Methods of treatment of salivary gland disorders
In the continuation of the article published today on Dr. Hossein Borjian's website The best dentist in Isfahan It has been compiled for you dear ones. We will study and review the methods of treating salivary gland disorders. Treatment of salivary gland disorders depends on the underlying cause, and some possible treatment options include::
- Mumps is a self-limiting disease without serious consequences in most patients and supportive treatment is appropriate.
- Acute purulent infection is treated with antibiotics and incision and drainage if an abscess develops.
- The flow of saliva should be enhanced by using warm compresses, sialagugs such as lemon drops, chewing gum or vitamin C tablets, hydration, massage of the salivary glands, and oral hygiene..
- In chronic infections, where ductal obstruction is evident, stones or strictures can be removed and the flow of saliva is enhanced.. Sometimes it may be necessary to remove the gland in cases where problems recur.
- Measles, mumps and rubella vaccine injection (MMR) It is necessary to ensure safety and prevent mumps from reappearing.
- Antibiotics can treat bacterial infections.
- Good dental care is critical to successful salivary gland treatment. Brushing and flossing At least twice a day can prevent salivary gland disorders and tooth decay.
Attention: Salivary gland diseases are rare in children (Except for acute parotitis, usually due to mumps)Therefore, any acute or chronic salivary gland problem that does not respond to conservative treatment should be referred for expert opinion.
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Treatment of salivary gland obstruction
Stones can form in the main salivary glands and their ducts, which cause obstruction of saliva flow, and are usually accompanied by pain and inflammation when eating.. They are mostly in the submandibular gland and its duct (۸۰-۹۰٪) seen, but it is likely to be seen in the parotid glands as well. Obstruction of the salivary glands is less common in the parotid gland, because its secretions are more watery and its ducts are wider.. Sublingual glands drain into 8-20 ducts, so they are rarely blocked.
Partial salivary gland obstruction also occurs, resulting in cyst-like swellings on the lips and cheeks.. The cause of salivary gland stones is unknown. Stones are composed of mucus, cell debris, calcium and magnesium phosphate. Obstruction of the parotid gland is mostly due to narrowing of the duct opening . This can sometimes be secondary to chronic trauma caused by ill-fitting dentures.
Obstruction of the salivary duct causes inflammation and swelling of the gland. If the obstruction of the salivary glands is not removed, the gland will be damaged and eventually it may need to be completely removed..
Treatment of salivary stones
Salivary stones account for half of all salivary gland disorders, accounting for 5.9 cases per 100,000 people each year.. On ultrasound, stones appear as prominent paracoccal lines or dots with distal acoustic shadows.. Ultrasound is now the first investigation and rules out other causes of inflammation such as malignancy or lymphadenopathy. Many stones pass on their own, so conservative treatment can include oral pain relievers and antibiotics where there is infection.. Good hydration, warm compresses, and massage of the glands may help pass the stone.
If you have a lump in your salivary gland, your doctor may recommend surgery to remove the lump or the gland itself. If the lump is cancerous, you may need radiation therapy to kill the cancer cells. These treatments usually don't start until your body has had time to heal. This is usually four to six weeks after surgery.
Neck radiation therapy can cause dry mouth, which can be uncomfortable and affect your digestion. Your doctor may recommend drinking more fluids and avoiding foods high in sodium. If the salivary gland lump is not cancerous, radiation therapy may not be needed. A mass that does not cause symptoms may be treated with conservative measures. This includes special mouthwashes to relieve dry mouth. You can also keep your mouth moist by rinsing with a mixture of 1/2 teaspoon of salt in 1 cup of water.
Surgical management
Proximal submandibular stones may be removed by widening or cutting Wharton's duct and transoral approach.. Stones in the submandibular duct may be removed through an incision in the floor of the mouth, while stones in the glandular substance may require removal of the gland..
CT-assisted sialendoscopy or lithotripsy is now usually used whenever possible with the aim of better preserving glandular function..
Those who have had salivary stones are more likely to experience them again. Currently, there are no evidence-based prevention methods. Maintaining good hydration helps saliva production and can reduce the risk of recurrence.
Treatment of sialadenosis
Sialadenosis is a general inflammation of the salivary glands that is caused by hypertrophy of the acinar component of the gland and is associated with a number of systemic diseases.. Treatment of sialadenosis depends on the underlying cause. The most common degenerative disease affecting the salivary glands is Sjögren's syndrome, which is an autoimmune condition.. It preferentially affects the parotid gland, but may also affect the submandibular and partial salivary glands, and usually the lacrimal glands..
Sjögren's syndrome may be associated with other systemic diseases such as rheumatoid arthritis, systemic lupus erythematosus, or primary biliary sclerosis..
Other causes of sialdenosis include::
- bulimia
- Anorexia
- Celiac disease and malnutrition
- Sarcoidosis and Hereford syndrome
- Drug-induced – eg, thiourea, anticholinergics
- Endocrine disorders such as Cushing's syndrome, diabetes mellitus and hypothyroidism
Treatment of Sjogren's syndrome
In patients with Sjogren's syndrome If the diagnosis is suspected, refer to rheumatology. Good dental care is essential to prevent tooth decay. Parasympathetic drugs, such as pilocarpine, can be used to treat decreased salivation and dry mouth. Despite the widespread use of these products for symptom relief, there is currently insufficient evidence to recommend topical stimulants, lubricants, and preservatives.. Tuberculosis is rarely done. The risk of malignant non-Hodgkin's lymphoma is increased in early Sjogren's syndrome . It may be difficult to diagnose it in the context of persistent parotid inflammation.
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Treatment of salivary gland tumors
Malignant salivary gland tumors are rare and most neoplasms are benign.
- Stabilization on the skin
- Rapid increase in the size of the inflation
- Ulcers or stiffness of the mucous membrane or skin
- Paresthesia or anesthesia of related sensory nerves
- Previous history of skin cancer, Sjogren's syndrome or radiation to the head and neck
However, all salivary inflammations require immediate referral and investigation.
Ultrasound is the first investigation, usually combined with fine-needle aspiration for cytology or core-needle biopsy where the tumor is seen.. MRI gives more information about tumor margin and staging, while CT scan and positron emission tomography-CT (PET-CT) Used to determine metastatic spread.
Tumors generally require removal and surgery. Postoperative radiotherapy may be required for malignant salivary gland tumors.
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