A review of saliva: Normal composition, flow, and function

An adequate provide of saliva is critical to the preservation and maintenance of oral tissue. Clinicians frequently do not respect the many benefits of saliva until quantities are decreased. a lot is written on the subject of salivary hypofunction, but small care is paid to normal salivary flow and officiate. This article is a brief, up-to-date overview of the literature on the basics of normal salivary composition, flow, and routine. A review of the literature was conducted using MEDLINE and Healthstar ( 1944 through 1999 ) ; articles were selected for inclusion on the basis of relevance and significance to the clinician. ( J Prosthet Dent 2001 ; 85:162-9. ) Saliva is a most valuable oral fluid that much is taken for granted. It is critical to the preservation and care of oral health, yet it receives fiddling attention until measure or quality is diminished. There has been much holocene research on the subject of salivary dysfunction as it relates to disease or as a side effect of certain medications. Saliva besides has become utilitarian as a noninvasive systemic sample distribution measure for medical diagnosis and research. consequently, it is necessary for clinicians to have a good cognition floor concerning the norm of salivary stream and serve. This article reviews the biomedical literature on convention salivary composition, flow, and function. A search of the literature was conducted by using the MEDLINE and Healthstar search engines ( years 1944 through 1999 ). Articles from the primary, junior-grade, and tertiary literature were selected for inclusion body on the basis of relevance and meaning to the clinician. Understanding the source of saliva angstrom well as the anatomy and localization of salivary glands can impact the management of decrease run in relationship to localized disease, systemic disease, radiation therapy, and/or salivary duct stones ( sialoliths ). The types of cells found in the salivary glands are acinar cells, versatile duct system cells, and myoepithelial cells. Acinar cells, in which saliva is foremost secreted, determine the type of secretion produced from the different glands. secretion can be classified as serous, mucous, or interracial ; serous secretions are produced chiefly from the parotid gland, mucous secretions from the minor glands, and shuffle serous and mucous secretions from the sublingual and submandibular glands.Duct system cells found in the salivary ducts are classified as intercalate, striated, and excretory. Intercalated duct cells are the first duct network connecting acinar secretions to the rest of the gland. These cells are not involved in the modification of electrolytes, as are the remaining duct cells. Striated cells are second in the network, functioning as electrolyte regulation in resorbing sodium. The concluding duct cells, the excretory duct cells, put up by continuing sodium resorption and secreting potassium. Excretory duct cells are the survive contribution of the duct network before saliva reaches the oral cavity. Myoepithelial cells, which are long cell processes wrapped around acinar cells, shrink on stimulation to constrict the acinar. This routine, secreting or “ squeezing out ” accumulating fluid, is the solution of a strictly neural process.

The average day by day flow of hale saliva varies in health between 1 and 1.5 L. Percentage contributions of the different salivary glands during unstimulated flow are as follows : 20 % from parotid, 65 % from submandibular, 7 % to 8 % from sublingual, and less than 10 % from numerous minor glands. Stimulated high flow rates drastically change percentage contributions from each gland, with the parotid contributing more than 50 % of total salivary secretions. Saliva is a clear, slenderly acidic mucoserous exocrine secretion. wholly saliva is a complex blend of fluids from major and minor salivary glands and from gingival crevicular fluid, which contains oral bacteria and food debris.The major salivary glands include the opposite parotid glands, which are located opposite the upper jaw first molars, and the submandibular and sublingual glands, which are found in the floor of the mouth. Minor glands that produce saliva are found in the lower brim, tongue, palate, buttock, and pharynx.The terms major and minor refer to the anatomic size of the glands. paradoxically, it could be argued that the minor salivary glands are the most important because of their protective components.Major glands do produce more saliva than minor glands, but the quality of content and frankincense the type of protection varies. The normal ph of saliva is 6 to 7, meaning that it is slightly acidic. The ph in salivary flow can range from 5.3 ( first gear run ) to 7.8 ( peak flow ). major salivary glands contribute most of the secretion bulk and electrolyte subject to saliva, whereas minor salivary glands put up little secretion bulk and most of the blood-group substances. Saliva is a very load fluid, composed of more than 99 % water. Saliva is not considered an ultrafiltrate of plasma.Initially, saliva is isotonic, as it is formed in the acinus, but it becomes hypotonic as it travels through the duct net. The hypotonia of unstimulated saliva allows the taste bud to perceive unlike tastes without being masked by normal plasma sodium levels. Hypotonicity, specially during low flow periods, besides allows for expansion and hydration of mucin glycoproteins, which protectively blanket tissues of the mouth.Lower levels of glucose, bicarbonate, and urea in unstimulated saliva augment the hypotonic environment to enhance taste. The components listed above by and large occur in humble amounts, varying with changes in flow, so far they continually provide an align of important functions. It is authoritative to stress that saliva, as a singular biological fluid, must be considered as a whole that is greater than the union of its parts.Salivary components, particularly proteins, are multifunctional ( performing more than 1 serve ), excess ( performing similar functions but to different extents ), and amphifunctional ( acting both for and against the master of ceremonies ) .Recent inquiry into the complex roles of salivary proteins and mucins support this hypothesis ; this research is discussed under “ Function. ” Saliva is composed of a variety show of electrolytes, including sodium, potassium, calcium, magnesium, bicarbonate, and phosphates. besides found in saliva are immunoglobulins, proteins, enzymes, mucins, and nitrogenous products, such as urea and ammonia. These components interact in related function in the follow general areas : ( 1 ) bicarbonates, phosphates, and urea act to modulate ph and the cushion capacity of saliva ; ( 2 ) macromolecule proteins and mucins serve to cleanse, aggregate, and/or bind oral microorganisms and contribute to dental brass metabolism ; ( 3 ) calcium, phosphate, and proteins influence in concert as an antisolubility factor and modulate demineralization and remineralization ; and ( 4 ) immunoglobulins, proteins, and enzymes provide antibacterial action. A working cognition of convention salivary flow is necessity for the clinician discourse affected role dwelling manage instructions. Low menstruate during sleep mandates the want to carefully cleanse the mouth before going to go to bed and after breakfast. The function of sugarless chewing glue or candy containing xylitol or sorbitol can be recommended as a mean of stimulating supernumerary salivary flow to aid caries management and lubrication.Acidic and sweetness taste stimuli are good choices as triggers for hope extra flow. Patients with decrease salivary menstruate besides should be made aware of the necessity to comply with suggest oral hygiene regimens after exposure to acid-producing food sources. Recommendations for professional and home fluoride treatments should be considered cautiously for patients with salivary dysfunction, specially those with senior high school caries rates and expose root surfaces. The successful consumption of removable prostheses by a affected role besides may be affected dramatically by decrease salivary hang. Hypofunction of provoke salivary run is not a normal age-related change. Although decrease concentrations of salivary mucins have been found with age in resting and induce whole human saliva, inquiry points to no significant age-related changes in the secretory responsiveness of salivary mucous cells.Many times, reduced flow in older patients is linked to side effects of prescription medications.Nutritional changes and deficiencies can influence salivary function as well. A modest decrease in daily food consumption may result in increase salivary protein, whereas hard thermal restrictions tend to reduce salivary hang, cell numbers, and salivary composing. salivary dysfunction is not discussed at duration in this article, but reference to it must be made to understand the subject of normal flow and function. dysfunction, more normally called hypofunction, is unmanageable to assess, namely because of the being of a wide range of variations accepted as normal. The diagnosis or judgment of salivary dysfunction is relatively subjective unless an individual base read of salivary menstruate has been established. About 30 % of the population reports some degree of dry sass, which indicates that it is not an infrequent charge or patient refer. Insufficient salivary flow results in 2 general, oral-related effects : ( 1 ) reduced preparation of food for digestion and taste, and ( 2 ) an increased susceptibility of oral structures to disease.A set of 4 well collected clinical parameters has been described in late research ; these promote successful designation of patients with salivary gland hypofunction. The parameters include testify of dry lips ; buccal mucous membrane sobriety ; miss of salivation on palpation ; and a high sum score on the decay, missing, or filled teeth index ( DMFT ). When all 4 parameters are scored jointly, positive results may lead to promote diagnostic evaluation, such as salivary flow rate measurements, minor salivary gland biopsy, and/or a sialography. salivary flow does not occur evenly throughout the mouth. regional variation in intraoral flow is locate specific, with the mandibular linguistic being a site of senior high school volume and the maxillary anteriors and interproximals being sites of low book flow.These areas of higher and lower volume stream regions have been referred to as “ salivary highways and byways. ” The regional clearance rate of acidic produced from bacteria is immediately influenced by regional variations in menstruate within the mouth.Consequently, salivary byways are areas in which acidic by-products may remain in longer contact with oral structures unless mechanical means of cleansing are used.Moreover, with varying amounts of components and secretions coming from different glands, it is suggested that saliva provides different types of security in unlike locations intraorally.For example, parotid saliva contains amylase, proline-rich proteins, and agglutinins with infinitesimal amounts of cystatins, lysozymes, and extraparotid glycoproteins. As a solution, upper jaw premolars exhibit higher counts of salivary agglutinins due to the proximity of the parotid duct. sublingual saliva contributes high concentrations of both types of mucins, MG1 and MG2, american samoa well as high gear levels of lysozymes. Submandibular saliva contains the largest measure of cystitis, whereas palatine secretions offer MG1 mucins and relatively high amylase concentrations.Considering that a 0.1-mm-thick layer of saliva on a tooth is thinner than a layer of brass, it is no surprise that the job of cleansing oral structures can not be completed successfully by saliva alone. A belittled amount of saliva, on average about 0.8 mL, remains in the mouth after swallowing.This is referred to as residual volume. Dawedescribed a model for oral clearance, comparing it with an incomplete siphon. The smaller the sum of residual volume, the faster the clearance rate for the talk. The distribution of saliva and sucrose around the mouth during the use of chewing gum and the implications for site-specificity of caries and calculus deposition. Having distinguished between unstimulated and stimulated stream rates, it probably is more meaningful and easier to measure whole saliva flow volume. As stated earlier, wholly saliva refers to the complex shuffle of salivary contents that includes stimulated and unstimulated saliva, gingival crevicular fluid, nonadherent oral bacteria and food debris, and traces of introduce chemicals or medicaments. sum daily flow of wholly saliva measures, on average, between 500 mL and 1.5 L, depending on the reference book. There are casual and annual ebb and peaks in flow. circadian ( casual ) first gear flow occurs during sleep, whereas peaks occur during high foreplay periods.Circannual ( annually ) low flow occurs during the summer, whereas bill hang is during the winter.Circadian stream variations affect not merely flow but besides the concentration degree of salivary components such as salivary electrolytes and proteins. The secretion of saliva is controlled by a salivary plaza composed of nucleus in the medulla oblongata, but there are specific triggers for this secretion. Three types of triggers, or stimuli, for this production are mechanical ( the dissemble of chewing ), gustatory ( with acid the most induce trip and sweet the least induce ), and olfactory ( a surprisingly inadequate stimulation ). other factors affecting secretion include psychic factors such as trouble, sealed types of medication, and assorted local anesthetic or systemic diseases affecting the glands themselves.Salivary glands are innervated by both sympathetic and parasympathetic heart fibers. respective neurotransmitters and hormones stimulate different receptors, different salivary glands, and different responses.When sympathetic innervations dominate, the secretions contain more protein from acinar cells, whereas predominant parasympathetic nervous system innervations produce a more watery secretion.Stimulation of 1 receptor frequently enhances and complements another receptor. therefore, the separation of contributing stimuli and resulting secretory products is not absolute.It must be emphasized that there is bang-up individual variability in salivary stimulation and secretion from cell type to cell type, thereby affecting the content of saliva regionally and as a whole. On average, unstimulated flow rate is 0.3 mL/min, with the average sum for 16 hours of unstimulated flow ( during waking hours ) being 300 milliliter. salivary menstruation during sleep is closely zero. Stimulated flow rate is, at maximum, 7 mL/min.Stimulated saliva is reported to contribute angstrom much as 80 % to 90 % of the average daily salivary production. There is capital variability in individual salivary menstruation rates. The accept range of normal stream for unstimulated saliva is anything above 0.1 mL/min. For stimulate saliva, the minimum bulk for the accept average increases to 0.2 mL/min. These numbers have been projected from inquiry on general populations. Salivary flow is, however, a very individualize measurement and ideally should be recorded as a base reference book after the long time of 15.Any unstimulated run rate below 0.1 mL/min is considered hypofunction.In a 1992 discipline, the critical crop separating persons with convention gland serve from those with hypofunction was more precisely identified as unstimulated whole salivary flow rates between 0.12 and 0.16 mL/min.If individualize base rates have been established, then a 50 % decrease in flow should be considered hypofunction .

serve

16

  • Moss S

clinical implications of late advances in salivary research .,  29

  • Mandel ID

The officiate of saliva .7

  • Levine MJ

Development of artificial saliva . salivary function can be organized into 5 major categories that serve to maintain oral health and create an appropriate ecological libra : ( 1 ) lubrication and protection, ( 2 ) buffering carry through and clearance, ( 3 ) maintenance of tooth integrity, ( 4 ) antibacterial activity, and ( 5 ) sample and digestion.As stated earlier, salivary components work in concert in overlapping, multifunctioning roles, which can be simultaneously beneficial and damaging .531

  • Slomiany BL
  • Murty VL
  • Poitrowski J
  • Slomiany A

salivary mucins in oral mucosal defense .,  32

  • Tabak LA

Stucture and affair of human salivary mucins .3

  • Edgar WM

Saliva and dental health. clinical implications of saliva : report of a consensus converge .32

  • Tabak LA

Stucture and function of human salivary mucins . As a seromucous coating, saliva lubricates and protects oral tissues, acting as a barrier against irritants. These irritants include, but are not limited to, proteo-lytic and hydrolytic enzymes produced in brass, likely carcinogens from smoking and exogenous chemicals, and dehydration from mouthpiece breathing.The best lubricating components of saliva are mucins that are excreted from minor salivary glands. Mucins are building complex protein molecules that are stage predominantly in 2 molecular weight typesand formed by polypeptide chains that stick together. These mucins have the properties of humble solvability, high viscosity, high elasticity, and firm adhesiveness. Any intraoral touch between delicate tissues, between delicate tissues and teeth, or between soft tissues and prostheses benefits from the lubricating capability of saliva supplied largely by these mucins.Mastication, manner of speaking, and swallowing all are aided by the lubricate effects of mucins .31

  • Slomiany BL
  • Murty VL
  • Poitrowski J
  • Slomiany A

salivary mucins in oral mucosal defense .,  32

  • Tabak LA

Stucture and function of human salivary mucins .30

  • Iontcheva I
  • Oppenheim FG
  • Troxler RF

Human salivary mucin MG1 selectively forms heterotypic complexes with amylase, proline-rich proteins, statherin, and histatins .33

  • Levine MJ
  • Reddy MS
  • Tabak LA
  • Loomis RE
  • Bergey EJ
  • Jones PC
  • et al.

geomorphologic aspects of salivary glycoproteins .,  34

  • Scannapieco FA
  • Levine MJ

salivary mucins and dental plaque geological formation .31

  • Slomiany BL
  • Murty VL
  • Poitrowski J
  • Slomiany A

salivary mucins in oral mucosal defense .31

  • Slomiany BL
  • Murty VL
  • Poitrowski J
  • Slomiany A

salivary mucins in oral mucosal defense .9

  • Tabak LA
  • Levine MJ
  • Mandel ID
  • Ellison SA

Role of salivary mucins in the auspices of the oral pit .32

  • Tabak LA

Stucture and serve of homo salivary mucins . Mucins besides perform an antibacterial function by selectively modulating the adhesion of microorganisms to oral tissue surfaces, which contributes to the control of bacterial and fungal colonization. Secretions from the sublingual and submandibular glands contain a high-molecular-weight, highly glycosylated mucin ( MG1 ) and a low-molecular-weight, single-glycosylated peptide chain mucin ( MG2 ) .The importance of these 2 major mucins has been the focus of much inquiry in the stopping point 2 decades. MG1 adsorbs tightly to the tooth and thereby contributes to the enamel pellicle, which protects the tooth from acid challenges. MG1 forms heterotypic complexes with other salivary proteins such as amylase, proline-rich proteins, statherin, and histatins, simultaneously attracting the attachment of certain bacteria and providing a short-run food generator for bacteria.MG2 binds to enamel but is displaced easily. It promotes the collection and clearance of oral bacteria, including streptococcus mutans.In the saliva of caries-resistant patients, MG2 predominates, whereas the degree of MG1 is higher in caries-susceptible patients.An authoritative character of the multifunctional role of salivary mucins in preserving mucosal integrity is their ability to regulate intercellular calcium levels.As a part of the enamel pellicle, mucins aid initiate bacterial colonization by promoting the growth of benign commensal oral flora, forming a protective barrier and lubrication against excessive wear, providing a dissemination barrier against acid penetration, and limiting mineral issue from the tooth surface.The results of research intelligibly indicate that salivary mucins perform a diverseness of functions essential to maintaining a stable oral defense mechanism .35

  • Mandel ID

impingement of saliva on dental caries .20

  • Mandel ID

The function of saliva in maintaining oral homeostasis .27

  • Johnson DA

regulation of salivary glands and their secretions by masticatory, nutritional and hormonal factors .2,  3

  • Edgar WM

Saliva and dental health. clinical implications of saliva : report of a consensus meeting .36

  • Lagerlof F
  • Oliveby A

Caries-protective factors in saliva . Buffering action and headroom are a second function of saliva through the follow components : bicarbonate, phosphate, urea, and amphoteric proteins and enzymes. Bicarbonate is the most authoritative cushion system. It diffuses into brass and acts as a buffer by neutralizing acids. furthermore, it generates ammonia water to form amines, which besides serve as a buffer by neutralizing acids.More than 90 % of the nonbicarbonate buffer ability of saliva is attributed to low-molecular-weight, histidine-rich peptides.Urea, another buffer present in saliva, releases ammonia after being metabolized by brass and therefore increases plaque pH.The buffering natural process of saliva works more efficiently during stimulated high flow rates but is about ineffective during periods of gloomy flow with unstimulated saliva.Phosphate is likely to be important as a cushion alone during unstimulated flow .23

  • Edgar WM

Saliva and dental health. clinical implications of saliva : report of a consensus meet .,  37

  • Stephan RM

Intra-oral hydrogen ion concentrations associated with dental caries activeness .38

  • Edgar WM

The function of saliva in the control of ph changes in human alveolar consonant brass .,  39

  • Bibby BG
  • Mundorff SA
  • Zero DT
  • Almekinder KJ

oral food clearance and the ph of plaque and saliva .,  40

  • Rugg-Gunn AJ
  • Edgar WM
  • Geddes DA
  • Jenkins GN

The impression of different meal patterns upon plaque ph in human subjects .39

  • Bibby BG
  • Mundorff SA
  • Zero DT
  • Almekinder KJ

oral food clearance and the ph of plaque and saliva .29

  • Mandel ID

The function of saliva .,  35

  • Mandel ID

affect of saliva on dental caries .41

  • Steinberg LM
  • Odusola F
  • Mandel ID

Remineralizing electric potential, antiplaque and antigingivitis effects of xylitol and sorbitol sweetened chewing gums . The ph of saliva may not be as authoritative a measure for buffering action on caries as the ph of plaque, which saliva modifies.Remaining fermentable carbohydrates and the buffer capacity of saliva affect plaque ph, unless the ph of the plaque is besides gloomy for bacterial enzymes to affair. The resting ph of plaque ( that is, the ph of plaque 2 to 2.5 hours after the last consumption of exogenous carbohydrates ) is 6 to 7.The ph rises during the first 5 minutes after the consumption of most foods. The ph then falls to its lowest level, to 6.1 or lower, approximately 15 minutes after food consumption. Unless there is extra consumption of fermentable carbohydrates, the ph of brass gradually returns to its resting ph of 6 to 7.Thus, salivary buffer, clearance, and flow rate make in concert to influence intraoral pH.As stated earlier, salivary flow can be augmented by the stimulation of chewing ampere well as by the muscular activity of the lips and tongue.With stimulated extra stream, chewing products ( such as gum ) that contain no fermentable carbohydrates can aid in the modulation of brass ph. Sugar-free sweeteners such as xylitol and sorbitol should be recommended for use without reverence of promoting caries. indeed, research has shown that the practice of gum containing xylitol or sorbitol reduces plaque collection and gingival inflammation and enhances remineralization potential.Taking into report the clock time human body for changes in brass ph related to the consumption of fermentable carbohydrates, dentists should recommend that patients, specially those who are caries-prone, brush soon after the intake of cariogenic meals and snacks .3

  • Edgar WM

Saliva and alveolar consonant health. clinical implications of saliva : report of a consensus meet .37

  • Stephan RM

Intra-oral hydrogen ion concentrations associated with dental caries bodily process.

Maintaining tooth integrity is a third function of saliva, one that facilitates the demineralization and remineralization march. Demineralization occurs when acids diffuse through brass and the pellicle into the liquid phase of enamel between enamel crystals. Resulting crystalline adjournment occurs at a ph of 5 to 5.5, which is the critical ph scope for the development of caries.Dissolved minerals subsequently diffuse out of the tooth structure and into the saliva surrounding the tooth. The buffering capacity of saliva greatly influences the ph of plaque surrounding the enamel, thereby inhibiting caries progression.Plaque thickness and the number of bacteria present determine the effectiveness of salivary buffers .23

  • Edgar WM

Saliva and dental health. clinical implications of saliva : report of a consensus converge .6

  • Dowd FJ

Saliva and dental caries .,  34

  • Scannapieco FA
  • Levine MJ

salivary mucins and alveolar consonant plaque formation .42

  • Richardson CF
  • Johnsson M
  • Raj PA
  • Levine MJ
  • Nancollas GH

The influence of histatin-5 fragments on the mineralization of hydroxyapatite .43

  • Margolis HC

Enamel-plaque fluid interactions .,  44

  • Perinpanayagam HE
  • ManWuyckhuyse BS
  • Ji ZS
  • Tabak LA

Charact-erization of low-molecular-weight peptides in homo parotid saliva . Remineralization is the march of replacing lost minerals through the constituent matrix of the enamel to the crystals. Supersaturation of minerals in saliva is critical to this process. The high salivary concentrations of calcium and phosphate, which are maintained by salivary proteins, may account for the festering and remineralization of enamel.Statherin, a salivary peptide, contributes to the stabilization of calcium and phosphate salts solution, serves as a lubricant to protect the tooth from tire, and may initiate the formation of the protective pellicle by binding to hydroxyapatite.Proteins in the protective pellicle, such as statherin, histatins, cystatins, and proline-rich proteins, are excessively large to penetrate enamel pores. therefore, they remain on the open, bound to hydroxyapatite, to aid in controlling crystalline growth of the enamel by allowing the penetration of minerals into the enamel for remineralization and by limiting mineral egress.This manipulate of haste and mineral egress enhances the stability of hydroxyapatite in the out tooth structure.Low-molecular-weight protein fractions, thought to be derived from the proteolytic work of larger proteins, are likely to be in commute with alveolar consonant plaque fluid. These protein fractions help adjust and augment remineralization, microbial fastening, and plaque metamorphosis at the tooth-saliva interface .3

  • Edgar WM

Saliva and alveolar consonant health. clinical implications of saliva : composition of a consensus meeting . The presence of fluoride in saliva speeds up crystal haste, forming a fluorapatite-like coating more resistant to caries than the master tooth structure. In that sense, little amounts of demineralization have been suggested as advantageous for the tooth because enamel components of magnesium and carbonate are replaced with the stronger, more caries-resistant fluor-apatite crystals.Fluoride in salivary solution works to inhibit dissolving of apatite crystals .7

  • Levine MJ

Development of artificial saliva .3

  • Edgar WM

Saliva and dental health. clinical implications of saliva : report of a consensus meeting . The contribution of saliva to the demineralization-remineralization process points to the importance of monitor salivary stream, particularly in patients taking multiple medications or having systemic entities that decrease salivary hang. For patients with expose root surfaces or with perennial or incipient carious lesions, fluoride supplement can promote remineralization. salivary stimulants and substitutes besides should be encouraged for patients with salivary hypofunction. Researchers presently are investigating a method to genetically engineer salivary proteins and other salivary components for use in future artificial salivas.Home care for persons with decrease salivary hang becomes a time-consuming action because brass and any food corporeal doggedly cling to hard and soft tissue surfaces in relatively dry environments. even professional therapy for patients with extreme salivary dysfunction is a challenge because of tissue dehydration and subsequent miss of ease in manipulating instruments and materials under such conditions. Clinicians should resist the temptation to “ overexplore ” blank spot lesions. excessive handling of the crystalline structure may interfere with further remineralization of the sphere .6

  • Dowd FJ

Saliva and alveolar consonant caries .,  45

  • McNabb PC
  • Tomasi TB

Host department of defense mechanism at mucosal surfaces .23

  • Edgar WM

Saliva and dental health. clinical implications of saliva : report of a consensus meeting .51

  • Edgar WM

saliva : its secretion, composing and functions .,  29

  • Mandel ID

The function of saliva . A one-fourth function of saliva is its antibacterial natural process. salivary glands are exocrine glands, and, as such, secrete fluid containing immunological and nonimmunologic agents for the protection of teeth and mucosal surfaces. Immunologic contents of saliva include secretory IgA, IgG, and IgM. Nonimmunologic salivary contents are selected proteins, mucins, peptides, and enzyme. Secretory IgA, the largest immunological part of saliva, is an immunoglobulin produced by plasma cells in connection tissues and translocated through the duct cells of major and minor salivary glands. IgA, while active on mucosal surfaces, besides acts to neutralize viruses, serves as an antibody to bacterial antigens, and works to aggregate or clump bacteria, therefore inhibiting bacterial attachment to host tissues.Other immunoglobulins deliver in saliva are in first gear quantities and credibly come from gingival crevicular fluid.It seems improbable that horde complement reply could act by and large in the oral fluid.IgA itself does not activate complement, but oral fluids can be augmented by gingival crevicular fluent host complement components when gingivitis is award around existing teeth .15

  • Rudney JD

Does variability in salivary protein concentrations influence oral microbial ecology and oral health ? .46

  • Biesbrock AR
  • Reddy MS
  • Levine MJ

interaction of salivary mucin-secretory immunoglobulin A complex with mucosal pathogens .247

  • Mandel ID

Nonimmunologic aspects of caries immunity .48

  • Lassiter MO
  • Newsome AL
  • Sams LD
  • Arnold RR

word picture of lactoferrin interaction with Streptococcus mutans . Immunologic and nonimmunologic antibacterial salivary subject come from 2 different sources—namely, plasma and ductal cells—with different responses to stimulation and different capacity levels. Nonimmunologic antibacterial salivary contents such as proteins, mucins, peptides, and enzymes ( lactoferrin, lysozyme, and peroxidase ), all products of acinar gland cells, avail protect teeth against forcible, chemical, and microbial insults.MG2, the low-molecular-weight mucin, and IgA building complex bind mucosal pathogens with greater affinity than either MG2 or IgA alone.Lactoferrin, produced in intercalate ductal cells, binds ferric iron in saliva. This process makes ferric cast-iron unavailable as a food source for microbes, such as cariogenic streptococcus, that need iron to remain viable.This procedure of starving bacteria of full of life nutrients is called nutritional immunity.Lactoferrin exhibits another disinfectant consequence not related to its iron-binding ability via the sensitivity of Streptococcus mutans to lactoferrin .5,  49

  • Pollock JJ
  • Lotardo S
  • Gavai R
  • Grossbard BL

Lysozyme-protease-inorganic monovalent anion lysis of oral bacterial strains in buffers and stimulate whole saliva .6

  • Dowd FJ

Saliva and dental caries .1

  • Edgar WM

saliva : its secretion, writing and functions .,  3

  • Edgar WM

Saliva and dental health. clinical implications of saliva : report of a consensus meet .6

  • Dowd FJ

Saliva and alveolar consonant caries .31

  • Slomiany BL
  • Murty VL
  • Poitrowski J
  • Slomiany A

salivary mucins in oral mucosal defense . Lysozymes, derived from the basal cells of striate ducts in parotid glands, split bacterial cellular telephone walls, leading to the destruction and inhibition of bacterial growth.Moreover, lysozymes promote the clearance of bacteria through collection. Gingival crevicular fluid besides contributes lysozymes from plasma.Peroxidase, besides known as sialoperoxidase or lactoperoxidase, catalyzes bacterial metabolic by-products with thiocynate, which is highly toxic to bacterial systems.Secreted by acinar cells, peroxidase additionally protects mucous membrane from the impregnable oxidize effects of hydrogen peroxide produced by oral bacteria.Cystatins, a kin of cysteine-containing proteins, have a minor role in the regulation of salivary calcium. But the main carry through of cystatins may be to inhibit cysteine-proteinase involved in the pathogenesis of periodontic disease .35

  • Mandel ID

impact of saliva on alveolar consonant caries .215

  • Rudney JD

Does variability in salivary protein concentrations influence oral microbial ecology and oral health ? . last, proteins such as glycoproteins, statherins, agglutinins, histadine-rich proteins, and proline-rich proteins work to aggregate bacteria. This “ clumping ” process, as described earlier, reduces the ability of bacteria to adhere to hard or easy tissue intraoral surfaces and thereby controls bacterial, fungal, and viral colonization.As a wholly, protein content increases proportionately with increasing run rate.But salivary protein concentrations, like early salivary components, may besides be subject to circadian variations and affected by stress, ignition, infection, and hormonal changes. In summation, protein content varies among persons, exhibits different polymorphous phenotypes, and can exhibit strain-species differences in protein-microbial interactions .50

  • Cowman RA
  • Schaefer SJ
  • Fitzgerald RJ

specificity of use of human salivary proteins for growth by oral streptococcus .1

  • Edgar WM

saliva : its secretion, composition and functions .,  3

  • Edgar WM

Saliva and alveolar consonant health. clinical implications of saliva : report of a consensus meet .51

  • Carlen A
  • Borjesson AC
  • Nikdel K
  • Olsson J

constitution of pellicles formed in vivo on tooth surfaces in different parts of the teething, and in vitro on hydroxyapatite . It is a paradox that, although saliva has numerous antibacterial functions, it besides supports the selective bacterial increase of noncariogenic microflora.Glucose levels in saliva are besides first gear to explain this phenomenon.Just as the content of saliva varies in different parts of the mouthpiece, so varies the composition of pellicle formed in different parts of the mouth. This may be significant in the institution of bacteria and tooth-related disease patterns from one area of the mouth to another .7

  • Levine MJ

Development of artificial saliva .,  52

  • Tenovuo J

disinfectant function of human saliva—how important is it for oral health ? . The concept of saliva ‘s antibacterial activeness highlights the clinical value of stimulating natural saliva, specially in patients with decreased routine. Saliva substitutes are highly important for lubrication and helpful for oral headroom and tooth integrity, but they offer little that can compare with the auspices given by natural salivary components. Because salivary components are considered multifunctional ( that is, having “ built-in ” compensatory pleonastic antibacterial properties ) and amphifunctional, depending on the intraoral environment or the molecule, the development of an effective artificial saliva is a unmanageable tax .216

  • Moss S

clinical implications of late advances in salivary inquiry .,  29

  • Mandel ID

The function of saliva .553

  • Valdez IH
  • Fox PC

Interactions of the salivary and gastrointestinal systems. I. The function of saliva in digestion .1

  • Edgar WM

saliva : its secretion, typography and functions.

,  27

  • Johnson DA

regulation of salivary glands and their secretions by masticatory, nutritional and hormonal factors .,  54

  • Hatton MN
  • Loomis RE
  • Levine MJ
  • Tabak LA

Masticatory lubrication. The function of carbohydrate in the lubricating property of a salivary glycoprotein-albumin complex . A one-fifth and final routine of saliva is to enhance taste and begin the digestive summons. The hypotonicity of saliva enhances the tasting capacity of piquant foods and nutrient sources. This enhanced tasting capability depends on the presence of protein and gustin, which bind zinc.Saliva has an early, limited character in full digestion by beginning the dislocation of starch with amylase, a major component of parotid saliva that initially dissolves sugar.The contribution of saliva to starch dislocation is limited because most of the digestion of starch results from pancreatic amylase, not salivary amylase.Salivary enzymes besides initiate fatness digestion.More importantly, saliva serves to lubricate the food bolus, which aids in swallowing.When one considers the contribution of saliva to taste and early digestion, it becomes clear that artificial supplements would be difficult to develop .

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Category : Health

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