Salivary gland disease

Salivary gland dysfunction affects the flow, amount, or quality of saliva produced. A reduced salivation is termed hyposalivation. Hyposalivation often results in a dry mouth condition called xerostomia, and this can cause tooth decay due to the loss of the protective properties of saliva. In addition, The results of a study have suggested that hyposalivation could lead to acute respiratory infection.[7] There are two potential reasons for increasing the incidence rate of this infection. First, reduced saliva secretion may impair the oral and airway mucosal surface as a physical barrier, which consequently enhances the adhesion and colonization of viruses. Second, this reduction may also impair the secretion of antimicrobial proteins and peptides.[7] Considering presence of many proteins and peptides with established antiviral properties in saliva, some of which can potentially inhibit virus replication especially coronavirus, it gives the impression that the protective effect of these salivary proteins against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be the same.[8] Therefore, hyposalivation could be a potential risk factor for acute respiratory infection. It may expose patients at high risk of getting coronavirus disease (COVID-19). However, further investigations are crucial to prove this hypothesis.[8]

Hypersalivation is the overproduction of saliva and has many causes.[9][10]

• Necrotizing sialometaplasia—a lesion that usually arises from a minor salivary gland on the palate. It is thought to be due to vascular infarction of the salivary gland lobules. It is often mistaken for oral cancer, but the lesion is not neoplastic.[2]

Infections involving the salivary glands can be viral or bacterial (or rarely fungal).

• Mumps is the most common viral sialadenitis. It usually occurs in children, and there is preauricular pain (pain felt in front of the ear), swelling of the parotid, fever, chills, and headaches.[2]
• Bacterial sialadenitis is usually caused by ascending organisms from the oral cavity. Risk factors include reduced salivary flow rate.
• Human immunodeficiency virus-associated salivary gland disease (HIV-SGD).[1]

Oral mucocele a mucous cyst

• Oral mucocele — these are common, and are caused by rupture of a salivary gland duct and mucin spillage into the surrounding tissues. Usually, they are caused by trauma. Classically, a mucocele is bluish and fluctuant, and most commonly occurs on the lower lip.[11]
• Ranula — the name used when a mucocele occurs in the floor of the mouth (underneath the tongue). Ranulas may grow to a larger size than mucoceles at other sites, and they are usually associated with the sublingual gland, although less commonly they may also arise from the submandibular gland or a minor salivary gland.[11] Uncommonly, a ranula may descend into the neck rather than the mouth (plunging ranula). If small, the ranula may be left alone, but if larger and causing symptoms, excision of the sublingual gland may be indicated.
• Nicotinic stomatitis — the hard palate is whitened by hyperkeratosis caused by the heat from tobacco use or hot liquid consumption. This irritation also causes inflammation of the duct openings of the minor salivary glands of the palate, and they become dilated. This manifests as red patches or spots on a white background.[12]

• Sjögren's syndrome
• Graft-versus-host disease

• Post-irradiation sialadenitis
• Sarcoidosis—there may be parotitis alone or uveoparotitis (inflammation of both the parotid and the uvea of the eyes), which occurs in Heerfordt's syndrome.
• Cheilitis glandularis—This is inflammation of the minor salivary glands, usually in the lower lip, eversion and swelling of the lip.[11]
• Chronic sclerosing sialadenitis is a salivary gland manifestation of IgG4-related disease.[13][14]

• Frey's syndrome

• Salivary gland neoplasm

• 
  Relative incidence of parotid tumors.[15]
• 
  Relative incidence of submandibular tumors.[15]

A salivary diverticulum (plural diverticuli) is a small pouch or out-pocketing of the duct system of a major salivary gland.[16] Such diverticuli typically cause pooling of saliva and recurrent sialadenitis,[17] especially parotitis.[18] A diverticulum may also cause a sialolith to form.[19][20] The condition can be diagnosed by sialography.[17] Affected individuals may "milk" the salivary gland to encourage flow of saliva through the duct.[17]

• Sialolithiasis - although several possibly coexisting factors have been suggested to be involved in the formation of salivary stones, including altered acidity of saliva, reduced salivary flow rate, abnormal calcium metabolism and abnormalities in the sphincter mechanism of the duct opening, the exact cause in many cases is unknown.
• Sialadenosis (sialosis) is an uncommon, non-inflammatory, non-neoplastic, recurrent swelling of the salivary glands. The cause is hypothesized to be abnormalities of neurosecretory control. It may be associated with alcoholism.[5][21][22]