Sunday, June 18, 2023

Patient complaining from pain in the floor of the mouth (beneath the lower jaw) your diagnosis is related to the salivary glands



Patient complaining from pain in the floor of the mouth (beneath the lower jaw) your diagnosis is related to the salivary glands, what’s the best x-ray to help you:

  • A) panoramic
  • B) occlusal
  • C) sialograph. *** (Specialized radiograph for the Salivary gland disorders).
Because the salivary glands consist of soft tissue, they cannot be seen on radiographs unless special steps are taken to make them visible. In a technique called sialography.

Saliva functions:

Saliva is one of the water secretions produced by salivary glands that help prepare food for chewing, swallowing, and tasting.
Saliva also moisturizes and cleanses the mouth, including the tongue and teeth. It contains substances that contribute to the prevention of infection. It contains antibacterial, fungal and viral substances.
Saliva helps digestion by moisturizing food, contains enzymes that help digest food, contributes to regulating the pH of the mouth, and helps to balance the acid that returns from the stomach through the esophagus.
The secretion of saliva is controlled by the autonomic nervous system, which controls the size and type of saliva produced by the salivary glands.
Strong stimuli to increase salivation include: the presence of food or irritants in the mouth, thinking or smelling food.

Place salivary glands:

Salivary glands are divided into two main types, the main salivary glands and the lesser salivary glands. The location and functions of these glands are as follows:

Salivary glands main:

Salivary glands are the largest and most important salivary glands, producing most saliva in humans.
The main salivary glands consist of three pairs and are as follows:

Parotid glands:

the parietal glands are the largest salivary glands, located in front of the ears.
The saliva produced in these glands is secreted in the mouth through a channel near the upper second molars.
Each gland consists of two folds, one superficial and the other deep, and passes between the facial nerve, which controls the ability to close the eyes and raise the eyebrows and smile.

- Submandibular glands:

the submandibular glands are located just below the jaw, and the size of the walnut.
As with the endocrine glands, the submandibular glands consist of two superficial and deep lobes.
Near these marginal mandibular nerve cells, which helps to smile, the tongue nerve that enables a person to feel his tongue, and the sublingual nerve that allows the movement of the tongue part that helps speech and swallowing.

- Sublingual glands:

the sublingual glands are the smallest of the major salivary glands, resembling almonds, located under the floor of the mouth and below the sides of the tongue.

Small salivary glands:

It can be said that there are hundreds of small salivary glands that spread throughout the mouth and digestive tract, and these small glands can only be seen using a microscope.
Most of these glands are located in the lining of the lips, tongue, and roof of the mouth, as well as inside the cheeks, nose, sinuses, and larynx.

Diseases of the salivary glands:

Salivary glands can be affected by many diseases, including:

- Immunotherapy:

(Sialolithiasis), a medical condition in which calcium-rich stones are formed within the salivary glands.
The exact cause of these stones is not known, but may be related to drought, which increases the thickness of saliva, low intake of food, which reduces the demand for saliva, and the use of drugs that reduce the production of saliva, such as some types of antihistamines, , And psychotropic drugs.
The stones may not cause obvious symptoms, but they may cause partial or total closure of the salivary ducts, causing pain in the gland, especially during eating.

- Salivary glands inflammation:

(Sialadenitis), inflammation of the salivary glands usually occurs due to bacteria, which is more common in older adults with salivary angiography. Inflammation of salivary glands can occur in infants during the first few weeks of life.
If the infection is left untreated, salivary glands may develop into a severe infection, especially in people with debilitating or elderly people.

- Viral Infections:

The presence of a viral infection in the body can affect the salivary glands, causing swelling of the face, pain, and difficulty eating.
Mumps is the most common example of viral infection of salivary glands.

- Cysts:

Cysts are small bags filled with fluids. Cysts in the parotid gland may affect newborns. Cysts may result from traumatic injury, infection, salivary glands, or tumors.

- Polyps:

(Benign tumors), most of the salivary gland tumors occur in the parotid gland, and appear in the form of slow growth and painless masses in the back of the jaw, and below the earlobe.
Risk factors for benign tumors include exposure to radiation and smoking.

- Malignant tumors:

(Malignant tumors), cancerous tumors of the salivary glands are rare.
Known risk factors for salivary gland cancer include: Sjogren's syndrome, radiation exposure, and a potential role for smoking.

- Schugren syndrome:

Schugren's syndrome is a chronic autoimmune disorder, in which the immune system attacks various parts of the body, including salivary glands, lacrimal glands, glands, and sometimes sweat.
This syndrome is more common in middle-aged women and is associated with rheumatoid arthritis, systemic lupus erythematosus, skin stiffness or muscle inflammation.

- Glandular gland disease:

(Sialadenosis), a medical condition that causes the expansion of the salivary glands, inflated without infection, inflammation, or tumor.

- Bacterial infection of salivary glands:

The inability to open the mouth completely, discomfort or pain when opening the mouth or eating, the appearance of pus in the mouth, dry mouth, pain in the mouth and face, fever or chills .