Saliva has multiple essential functions in relation to the digestive process taking place in the upper parts of the gastrointestinal (GI) tract This paper reviews the role of human saliva and its compositional elements in relation to the GI functions of taste, mastication, bolus formation, enzymatic digestion, and swallowing The indirect function of saliva in the digestive process that includes maintenance of an intact dentition and mucosa is also reviewed Finally, pathophysiological considerations of salivary dysfunction in relation to some GI functions are considered

https://onlinelibrary.wiley.com/doi/epdf/10.1034/j.1601-0825.2002.02851.x

Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion

Sjogren syndrome (SS) is a common autoimmune disease evidenced by broad organ-specific and systemic manifestations, the most prevalent being diminished lacrimal and salivary gland function, xerostomia, keratoconjunctivitis sicca, and parotid gland enlargement. Primary SS presents alone, and secondary SS occurs in connection with autoimmune rheumatic diseases. In addition, symptoms do not always present concurrently. This diversity of symptomatic expression adds to the difficulty in initial diagnosis. Armed with the recently refined criteria for diagnosis, specialists, such as rheumatologists, primary care physicians, ophthalmologists, and dentists, who would otherwise focus only on those symptoms that encompass their areas of expertise, can get a comprehensive image of the presenting patient, leading to earlier identification and treatment of SS.

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/217138/ira30008.pdf

Clinical Manifestations and Early Diagnosis of Sjogren Syndrome

The head and neck region is composed of numerous structures, each with an inherent response to radiation that is largely governed by the presence or absence of mucosa, salivary glands, or specialized organs within that site. Irradiated mucocutaneous tissues demonstrate increased vascular permeability that leads to fibrin deposition, subsequent collagen formation, and eventual fibrosis. Irradiated salivary tissue degenerates after relatively small doses, leading to markedly diminished salivary output. This, in turn, effects the teeth by promoting dental decay which, in turn, effects the integrity of the mandible. Details of these changes are presented, including their pathophysiology, clinical syndromes, and potential treatment.

Late effects of radiation therapy in the head and neck region.

The sensitivity of the impression culture, the neat rinse culture (NRC) and the concentrated rinse culture (CRC) methods in detecting the oral carriage of yeasts, coliforms and Staphylococcus aureus was estimated in 75 individuals. The recovery of organisms from the imprint cultures of the tongue and the CRC was similar and there was highly significant positive correlation between the two techniques. The CRC was simple to perform, equally sensitive and superior in quantifying yeast, coliform and S. aureus carriage than the imprint culture technique. Hence, it is suggested that the CRC technique be preferentially employed in future investigations to obtain comparable data from different centres.

A comparison of oral rinse and imprint sampling techniques for the detection of yeast, coliform and Staphylococcus aureus carriage in the oral cavity

The subgingival occurrence of yeasts and species of Enterobacteriacae and Pseudomonas was studied in 500 adults with severe periodontitis All subjects had sites non-responding or “refractory” to conventional periodontal therapy Most subjects had received one or more courses of broad-spectrum systemic antibiotics Subgingival microbial samples were collected with paper points and transported in VMGA III The bacterial samples were plated on enriched brucella blood agar and incubated anaerobically, and on TSBV, TBC, and Sabouraud agar, which were incubated in 10% CO2 Yeasts were speciated using the API 20C micro-method system and the germ tube test (for Candida albicans) Enteric organism's and pseudomonads were speciated with the API 20E kit system Yeasts, enteric rods and pseudomonads were subjected to antibiotic susceptibility testing The occurrence of Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, and Bacteroides intermedium was also determined in the patients studied In the 500 periodontitis patients, yeasts were detected in 84 (168%), enteric rods or pseudo-monads in 51 (102%), and both yeasts and enterics or pseudomonads in 6 (12%) Candida albicans comprised 833% of the isolated yeasts Enterobacteriaceae averaged 21–39% of the cultivable flora in culture-positive cases, with Enterobacter cloacae, Enterobacter agglomerans, Proteus mirabilis, Klebsietta pneumonias, and Klebsiella oxytoca being the most frequent species Pseudomonas aeruginosa was isolated from 10 patients, averaging 234% of the cultivable subgingival flora All Candida isolates, and 86–95% of the enteric rods and pseudomonads, were resistant to 1 μg/ml of tetracycline, penicillin G, and erythromycin In patients positive for yeasts, enteric rods or pseudomonads, A actinomycetemcomitans was isolated from about one-fifth, B intermedius from about one-third, and B gingivalis from 5% of the individuals The present findings suggest that yeasts or enteric rods or pseudomonads occur in the subgingival flora of about one-third of “refractory” adult periodontitis patients We caution against using antibiotics without prior microbiological screening in treating this patient group

Yeasts, enteric rods and pseudomonads in the subgingival flora of severe adult periodontitis.

The effect of cytotoxic therapy on saliva and oral flora

The oral carriage of yeasts and coliforms in a healthy adult population and a group of patients with malignancies, undergoing cytotoxic therapy was investigated. A quantitative increase in the intra-oral carriage of Candida species and coliforms was observed during cytotoxic therapy. The most frequent yeast and the coliform isolated were Candida albicans and Escherichia coli, respectively. Thus, the oral cavity may constitute a reservoir of potentially pathogenic flora in patients on cytotoxic therapy.

J. Willox

Papers

The effect of cytotoxic therapy on saliva and oral flora

The oral carriage of yeasts and coliforms in patients on cytotoxic therapy