This document discusses the role of saliva in dental caries. It notes that saliva helps prevent dental caries through several properties: dilution and clearance of sugars, neutralization and buffering of acids in plaque, and supply of ions for remineralization. Adequate salivary flow is important for rapid clearance of sugars and bacteria from the mouth. Components of saliva like mucins, agglutinins, and sIgA help clear bacteria and aggregate them for easier removal. Higher levels of sIgA in saliva are associated with lower rates of dental caries in children.
Saliva - applied physiology and its role in dental cariesKarishma Sirimulla
this seminar includes formation of saliva,factors effecting salivary flow,various conditions associated with flow of saliva and most importantly role of saliva in dental caries.remineralization and demineralization balance maintained by saliva
Saliva - applied physiology and its role in dental cariesKarishma Sirimulla
this seminar includes formation of saliva,factors effecting salivary flow,various conditions associated with flow of saliva and most importantly role of saliva in dental caries.remineralization and demineralization balance maintained by saliva
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Tooth hypersensitivity is a common problem encountered in everyday life and clinical practice. This presentation clearly shows causes, methods of prevention and treatment in such cases.
PHYSICAL PROPERTIES
CHEMICAL PROPERTIES
STRUCTURE OF ENAMEL
DEVELOPMENT OF ENAMEL
EPITHELIAL ENAMEL ORGAN
AMELOGENESIS
LIFE CYCLE OF AMELOBLASTS
AGE CHANGES IN ENAMEL
DEFECTS OF AMELOGENESIS
CLINICAL IMPLICATIONS
this contains the steps for the class 1 cavity preparation for amalgam in detail. also contains the difference between composite and amalgam cavity preparation.
CONSIST OF INDTRODUCTION, PAIN DEFINITION , MECHANISM OF PAIN, THEORIES OF PAIN, PATHOPHYSIOLOGY OF PAIN, THORIES OF DENTIN HYPERSENSTIVITY , TREATMENT
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Tooth hypersensitivity is a common problem encountered in everyday life and clinical practice. This presentation clearly shows causes, methods of prevention and treatment in such cases.
PHYSICAL PROPERTIES
CHEMICAL PROPERTIES
STRUCTURE OF ENAMEL
DEVELOPMENT OF ENAMEL
EPITHELIAL ENAMEL ORGAN
AMELOGENESIS
LIFE CYCLE OF AMELOBLASTS
AGE CHANGES IN ENAMEL
DEFECTS OF AMELOGENESIS
CLINICAL IMPLICATIONS
this contains the steps for the class 1 cavity preparation for amalgam in detail. also contains the difference between composite and amalgam cavity preparation.
CONSIST OF INDTRODUCTION, PAIN DEFINITION , MECHANISM OF PAIN, THEORIES OF PAIN, PATHOPHYSIOLOGY OF PAIN, THORIES OF DENTIN HYPERSENSTIVITY , TREATMENT
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
topic includes salivary glands, structure & duct system of salivary glands, properties & composition of saliva, functions of saliva, regulation of salivary secretion, effect of drugs & chemicals on salivary secretion, saliva & oral biofilm, applied physiology.
Saliva & Salivary glands A Prosthodontics Perspective Dr. Aayush Shah
The seminar aims to provide a comprehensive understanding of the significance of saliva and salivary glands in prosthodontics. Saliva plays a crucial role in maintaining oral health, aiding in mastication, digestion, lubrication, and antimicrobial defense. The functionality of salivary glands directly impacts the success and longevity of prosthodontic treatments, such as dentures, dental implants, and oral rehabilitation procedures. This seminar will explore the intricate relationship between saliva, salivary glands, and prosthodontics, highlighting their clinical implications and management strategies.
PHYSIOLOGY OF SALIVA AND ITS SIGNIFICANCE IN PROSTHODONTICS.pptxBaishali Ghosh
EMBRYOLOGY
ANATOMY
HISTOLOGY
MECHANISM OF SALIVARY SECRETION
CONTROL OF SALIVARY SECRETIONS
COMPOSITION
FUNCTION OF SALIVA
SALIVA AS DIAGNOSTIC TOOL
SIALORRHEA
XEROSTOMIA
RETENTION IN COMPLETE DENTURE
It is the surrounding environment of the teeth, which is one of the most important factors that can protect, process and predict the oral health of an individual. And the main thing that makes that environment is the SALIVA – one of the most important body fluid that is the nature’s miracle in your mouth, the primary defence system for the oral environment. The quality, quantity and composition depending, this miracle fluid helps us in maintaining our health in the following ways:
1. Keeping our mouth in a normal pH (acid-alkaline balance) - neutralizing acid challenges
2. Re-mineralization of teeth -delivering calcium, phosphate and fluoride to the tooth surface
3. Oxygenation and cleaning of oral tissues, flushing food and bacteria
4. Aid in speech and taste
5. Digest and swallow food
6. Anti-bacterial / Anti-viral / Anti-fungal
7. Diagnosis of diseases, hormones, pregnancy, drugs and alcohol testing
Similar to SALIVA AND ITS ROLE IN DENTAL CARIES 1st 3rd march.pptx (20)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
3. Contents
Introduction
Definitions
Properties of saliva
Composition of saliva
Functions of saliva
Salivary glands
- classification
- anatomy
Formation of saliva
Nervous regulation of salivary secretion
3
4. Role of saliva in dental caries
Conclusion
References
4
5. The oral cavity is kept moist by a film of fluid
called
saliva that coats the teeth and the mucosa.
Saliva is a complex fluid, produced by the salivary
glands.
Individuals with a deficiency of salivary secretion
experience difficulty in eating, speaking and
swallowing and become prone to mucosal
infections and rampant caries.
5
6. Saliva
According to TEN CATE,
- saliva is a complex fluid , produced by the salivary
glands ,the most important function of which is to
maintain the well being of the mouth.
According to ORBAN,
- the clear, alkaline, somewhat viscid secretion from the
parotid, sublingual and smaller mucous glands of the
mouth.
6
7. Stimulated saliva and unstimulated saliva
Salivary flow is termed resting (unstimulated) when no
exogenous or pharmacological stimulation is present.
It is termed stimulated when secretion is promoted by
mechanical or gustatory stimuli or by pharmacological
agents.
7
8. Properties of saliva
Volume: 1000-1500 ml of saliva is secreted per day
contribution by each major salivary glands:
a) parotid- 20%
b) submandibular- 65%
c) sublingual- 5%
d) minor-10%
Mixed saliva from all the glands is slightly acidic-
pH of 6.35-6.85.
Specific gravity: ranges from 1.002-1.012.
Tonicity - saliva is hypotonic to plasma.
Freezing point - 0.07 to 0.34 degree C.
8
11. Factors Influencing Composition
and Flow of Saliva
Water Intake: If water content of body reduced to
8% salivary flow decreases to zero.
Visual and Mental Stimulation.
Salivary Flow Index: when salivary flow increases.
Concentration of proteins, NaCl ,
HCO3
Concentration of phosphates and
Mg
12. Body posture: individual in standing position
secret more saliva.
Smoking and medication: Individuals those who
smoke have higher flow than non- smokers.
Certain medications, such as antidepressants,
antihistamines, etc. (drugs having anticholinergic
action) cause reduction in salivary flow.
12
13. Functions of saliva
13
• Mucin and other glycoproteins.
• Prevents dessication of oral tissues.
• Flush away debris and other non adherent
bacteria.
Lubrication
• Bicarbonates , phosphates and salivary proteins.
• Metabolism of salivary proteins provides urea
and ammonia which help increase pH which is
not conductive for cariogenic bacteria to survive.
Buffering
14. 14
• Proline rich proteins, statherin, glycoproteins
bind to tooth surface forming enamel pellicle
which behaves as protective membrane.
Pellicle formation
• Keeps oral tissue moist and lubricated which
facilitates speech.
• Helps in vocalization and communication ability.
Speech
15. 15
• High concentration of calcium and phosphates
causes posteruptive maturation of enamel,
increases surface hardness and resistance to
demineralization.
• Remineralization of initial carious lesions by
fluoride ions.
Maintenance of tooth integrity
• Antibacterial agents: lysozymes, lactoferrin,
calprotectin, immunoglobulins.
• Antiviral agents: cystatins, mucins.
• Antifungal agents: histatins, chromogranin A.
Antimicrobial action
16. 16
• Amylase (ptyalin)- breaks down starch.
• Lingual lipase- responsible for first phase of fat
digestion.
Digestion
• Moistens the food and helps in breakdown into
small particles.
• Formation of bolus and facilitates deglutition.
Mastication and deglutition
17. 17
• Food is emulsified in saliva and dissolved which
is prerequisite for the sense of perception of
taste.
• It is due to the presence of water and lipocalins.
• Also helps in maintaining taste receptors.
Taste perception
• Variety of growth factors and trefoil proteins are
present in small quantities in saliva which
promotes tissue growth, differentiation and
wound healing.
Tissue repair
18. 18
• Many substances both organic and inorganic
are excreted in saliva.
• Glucose in DM.
• Excess urea in nephritis.
Excretion
24. Parotid gland
Largest salivary glands.
Purely serous.
Weight: 14-28 grams.
Pyramidal in shape.
2 parts- a) Superficial
b) Deep
Superficial portion lies in front
of external ear
& deeper portion lies
behind the ramus of
mandible.
B.D.CHAURASIA’S HUMAN
ANATOMY VOL.3
26. Blood supply
terminal branch of external carotid artery
& internal maxillary artery.
Nerve supply
parasympathetic nerve supply is mainly from the
glossopharyngeal nerve and auriculotemporal
nerve.
sympathetic innervation of all salivary gland is
provided by the postganglionic fibers from the
superior cervical ganglion.
26
27. Submandibular gland
Second largest salivary gland
Weight: 7-15 grams.
Secretion is both serous and
mucous.
Located on the medial aspect of
the body of mandible in the
submandibular triangle.
Main excretory duct: wharton’s
duct opens at the sublingual
papillae lateral to the lingual
frenum.
27
B.D.CHAURASIA VOL.6
28. Blood supply
- receives blood supply from the lingual and facial
branch of the external carotid artery.
Nerve supply
- parasympathetic innervation is derived primarily
from the facial nerve reaching the gland through
the lingual nerve after synapsing in the subman-
dibular ganglion.
28
29. Sublingual gland
Smallest of all the major salivary glands.
Weight: 3-4 grams.
Secretes predominantly mucous saliva.
Located in sublingual space.
Lies on the lingual aspect of mandible and above the
mylohyoid muscle.
29
Sublingual salivary gland
30. Main duct: bartholin’s duct opens with or near the
submandibular duct.
Several small ducts- ducts of rivinus open independently
along sublingual fold.
30
31. Blood supply
-from the sublingual and submental arteries
which are branches of the lingual and facial artery
respectively.
Nerve supply
- parasympathetic nerve supply is derived from the
facial nerve which reaches the gland via the lingual
nerve after synapsing in submandibular ganglion.
31
32. Minor salivary glands
600-1000 minor salivary glands lie in the oral cavity and
oropharynx.
32
33. Classified according to location:
- labial or buccal
- palatine
- glossopalatine
- lingual:
a) anterior lingual (glands of blandin & nuhn)
b) posterior lingual (von ebner’s glands)
33
34. They are absent in: gingiva
anterior raphe of hard palate
anterior 2/3rd of dorsum of tongue
Labial and buccal glands
- glands of lips and cheeks
- secretions are seromucous.
34
35. Glossopalatine glands
pure mucous gland.
localized to the region of isthmus in the
glossopalatine fold.
May extend from the posterior extension of
sublingual gland to the glands of soft palate.
35
36. Palatine glands
- purely mucous.
- posteriolateral region of hard palate in the
submucosa of the soft palate and uvula.
Lingual glands
- 2 types
a) anterior lingual (glands of blandin & nuhn)
- located near the apex of tongue.
- chiefly mucous.
36
37. b) posterior lingual glands
- mucous glands are located lateral and posterior to
the vallate papillae and their ducts open into the dorsal
surface of the tongue.
- (von ebner’s glands): located between the
muscle fibers of the tongue below the vallate papillae
- wash out the trough of the papillae and ready the
taste buds for new stimulus.
37
38. Clinical importance:
For most patients, it should
technically be possible to
avoid delivering radiation to
this newly discovered location
of the salivary gland system in
the same way we try to spare
known glands.
38
Location: upper part of throat
behind the nose.
Size: 1.5 inches long.
Function: moisten the upper
part of throat.
Secretions: predominantly
mucous glands.
39. Formation of saliva
Occurs in 2 stages:
39
• Cells of the secretory end pieces and intercepted ducts
produce primary saliva.
• It is isotonic in nature containing most of the organic
components and water.
1st
stage
• Primary saliva is modified as it passes through the ducts,
mainly by reabsorption and secretion of electrolytes.
• The final saliva that reaches the oral cavity is hypotonic.
2nd
stage
40. Nervous regulation of salivary secretion
Saliva secretion is regulated by nervous mechanism
- parasympathetic fibers
stimulation of these fibers activate the acinar cells and
dilate the blood vessels of salivary glands leading to
secretion of large quantity of watery saliva with lesser
organic constituents.
40
41. - sympathetic fibers
stimulation of these fibers activate acinar cells and
cause vasoconstriction by secreting nonadrenaline
leading to secretion of less saliva which is thick and
rich in mucous.
41
42. Normal Flow of saliva
42
Flow rate
(ml/min)
Whole saliva
Resting 0.2-0.4
Stimulated 1.5-2.0
If resting flow rate is <0.1ml/min : Hyposalivation.
If stimulated flow rate is <0.7ml/min : Hyposalivation.
43. Collection of saliva
43
Saliva can be collected in different forms
Resting or unstimulated whole
saliva
Stimulated whole saliva
Glandular saliva(mainly parotid)-
with or without the stimulation
44. 44
• Mixture of secretions which enters the mouth in
the absence of exogenous stimuli.
• In salivary diagnosis, unstimulated saliva is
often preferred since stimulated contains only a
diluted concentration of biomarkers.
Unstimulated saliva
45. 45
• Secreted in response to either masticatory or
gustatory stimulations.
• Masticatory-paraffin wax, rubber bands,
unflavoured chewing gum base, cotton puff.
• Gustatory-citric acid, sour candy drops.
Stimulated saliva
46. Methods of collection of whole saliva
46
Spitting method
Suction method
Swab method
Draining method
47. Recent techniques of collection of
saliva
47
• Preservatives are added to protect the
sample integrity.
Orangene
• Uses collection tubes into which saliva is
expectorated for a predetermined
volume.
Saligene
• Collection through an absorbent foam
swab which picks up 1 ml of saliva.
• Use in diagnosis of HIV, hepatitis A and
B, mumps and rubella.
Oracol
• Utilises high quality immuno-
chromatographic strips for delivery of
immediate results.
Verofy
49. Saliva and dental caries
In addition to moderating microbial factors and
encouraging preventive dietary behaviors , a core
goal in caries prevention is promoting the natural
protective mechanisms of saliva.
The pH of the dental plaque is the key factor in the
balance between acid demineralisation of teeth and
Remineralisation of the initial dental caries.
49
50. Dental caries-
According to Shafer: microbial disease of the
calcified tissues of the teeth, characterized by
demineralization of the inorganic portion and destruction
of the organic substance of the tooth.
50
Key’s triad for contributing factors for dental caries
51. SALIVA ROLE IN CARIES CONTROL
Saliva is well known to have specific protective
effects against dental caries.
ex : Rampant caries followed by irradiation.
The principal properties of saliva that protect the
teeth against caries are:
Dilution and clearance of dietary sugars
Neutralization and buffering of acids in plaque
Supply of ions for remineralization
Antiplaque and antimicrobial factors
51
52. 1) Dilution and clearance of dietary
sugars and bacteria
The most important function of saliva is the clearance of
oral micro organisms for a healthy balance between host
defense and endogenous and exogenous microbial attack
in the mouth.
The disturbance in this balance can be due to extensive
growth of bacteria or some systemic disease or reduced
salivary secretion rate.
A high saliva stimulation rate will result in rapid clearance.
52
53. Sreebny et al noted
that sugar solutions
were cleared in two
stage pattern.
rapid clearance-
over first 6 minutes
followed by slower
clearance rates.
53
54. Bacterial Clearance
The flushing effect of this salivary flow is, by itself,
adequate to remove virtually all microorganisms
not adherent to an oral surface.
Because the flow of saliva is combined with the
swallowing reflex, the clearing effect is highly
increased due to actual elimination of substances
away from the oral cavity into the esophagus.
Bacterial clearance is also related to the
composition of saliva.
54
55. Agglutinins
• Clumping of
bacteria into
large
aggregates.
• Increased oral
clearance.
• More easily
flushed.
Mucin
• Aggregate oral
bacteria.
• Easy clearance.
sIg A
• Specific defence
factor.
• Aggregates oral
bacteria for easy
swallowing.
Components of saliva which help
in the clearance of bacteria are:
56. Conclusion:
The total salivary
concentration of sIg A is
significantly higher in the
low caries-active children
group than caries-active
children group. There is
a negative correlation
between sIg A level and
dental caries activity in 6
to 9 year-old children.
57. 2) Neutralization and buffering of
acids in plaque
Role of saliva: to restore the pH to the normal range as
quickly as possible.
The primary buffering system of saliva is formed by
bicarbonates (HCO3).
To some extent phosphate ion (HPO4) and salivary
proteins contribute to the buffering action.
The bicarbonate in saliva is able to diffuse into the dental
plaque to neutralize the acid formed from carbohydrate
by the microorganisms.
57
58. Bicarbonate buffer
system
Phosphate buffer
system
Protein buffer system
composed of :
•bicarbonate (HCO3-)
•carbonic acid (H2C03)
•dissolved carbon
dioxide gas (CO2)
contributes to the
buffer capacity from
pH 6-8.
Act as buffers when the
pH is above or below
their isoelectric point
(pH 5).
•maximum buffer
capacity is obtained at
pH 6.
Buffer below pH 5,
where neither
phosphate nor
bicarbonate
contributes much to
the buffer capacity .
•“Chief Determinant” of
pH of saliva.
Buffering effect of
proteins is least.
Phase buffering -the
bicarbonate buffer system
is also in equilibrium with
gaseous C02 in the
surrounding air
-adds an actual pH-rising
capacity to the buffer
system.
59. The buffering effect of saliva is measured by laboratory
method or a chair side Dentobuff strip system.
59
Dentobuff system
60. 3) Demineralization and re-
mineralization of tooth surfaces
The main factors governing the stability of enamel are pH and free
active concentration of CALCIUM,PHOSPHATE and FLOURIDE.
The carious process is initiated by bacterial fermentation of
carbohydrates leading to formation of acids and fall in pH.
Initially H+ will be taken up by buffers in plaque and saliva.
Inspite of that if pH continues to fall due to continuous release of
H+ the fluid medium will be depleted of OH- and PO3 4.
60
61. In summary, hydroxyapatite crystals dissolve in acid
because the surrounding solution becomes unsaturated
owing to the removal of phosphate and hydroxyl ions
from solution.
61
62. Salivary calcium and phosphate ions
act by 2 mechanisms on carious
process:
62
Solubility of
enamel
surface
• Salivary calcium and phosphate ions
suppress tooth mineral dissolution
through mass action, and if the pH is high
enough, they remineralize lost tooth
mineral.
Deposition Of
A Salivary
Aggregate
• consists of calcium phosphate-carbonate-
protein complex (salivary precipitin).
• When acid is produced by the plaque
bacteria from fermentable carbohydrate
and the pH drops, these salivary precipitin
in plaque, dissolves before the
hydroxyapatite of the tooth.
• Surrogate source of calcium and
phosphate ions.
63. Conclusion:
• Individuals who have
increased salivary inorganic
calcium, phosphate, pH,
flow rate and maintain poor
oral hygiene could be at a
higher risk for developing
periodontitis and have less
dental caries and more
number of intact teeth.
63
64. 64
ROLE OF SALIVARY FLUORIDE:
Diffuses from saliva into plaque as calcium
fluoride.
Fluorapatite layer is much more acid-resistant
than the original hydroxyapatite and is formed
more quickly than ordinarily remineralized
enamel.
Mechanism of action of fluoride
1. Increases the enamel resistance and reduces.
the enamel solubility.
2. Increases the rate of post eruptive maturation.
3. Remineralisation of incipient caries.
4. Interfere with microorganisms.
65. 4) PROTECTIVE AND
ANTIMICROBIAL
PROPERTY
65
1.Mucous glycoproteins
Produced by minor salivary glands.
Serous glycoproteins.
They help in super saturation of the calcium and phosphate
reduces dissolution and promotes remineralization of the tooth
enamel.
Statherins and acidic proline-rich proteins in saliva inhibit
spontaneous precipitation of calcium phosphate salts.
Maintaining the physical-chemical integrity of tooth.
66. 66
2. Pellicle Formation
Thin (0.5 μm) protective diffusion barrier formed on
enamel by the salivary proteins.
Statherins and certain of the proline rich proteins bind to
the tooth surface, forming the acquired enamel pellicle.
Its functions include not only protection and lubrication,
but also Remineralisation and hydration.
It also functions as a diffusion barrier and possess
buffering ability.
67. Antimicrobial action
1. Salivary Ig A:
is the largest immunologic component of saliva.
Inhibits bacterial colonization by agglutination.
Inhibits bacterial adherence to oral tissues.
Affects enzymes essential for bacterial metabolism.
Neutralize viruses, bacterial, and enzyme toxins.
68. 2. Lactoferrin:
Causes bactericidal or bacteriostatic effects on
various microorganisms.
3. Lysozyme:
It is an enzyme that hydrolyzes the polysaccharide
of bacterial cell walls, resulting in cell lysis.
It is a positively charged enzymatic protein.
It alters aggregation and inhibits of bacterial
adherence.
69. 4. Mucin:
MG1- High molecular weight glycoprotein,
Adsorbed on tooth surface and contributes to
enamel pellicle formation and protect tooth surface
from chemical and physical attack including acid
attack.
MG2- Low molecular weight, Also adsorbed on
tooth surface but is easily displaced.
69
70. 70
5.Proline rich protein-
Binds tightly to hydroxyapatite Prevent precipitation
of Calcium phosphate Protect enamel surface and
prevents demineralization.
6.Histatins-
Bind to hydroxyapatite crystals in Supersaturated
saliva and Prevent calcium phosphate precipitation.
71. Impact of saliva on restorative
dentistry
Amalgam – Delayed expansion in amalgam alloys.
GIC –contamination – Dissolution of matrix.
Composite – Bond failure.
Re-etching – if contaminated.
Impressions – Disinfection protocol to prevent cross
infection.
71
72. conclusion
Saliva has an important role in patents quality of life.
Dental professionals need to be aware of problems that
arise when there is over production or underproduction
of saliva.
It is advantageous for dental professionals to check the
salivary flow rate on regular basis.
72
73. Saliva contains many important substances and also
acts as a transporter of many important ions, such as
calcium, phosphate and fluoride.
Saliva helps to maintain a constant reservoir of ions that
help to neutralize the pH and prevent demineralization.
73
74. References
1. Orban’s oral histology and embryology. 13th edition.
2. Dentistry for child and adolescent-MC Donald and Avery-
9th edition.
3. Essential of medical physiology – Sembulingam 6th edition.
4. Shafer’s Textbook of oral pathology, 8th edition.
5. Chaurasia B D. In Human anatomy vol 3.4th edition.
6. Priya Y, pratibha M. methods of collecting saliva- A review. Int.
Dent oral health 2017;3(3):149-53.
74
75. 7. ghoms SA. Textbook of oral medicine. 3rd edition.
8. Soesilawati P, Notopuro H, Yuliati Y, Ariani MD, Alwino Bayu
Firdausi M. The role of salivary sIg A as protection for dental caries
activity in Indonesian children. Clin Cosmet Investig Dent.
2019;11:291-295.
9. A potential new organ at risk for radiotherapy. Radiotherapy and
oncology : journal of the European Society for Therapeutic Radiology
and Oncology, 154, 292–298.
75
Lysozymes hydrolyses the polycaccharide of bacterial cell wall resulting in cell lysis
Salivary immunoglobulins act primarily through their ability to inhibit the adherence of microorganisms to oral tissues
Lactoferrin an iron binding protein enhances the inhibitory action of antibody on microorganisms