Sialometria: Aspectos de interesse clínico

Abstract

Whole saliva is a multiglandular secretion complex consisting of gingival fluid, desquamated epithelial cells, microorganisms, products of bacterial metabolism, food debris, leukocytes mucus from the nasal cavity and the pharynx. Saliva has many functions, including tissue repair, tamponage, protection, digestion, taste, antimicrobial action, maintaining tooth integrity and antioxidant defense system. A decrease in salivary flow (hyposalivation) is a common disorder and it is estimated that approximately 20% of the general population have this alteration. Hyposalivation may be due to diabetes mellitus, hypothyroidism, dehydration, impaired glandular parenchyma by infectious processes, granulomatous diseases or autoimmune and inflammatory conditions (such as Sjogren's syndrome and rheumatoid arthritis), radiotherapy of head and/or neck region, or it may be associated with mood disorders, adverse effects caused by the use of some medications or even be idiopathic. Conventional therapies for the treatment of reduced saliva flow with the use of chemical and gustatory secretagogues are still limited. However, new alternatives have shown great perspective in the treatment of this disorder. To diagnose a patient as having chronic hyposalivation is a challenge in clinical practice and methods of salivary flow assessment are little known by rheumatologists. The serial evaluation of salivary flow is important for the diagnosis and prognosis of certain oral and systemic conditions. This review addresses some aspects related to the role of saliva, the consequences of hyposalivation and methods of salivary flow rate measurement, useful concepts in the daily practice of rheumatology.

Oral evaluation of children and adolescents in intensive care unit

“…The importance of the saliva to the pH maintenance of the superior gastrointestinal tract is primordial. Moreover, it has defense factors like antibodies, cytokines, and growth factors that act in oral inflammatory processes, oropharynges, esophagus, and stomach [5].…”

“…We did not found any report in the literature assessing the oral condition in children hospitalized in intensive care units, to perform comparisons. Nonetheless, data from the literature show that the greater the age range, the greater the probability that oral alterations occurs in hospitalized patients [5].…”

Relationship of salivary flow of diabetic patients

“…T h e l i t e r a t u r e a l s o r e p o r t s t h a t t h e symptomatology of xerostomia and/or hyposalivation can result in psycho-social problem for patients that have thus interfere strongly in the patient's routine [4,13,17]. Concerning to symptomatology, all were marked, except for volume increase and edema of salivary glands, which reinforces the need for a dental-medical relationship…”

Recommendations from the Brazilian society of rheumatology for the diagnosis of Sjögren’s syndrome (Part I): glandular manifestations (systematic review)

“…The technique might target the whole saliva or the saliva produced by some particular salivary gland under stimulated or unstimulated conditions. Stimuli for saliva secretion collection may be gustatory (2% citric acid administered to the lateral margins of the tongue) or mechanical (chewing paraffin, silicon or unflavored chewing gum) [9]. The whole salivary flow (WSF) varies as a function of the time of year and time of day, environmental noise, relative humidity, environmental temperature and duration of fasting.…”

“…The whole salivary flow (WSF) varies as a function of the time of year and time of day, environmental noise, relative humidity, environmental temperature and duration of fasting. The best standards should be adopted in the collection methods to ensure the reliability of the results [8,9]. The unstimulated WSF (UWSF) method is the most widely used method in clinical practice.…”