance of tooth integrity
Protective function begins immediately after tooth
eruption into the oral cavity.
Although the crown of the tooth is fully formed
morphologically when it erupts, it is crystallographically
incomplete.

32. Interaction with saliva provides a post-eruptive
maturation through diffusion of ions such as calcium,
phosphorus, magnesium, and fluoride, as well as other
trace components, into the surface enamel.
This maturation increases surface hardness,
decreases permeability, and has been experimentally
shown to increase resistance to caries.
12) HORMONAL FUNCTION
Parotin – deposition of Ca on tooth
nerve growth factor – growth of sympathetic
ganglia

33. TYPES OF SALIVA
• Stimulated
• Unstimulated

34. FACTORS AFFECTING UNSTIMULATED
SALIVARY FLOW

35. FACTORS AFFECTING
STIMULATED SALIVARY FLOW

36. EFFECTS OF DRUGS &
CHEMICALS ON SALIVARY
SECRETION
• Sustances which increase the salivary secretion
1. Sympathomimetic drugs like adrenaline & ephedrine
2. Parasympathomimetic drugs like acetylcholine,
pilocarpine, muscarine & physostigmine
3. Histamine

37. • Substances which decrease the salivary
secretion
1. Sympathetic depressants like ergotamine &
dibenamine
2. Parasympathetic depressants like atropine &
scopolamine

38. Collection of saliva
Stimulated Unstimulated
Expectoration every 30-60secs Draining method
- gustatory - aids Spitting method
- mechanical – chewing Swab method
paraffin wax Suction method
ROLE OF SALIVA IN
DIAGNOSIS

39. SALIVA FUNCTION TEST
• Simple screening test
- Saliometry
- Visual inspection of saliva
-Ph & buffering capacity
-Dip stick methods
• Other tests
-Carlson crittenden collector
(parotid gland)
-Peristron (minor salivary
glands)

40. SALIVA IN ONCOLOGIC
DIAGNOSIS
• Used in the diagnosis of many malignancies
breast cancer
brain tumor
spino cellular carcinoma

41. SALIVA IN CARDIOVASCULAR
DISEASES
• Salivary amylase as a protein biomarker
• Primary function – breakdown of sugars
• Studies show there is increased production of salivary
amylase during high stress.

42. SALIVA IN DIAGNOSTIC
TESTING OF DRUGS
• Salivary glands –highly vascular – easy cross over of
drugs from boold to saliva
• Level of drugs remain in the saliva num of hours after
intake
• Eg :- amphetamines, barbiturates, benzodiazepines,
cocaine, heroine, nicotine

43. SALIVA IN DIAGNOSIS OF
INFECTIOUS DISEASES
• Bacteria
- Mycobacterium tuberculosis – high levels in saliva
during the acute stages
• Viral
- HIV : ELISA + western blots – higher chances of
accurate results with saliva

44. THE ROLE OF SALIVA IN
PROSTHODONTICS
• Plays an important role in the normal functioning of the
complete denture prosthesis.
• Difficulty in impression making if saliva is mucous
Atropine sulfate – prior to impression making
• denture stomatitis ( due to lack of salivary mucins)
• Alteration in taste perception due to denture

45. Adhesion: It is the physical molecular attraction of unlike
surfaces in close contact. It acts when saliva wets and sticks
to the basal surfaces of dentures and at the same time to the
mucous membrane of the basal seat.
Effectiveness of adhesion depends upon
close adaptation of denture base to the supporting tissues
and fluidity of saliva.
Cohesion: It is the molecular attraction between two similar
surfaces in close contact. It occurs in the layer of saliva
between the denture base and mucosa.

46. The physical factors consist of:
Adhesion
Cohesion
Surface tension
Capillary attraction
Atmospheric pressure
Optimal salivary flow and quantity and quality of saliva is
important not only in the fabrication of complete denture but
also in the retention, stability and support of denture

47. • Interfacial surface tension: It is the resistance to
separation possessed by the film of liquid between two well
adapted surfaces. It is found in the thin film of saliva between
the denture base and the mucosa of basal seat.
• Capillary attraction: It is the force that causes the surface
of liquid to become elevated or depressed when it is in
contact with a solid. When the adaptation of denture base to
mucosa on which its rests is sufficiently close, the space filled
with a thin film of saliva acts like a capillary tube and helps
retain the denture.

48. DISTRIBUTION OF SALIVA
OVER DENTURE
Complete coverage
of denture & mucous
membrane
No meniscus
hence no
retention
Coverage of
mucous membrane
& partial coverage
of denture
Coverage of basal
tissue &denture
surface
Produces a meniscus
&retentive force
exists
Mensicus present –
cosiderable retentive
force present

49. Too much
• An overly profuse supply of saliva will not increase the
retention and may complicate the impression procedure to a
degree.
• Excessive sol can be controlled by having the patient rinse
with water just before the impression tray is inserted into the
mouth, in order to close the orifices of the salivary glands
partially
• In some cases antisialogogus such as pamine may be
increased.

50. Too little
• Xerostomia may be present with systemic disorders such as
diabetes or nephritis.
• It may also be induced by regular use of tranquilizing drugs
and may be associated with nutritional deficiency.

51. Thick viscous type of saliva
• This type of saliva sometimes reduces retention by interfering
with intimate contact between the denture and the mucosa. It
may interfere with obtaining an accurate impression . This
type of saliva can be controlled for impression registration
with an oral rinse administered just before making the
impression.
• This type of saliva is usually associated with the patient
who has a marked tendency to gag. `

52. • Thick Mucinous type of saliva
More than 350 palatine glands are located in the
post 2/3rd of the palate.
This type of saliva can be controlled by means of
mouth wash consisting of ½ teaspoon of bicarbonate in half
glass of water.
• This pre impression rinse has a thinning effect on the saliva .
• If a mouth wash is not at hand the tandem impression
technique is employed. Where 1st impression is taken to soak
up the bubbles and mucinous saliva, followed by a 2nd
impression which will record the tissue in a relatively saliva
free state.

53. ARTIFICIAL SALIVA
RESERVOIR
WEARING DENTURES CAN BE AN EXTREMELY
UNCOMFORTABLE EXPERIENCE FOR PEOPLE WITH
XEROSTOMIA.
FOR THESE PATIENTS, MASTICATION,
DEGLUTITION, PHONATION AND WEARING DENTURE
ITSELF IS DIFFICULT. DUE TO LOSS OF SALIVARY
FLOW, THERE IS NO LUBRICATION, CLEANSING
ACTION OF SALIVA WHICH CAUSES FRICTIONAL
EFFECT ON THE MUCOSA AND DENTURE WILL
CAUSE HIGH IRRITATION TO THE MUCOSA.

54. Salivary stimulation is induced by the artificial
substitutes such as lemonades, lozenges, pilocarpine drugs
and salivary substitutes sugar free gums like xylitol, artificial
saliva gel, and salivary substitute mouth wash.
Another approach is by providing salivary
reservoirs in maxillary and mandibular dentures thereby
injecting the artificial saliva in the reservoirs, it acts as a
lubricating device.

55. INLET AND OUTLET HOLES LATEX MEMBRANE
RESERVOIR

56. SPLIT MANDIBULAR DENTURE

57. CONCLUSION
The secretion of saliva not only varies
in rate between different individuals but also in
its composition. Rather than providing just
lubrication for the oral tissues, it is important for
the metabolic health of the mouth as a whole.

58. REFERENCES
• Human Anatomy By B D Chaurasia's 5th Edition
• Orban’s oral histogy and embryology 14th edition
• Essentials of human physiology by Sembulingam 2d edition
• Shafer’s textbook of oral pathology 7th edition
• Ten Cate’s oral histology 9th edition Burkets oral medicine 12th
edition

59. • Physiology & composition of saliva and its influence in prosthodontics - A review –
Dr.B.Shivasaranya
• The composition, function and role of saliva in maintaining oral health:
A review Brij Kumar, Nilotpol Kashyap, Alok Avinash, Ramakrishna Chevvuri,
Mylavarapu Krishna Sagar, Kumar Shrikant
• New design for an artificial saliva reservoir for the mandibular complete denture Gary
F. Sinclair, LCG, CertEd,a Peter M. Frost, BDS, DGDP, RCS,b and John D. Walter,
BDS, DDSC
• Saliva and oral health-Michael Edgar 4th edition