Diagnosing salivary stones

Article Abstract:

The clinical signs associated with salivary stones (stones formed within the salivary gland) are reviewed and a case report is presented to illustrate diagnostic issues. The patient in the report had pain and swelling on the right side of his face, with particularly severe pain at mealtimes. Examination showed that one of the salivary glands on the right side was firm and enlarged, with little saliva production. A small, very hard mass was felt in the duct leading from the gland; attempts to manipulate the mass out of the duct were not successful. The mass could be seen with X-ray. It was surgically removed and the patient experienced no further pain or swelling. To diagnose sialolithiasis (salivary stones), dentists should observe the face for asymmetry, palpate the duct to find a rock-hard nodule, 'milk' it to assess the rate of salivary flow, take X-rays, and verify that the pain intensifies at mealtimes. This diagnosis should be kept separate from a diagnosis of inflammation of the salivary gland (sialoadenitis), mumps, or tumors of the gland. The symptoms associated with those conditions are reviewed. Salivary stones result from particular anatomical configurations of the duct, slow salivary rates, and certain compositions of the saliva. When diagnosed, they must always be removed, either by milking or by surgery. If an infection is present, antibiotics should be given before surgery. Patients rarely develop recurrences, but scarring occasionally promotes the formation of another stone. (Consumer Summary produced by Reliance Medical Information, Inc.)

Salivary glands

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Bulimia nervosa: its effect on salivary chemistry

Article Abstract:

Bulimia nervosa is a disorder characterized by distortion of the body image, a preoccupation with weight and food, and eating binges followed by purging (vomiting and enemas). Its effects on the composition and production of saliva were studied in 15 female patients (average age, 25). The condition leads to tooth erosion because stomach contents are very acidic; this, in turn, causes tooth sensitivity and increased cavity formation. An additional complication is the decreased salivary flow in bulimics, which leads to poorer digestion and the loss of the protective effect exerted by saliva on the oral mucosa. Dental examinations were carried out and salivary flow and composition measures completed for the bulimic subjects and for 15 age- and race-matched control subjects. In addition, subjects' olfaction (sense of smell) was evaluated. Results showed that bulimic and normal subjects had saliva of similar composition (potassium chloride, calcium, urea nitrogen and albumin). Differences between the groups in olfactory function were not found. A discussion is presented of the physiologic mechanisms that determine the concentrations of salivary components. The results suggest that the oral tissue abnormalities associated with bulimia are the result of diet and binging-purging, rather than a consequence of salivary changes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Physiological aspects, Composition, Saliva, Enamel, Dental, Dental enamel

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Diagnosing bulimia nervosa with parotid gland swelling

Article Abstract:

The cause of parotid gland enlargement can be determined from the results of a serum electrolyte study. Patients with bulimia nervosa and parotid gland swelling are usually secretive about their purging and so the diagnosis may be confirmed by conducting a clinical examination.

United States, Care and treatment, Diagnosis, Risk factors, Medical examination, Diseases, Patients, Parotid glands

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