Salivary glands secrete saliva that in normal conditions is secreted in amounts that keep the mucous membranes of the mouth and the pharynx moist and cleanse the mouth and the teeth. But when food enters the mouth, the amount of saliva secretion increases which serves the function of lubricating, dissolving and beginning the chemical breakdown of food. There are many minor salivary glands but most of the saliva is secreted by major salivary glands that include the parotid, submandibular and sublingual glands. Recently, a new pair of salivary glands have been discovered which are hidden between the nasal cavity and throat. The proposed name is tubarial glands.

Saliva is composed chemically of water (99.5%) and solutes (0.5%).  The solutes are ions that include sodium, potassium, chloride, bicarbonate, and phosphate. The other constituents are some dissolved gases and various organic substances that include urea and uric acid, mucus, immunoglobulin A, lysozyme (the bacteriolytic enzyme), and salivary amylase, the digestive enzyme that acts on starch. Different salivary glands supply different things. Parotid gland secretes a more watery, serous fluid that contain salivary amylase, the submandibular glands secrete mucus along with amylase while sublingual glands secrete a thick with more mucus and less salivary amylase. The water in saliva serves the function of a solvent where foods get dissolved. Amylase present in saliva starts the breakdown of starch to maltose, maltotriose and α-dextrin. Bicarbonate ions present in saliva act as buffer for acidic foods that enter the mouth. Saliva, like sweat, helps in removing waste molecules from the body, the mucus helps to lubricate food so that it can be moved easily, formed into a ball and swallowed easily. Immunoglobulin A prevents the attachment of microbes and lysozyme kills bacteria. 

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Frequently asked questions about Salivary Gland

What are the symptoms of diseases of salivary glands?

The symptoms of salivary gland diseases depend on the disease developed. Salivary gland stones cause painful lump in the affected gland. Eating may aggravate pain. Sialadenitis causes painless lump in the neck, a bad smelling discharge of pus from the duct into the mouth, and in severe cases it can cause fever, chills and general weakness. Viral infections can cause fever, headache, muscle and joint pain, malaise and poor appetite. Cysts are usually painless but sometimes they grow to an extent that they interfere with eating. Tumors both cancerous and non-cancerous grow slowly and can sometimes be painful. Sjögren's syndrome cause dry eyes, dry mouth and swelling of the salivary glands. Mumps is a viral infection that cause swelling of the parotid glands. It usually affects children and is now very much controlled by vaccine.

What are the different types of salivary gland tumors?

The different types of salivary gland tumors are:

  • Mucoepidermoid carcinoma
  • Adenoid cystic carcinoma
  • Acinic cell carcinoma
  • Polymorphous adenocarcinoma
  • Adenosquamous carcinoma
  • Basal cell adenocarcinoma
  • Carcinoma ex pleomorphic adenoma
  • Carcinosarcoma
  • Clear cell carcinoma
  • Cystadenocarcinoma
  • Epithelial-myoepithelial carcinoma
  • Lymphoepithelial carcinoma
  • Lymphomas
  • Myoepithelial carcinoma
  • Oncocytic carcinoma
  • Poorly differentiated carcinoma
  • Salivary duct carcinoma
  • Sebaceous adenocarcinoma
  • Secretory carcinoma
  • Squamous cell carcinoma
What are the common diseases that affect the salivary glands?

Some of the common salivary gland disorders are:

  • Salivary gland stones
  • Cysts
  • Sialadenitis
  • Viral infections
  • Mumps
  • Sjögren's syndrome
  • Tumors 
How are salivary gland diseases diagnosed?

Depending on the symptoms, the doctor prescribes various tests. MRI, CT scans and sometimes biopsies are done to confirm the suspected diagnosis.

Are salivary glands removed for any reason?

If a stone forms in the salivary gland, then its surgical removal might be the option. Salivary glands are removed in that case. 

Do stones form in salivary glands?

Stones do form in salivary glands. These are also known as salivary duct stones and are calcified structures that form inside the gland or duct. They can block the flow of saliva into the mouth. Majority of stones affect the submandibular glands located at the floor of the mouth. Rarely, stones are formed in the parotid glands, located on the inside of the cheeks or the sublingual glands which are under the tongue.

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Salivary glands serve very important function for digestion and swallowing of food while preventing entry of microbes to a certain extent. If salivation is affected, dry mouth may ensue known as xerostomia. Many diseases can affect the salivary glands, necessitating treatment and sometimes even surgical removal. The diseases can fall into 2 broad categories: 

  • Congenital that is present since birth
  • Acquired 

Congenital conditions are rare but may include:

  • Aplasia
  • Atresia
  • Ectopic salivary gland issue
  • Stafne defect

Acquired conditions may be due to many reasons. Some of these are:

  • Dysfunction due to any reason
  • Vascular
  • Infective which commonly includes mumps and HIV associated salivary gland disease
  • Traumatic which include mucocele, ranula, and nicotinic stomatitis
  • Autoimmune diseases like Sjögren's syndrome and Graft-versus-host-disease
  • Inflammatory like post-radiation sialadenitis, sarcoidosis, Cheilitis glandularis, chronic sclerosing sialadenitis
  • Neurological like Frey’s syndrome
  • Neoplastic which includes salivary gland neoplasm
  • Diverticulum like a salivary dicerticulum
  • Unknown etiology like sialolithiasis (salivary stones) and sialadenosis (non-neoplastic recurrent swelling of salivary glands)
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