M.

Prabavathi
III-BDS
Parotid Gland Functions
The main function of the parotid
gland is to produce and transport
saliva to the mouth.
The gland has a tube connected
to it called “the duct”. The parotid duct is
also called the Stensen’s Duct.
Out of the saliva produced a day, 20-25% comes
from the parotid gland.
The major part of the salivary amylase is produced
by the parotid gland.
The saliva produced by the parotid gland is purely
serous.
SALIVA
It is a secretion of salivary glands, which helps in
lubrication, digestion, and keeps the oral cavity moist.
It comprises
#99.5% of water plus electrolytes,
#Mucus,
#White blood cells,
#Epithelial cells,
#Enzymes like amylae and lipase,
#Antimicrobial agents like secretory IgA and
lysozyme.
Functions Of Saliva
Saliva keeps the mouth and other parts of
digestive system moist.
It cleanses the teeth by clearing the food
from oral cavity and oral mucosa.
Saliva helps in mastication and begin the
digestion of starches.
It also helps to break down the
carbohydrates with salivary amylase.
Functions Of Saliva
Saliva helps in lubrication of the passage
of food down from the oro-pharynx to the esophagus
to the stomache.
Saliva also has the lubricating property
which protect the alimentary canal during meals.
It acts as an ion reservoir which helps in
teeth remineralisation.
It act as a buffer by neutralising the plaque
pH after eating.
Functions Of Saliva
A protective layer of
salivary protein that forms over
enamel acts as a diffusion
barrier.
Saliva has antimicrobial
action which protects the enamel
thus preventing dental caries.
It facilitates taste by interaction of food stuff
with taste buds.
Classification of Salivary Gland
Diseases
 DEVELOPMENTAL DISORDER
Aplasia
Abberancy
Atresia
Hypoplasia
Diverticuli
Congenital Fistula
 FUNCTIONAL DISORDERS
Xerostomia
Sialorrhea
• OBSTRUCTIVE DISORDERS
Sialolithiasis
Mucus Plug
Stricture and Stenosis
Extra ductal cause
• CYSTS
Mucocele
Ranula
 ASYMPTOMATIC ENLARGEMENT
Sialosis
Allergic
 SIALADENITIS DUE TO INFECTION
Viral Infection
Bacterial Infection
 AUTOIMMUNE DISORDERS
Sjogren’s Syndrome
Mikulicz’s Syndrome
 NEOPLASMS
Benign but seldom recurrent
Benign but often recurrent
Malignant
 NEOPLASMS
Benign but seldom recurrent
Warthin’s Tumour
Monomorphic Salivary Adenomas
Benign but often recurrent
Pleomorphic Adenoma
Acinic cell tumor
Malignant
Adenoid cystic carcinoma
Acinic Tumor
Squamous carcinoma
 DEVELOPMENTAL DISORDERS
SALIVARY GLAND APLASIA
Also termed salivary gland agenesis, is the
congenital absence of salivary gland.
Usually the term relates to the absence of
some or all of the major salivary gland.
It is a rare condition seen in association
with ectodermal dysplasia, mandibulofacial dysostosis,
hemifacial microsomia.
The main signicance of the condition is
xerostomia, with accompanying susceptibility to
caries.
ABERRANCY
This is a condition in which normal secreting
salivary gland tissue develops at an abnormal position
( ECTOPIC).
It has no clinical or pathological significance
apart from the fact that the aberrant tissue may be the
site of development of cyst or neoplasm.
ATRESIA
Salivary gland atresia is a congenital blockage
or absence of the orifice of major salivary gland duct or
part of the duct itself.
Submandibular gland is usually involved,
having failed to cannulate during embryological
development.
HYPOPLASIA
Hypoplasia is a relative under development
of salivary glands.
It may result from lack of neuromuscular
stimulation.
It may be associated with Melkersson-
Rosenthal syndrome and hereditary ectodermal
dysplasia.
This also leads to xerostomia.
DIVERTICULUM
It is a small pouch or out-pocketing of the
duct system of major salivary glands.
This may lead to pooling of saliva and
recurrent sialadenitis, especially parotitis.
Diverticulum may lead to sialolith
formation.
CONGENITAL FISTULA
An abnormal passage between
a salivary duct or gland and the
cutaneous surface or into the oral cavity
through other than a normal pathway.
Parotid gland is most involved.
The fistula can communicate
with the mouth, paranasal sinus or facial skin.
The cause may be trauma, complication of
surgery, congenital or if the duct obstructed with
calculus.
 FUNCTIONAL DISORDERS
XEROSTOMIA
When a person’s salivary gland do not work
properly and stop to produce saliva or produce too little
saliva, a person will develop dry mouth – called
xerostomia.

CAUSES:
Dehydration
Radiation treatment
Salivary gland removal
Smoking and using Tobacco
Mouth breathing etc.

TREATMENT:
Artificial saliva and saliva producing medications
SIALORRHEA
Sialorrhea or hypersalivation or ptyalism is a
condition were excess amount of saliva is produced.
The excess amount of saliva in mouth may be
due to reduced clearance.

CAUSES:
Excessive starch intake
GERD
Pancreatitis
Liver Disease
Oral ulcers and infections.

TREATMENT:
Diet changes
Oral motor exercises
Intra oral devices like palatal training devices
Botulinum toxin injections
 OBSTRUCTIVE DISORDERS
SIALOLITHIASIS
Sialothiasis is a condition where a calcified
mass or sialolith forms within a salivary gland, usually in
the duct of submandibular salivary gland(Wharton’s
Duct).
CAUSES:
Dehydration may cause thickening of
saliva and decreased water content which
cause Calcium and phosphate to form stones.
TREATMENT:
Small stones can be pushed out from the duct by taking
plenty of water.
Large stones often needs surgery.
MUCUS PLUG
When the salivary output is reduced from the
parotid gland, saliva stagnates and forms an mucus
plug behind the stricture, when the secretion is
stimulated the mucus plug blocks the pathway,
resulting in swelling and pain.
TREATMENT:
Salivary stimulating medications for small plugs
and surgery is recommended for larger plugs.
STRICTURE AND STENOSIS
Stricture in the salivary gland is narrowing
of the duct. When the flow is stimulated, the duct may
be too narrow to allow passing, causing saliva build up
leading to swelling of the gland.
CAUSES:
Chronic inflammation of the
duct system may cause narrow duct
due to fibrosis.
TREATMENT:
Endoscopic dilatation or surgery.
EXTRA DUCTAL CAUSE
Sometimes obstruction in the duct may
cause swelling, pain and infection to the gland.
EXAMPLE:
If there is a parotid gland obstruction, it may
lead to additional symptoms like fever.
TREATMENT:
Additional antibiotics given in case of
infections.
 CYSTS
MUCOCELE
A mucocele is a benign, mucus containing cystic
lesion of the minor salivary gland.
CAUSES:
Ruptured salivary gland duct
caused by local trauma.
In case of mucus extravasation
phenomenon.
TREATMENT:
It goes on its own most of the times
if not, Surgical removal of the gland and
marsupialization(technique to help new
duct formation)is done.
RANULA
A ranula is a mucus extravasation cyst involving
sublingual gland and is a type of mucocele found on the
floor of the mouth.
CAUSES:
Injury to the duct
Trauma to the floor of the mouth.
TREATMENT:
Incision and drainage
Ranula excision
Marsupialization
Gland removal with ranula.
 ASYMPTOMATIC ENLARGEMENT
SIALOSIS
Sialosis refers to diffuse, non inflammatory, non
neoplastic recurrent enlargement of the major salivary
glands.
CAUSES:
Diabetes Mellitus
Alcoholism
Malnutrition
Hormonal insufficiency
Radiation therapy.
TREATMENT:
Sialosis cures if the causative agents are removed.
SIALECTASIS:
It is an aseptic dilatation of salivary ductules causing
grape like (cluster like) dilatations.
ALLERGIC
Salivary gland swelling may be elicited by some
individuals who are allergic to certain drugs. Parotid
gland swelling is often reported due to allergy.
TREATMENT:
Swelling is reduced after oral dose of anti
histamin.
SIALADENITIS
Sialadenitis is the infection of salivary gland
usually caused by bacteria or virus.
 SIALADENITIS DUE TO INFECTION
VIRAL SIALADENITIS
MUMPS:
Mumps is a contagious viral disease
caused by mumps virus primarily affecting the
parotid gland.
It causes fever, musle pain, headache, followed by parotid
swelling.
The infection can be prevented by Mumps vaccine.
The disease may spread through saliva, respiratory
secretions etc.
HIV:
HIV infected people may suffer parotid gland enlargement,
usually secondary to the development of benign
lymphoepithelial cysts(BLEC).
BACTERIAL SIALADENITIS
#NEONATAL SUPPURATIVE PAROTITIS – Due
to S.aureus , Pseudomonas aeruginosa etc.
#SUPPURATIVE PAROTITIS IN CHILDREN
AND ADULT – S.aureus and mixed aerobes & anaerobes.
#OBSTRUCTIVE SIALADENITIS – S.aureus.
 AUTOIMMUNE DISORDERS
SJOGREN’S SYNDROME
Sjogren’s syndrome is an autoimmune disease
characterised by progressive lymphocytic and
plasmacytic infiltration, mainly of salivary glands and
lacrimal gland.
TREAMENT:
Taking plenty of water
Medications
Surgical procedures.
MIKULICZ SYNDROME
Mikulicz syndrome is a chronic condition
characterized by the abnormal enlargement of glands
in the head and neck, including parotid gland.