Salivary Gland Disease

Location of major salivary glands

 

Salivary gland disease

Saliva is essential for speech and swallowing and plays an important role in oral health by maintaining the integrity of the oral mucosa. It also has a role in controlling dental decay and periodontal disease through its antibacterial and acid buffering properties.

Causes of salivary gland disease
Most salivary gland problems are due to infections, obstruction from stones/mucous plugs, benign and malignant tumours and autoimmune diseases.

Infections – mumps is the most common cause of viral salivary gland infection. Bacterial infection of the major glands usually arises from the mouth and is often a recurrent problem, especially in a gland previously damaged by stones or radiotherapy or in debilitated patients.

Obstructions – calculi or stones can form in the major salivary glands (most commonly in the submandibular glands) and their ducts. They cause obstruction of salivary outflow causing pain and swelling, typically at meal times. If the obstruction is not relieved the gland can be damaged and may require surgical removal. Calculi can be removed surgically or endoscopically. Obstruction of the smaller minor salivary glands also occurs and results in cyst like swellings of the lips and cheeks (mucocoeles).

Tumours – a large variety of both benign and malignant tumours can involve any of the major or minor salivary glands. Although the vast majority are benign, they grow continuously and can reach a large size. Malignant tumours of the salivary glands are rare. The management of salivary gland tumours requires specialised surgical skills due to the proximity of important structures, especially the nerve that moves the muscles of the face. Patients with malignant disease should be managed via a multidisciplinary head and neck oncology clinic.

Degenerative disease – the salivary and lacrimal glands can be affected by an auto-immune, destructive condition called Sjögren’s syndrome which results in dry eyes and a dry mouth. Sjögren’s syndrome is often associated with other systemic diseases such as rheumatoid arthritis and lupus erythematosus. Patients develop severe oral and eye symptoms relating to failure of saliva and tear production.

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