1. Disorders of the salivary glands
DNT 243
Disorders of the salivary glands
Dr. Shahzadi Tayyaba Hashmi

2. Disorders of the salivary glands
Saliva is produced by three paired major salivary glands, the parotid, submandibular and sublingual glands, and numerous minor salivary glands which are present throughout the oral mucosa
Any of these salivary glands may be affected by disease
The most important disorders of salivary glands are
Mucocele
Mucous retention cysts
Mucous extravasation cysts
Sialoadenitis
Sjogren’s syndrome
Salivary glands neoplasms

3. 1) Mucocele Clinical features:
Mucocele is a clinical term given to a cystic swelling usually caused by trauma affecting the minor salivary glands
Clinical features:
Commonly occurs on the lower lip
and cheeks of young individuals
They appear as sessile ( broad-based) blue swellings
Patient often give a history of a rapid increase in size following trauma

4. Histological types of mucocele
Two histological types are recognized,
Mucous retention cysts
Mucous extravasation cysts

5. A) Mucous extravasation cysts
Most Common type
Occurs as a result of trauma to the minor salivary gland duct
Trauma causes the duct to rupture and saliva spills into the tissue rather than the oral cavity
Healing cannot takes place

6. B) Mucous retention cysts
Relatively rare as compared to mucous extravasation cysts
Caused by trauma but the duct becomes blocked usually by scar tissue
Saliva is unable to enter the oral cavity
Duct swells up like a balloon filled with water
Treatment:
The treatment of
both lesions is
excision including the
underlying
minor salivary glands

7. 2) SIALOADENITIS Etiology: Clinical features:
Inflammation affecting the salivary glands is known as Sialoadenitis
Etiology:
Infections ( mumps)
Ductal obstruction
( A salivary stone or calculus is a common cause of obstruction and submandibular gland is most often affected)
Clinical features:
Patient complains of pain and swelling of the submandibular gland particularly just before or at meal times because the increased outflow of saliva is blocked

8. 2) SIALOADENITIS Treatment:
Stone is removed if it is accessible but sometimes it is necessary to remove the gland as well

9. 3) SJOGREN'S SYNDROME Etiology: Autoimmune disease
Affect salivary glands, lacrimal glands and many other organs in the body
Etiology:
Unknown
Patients have circulating auto antibodies in their blood and their salivary glands are destroyed by numerous lymphocytes which infiltrate into the glands
This caused lack of saliva and dry mouth ( xerostomia)

10. Types of Sjogren's syndrome
Primary Sjogren's syndrome, in which patients have dry eyes and a dry mouth ( xerostomia)
Secondary Sjogren's syndrome, in which patients have another autoimmune disorder such as rheumatoid arthritis, in addition to dry eyes and dry mouth
Treatment:
Artificial saliva
Pilocarpine to enhance
salivary secretion

11. 4)Salivary glands neoplasms
May be benign or malignant
Majority of salivary gland neoplasms are benign and the most common type is Pleomorphic adenoma
Malignant neoplasms are rare but mucoepidermoid carcinomas and adenoid cystic carcinomas are most common

12. Difference between benign and malignant neoplasms of salivary glands
Benign tumours
Malignant tumours
Slow growth of lesions
Rapid growth of lesions
Well-defined margins, which are easy to feel
Indistinct margins and difficult to feel
If they arise from minor salivary glands in the oral cavity, they do not ulcerate the oral mucosa
If they arise from minor salivary glands in the oral cavity, they often ulcerate through the oral mucosa
Painless
Painful