November 22, 2018
by Dorothy Garlough RDH, MPA
The public’s perception of saliva is low indeed. The act of spitting on someone is considered a vile act, one of disrespect, and even hate. Yet, in some cases, spitting can be done in a joking manner, as in a Canadian produced comedic program where residents of one town, upon hearing the name of their rival town, spit humorously in unison. In actuality our lowly saliva serves us royally.
Saliva is packed with proteins that carry masses of microbes that are beneficial to people by helping guard against pathogenic microorganisms. 1 At least one protein in saliva (SLPI) has anti-inflammatory, anti-viral, anti-fungal and anti-bacterial properties. 2 This alkaline ropey fluid has multifaceted functions and as it lubricates the oral mucosa, it limits oral bacterial growth and can even help to re-mineralize teeth.
Saliva plays an important role in digestion. Spittle begins the digestion process with the salivary enzyme, amylase, breaking down some starches (dextrin and maltose). 3 Saliva also helps heal wounds, aids in balancing hormones and protects our teeth. from dissolving. Interestingly, it also tells stories. Saliva can reveal if people smoke, 4 have consumed alcohol, used drugs, and can even have some diseases. 5 Malmö University’s Faculty of Odontology in Sweden has recently discovered that illnesses such as cancer leave traces of their presence in patients’ saliva. Easy and safe to obtain, saliva is also used for genetic research and clinical diagnostic application. DNA, which holds a wide spectrum of genetic data, is easily obtained with a buccal epithelial cell swabbing. 6
The lowly saliva is seemingly a magical potion.
Yet another notable function of this excretion is the regulation of the flow of water in and out of the cells. Magnesium, potassium, calcium and regular table salt dissolve into positive and negative charges adjusting the balance of water at the cellular level within our bodies. 7 Healthy adults extract about 1 to 1.5 liters a day from three major pairs of salivary glands. 4 Without the stringy substance of saliva, mouths feel like a desert, parched and dry and it can feel as if epithelial tissue will peel off the hard palate as patients try to remove their pasted tongues. Without succulent saliva, tongues become like craters, fissured and cracked and an ideal breeding ground for bacteria and yeast. 8 With the rich vascular supply of nerves to the tongue, it can become sore and a constant irritant. Cavities bloom in a spit-depleted world and even speaking or swallowing become challenging.
The numbers of people suffering from xerostomia (dry mouth) are growing as the population ages. Saliva reduces naturally with age and there is a higher incidence of disease as well. Many diseases, such as Diabetes, Alzheimer’s, Lupus, HIV/Aids, and Parkinson’s contribute to dry mouth. 3 Additionally, over 400 medications affect salivary production Anti-inflammatory, antihistamines, antidepressenats and antihypertensive medications dry up the oral cavity, leading to a multitude of problems ranging from discomfort to rampant caries.
Chemotherapy and radiation are two common medical therapies that damage or destroy salivary glandular tissue. Salivary glands do not regenerate after radiation therapy and liquid production diminishes permanently. There are a multitude of other conditions that can contribute to xerostomia as well; Bone marrow transplants; Trauma or disease to the head, neck or mouth; Stress: Mouth Breathing; Nerve damage from wounds or surgery; and Infections prior to or following surgery. 8
Dental professionals work in prevention and therapy. Educating patients on some of the contributing factors of dry mouth (smoking, alcohol, spicy foods, etc.)ii will help with prevention and aggravation. Clinicians can also encourage drinking water often and much, sucking on sugar free lozenges, sleeping with a humidifier in bedrooms and they can offer hydrating mouth rises.
Hydrating rinses are a means of keeping patients comfortable. As the demographics of the population changes, dental clinicians will need to be armed with products that help with the discomfort of xerostomia. Affected by medical therapies, medications and simply the passage of time, primary care providers will be a resource of knowledge for patients suffering with xerostomia.
Some products that have been shown to provide comfort to patients suffering with xerostomia are in the chart above.
Research is ongoing in the science of saliva. The potential links to the micro biome of saliva and its relation to health and disease is an emerging field. Techniques and medications are being researched to protect glands when medical intervention is required. Stem cell research and gene therapy is being studied to aid in the repair of salivary glands and medications are being developed to help salivary flow. Saliva screenings are being developed to distinguish between bacterial and viral infections and the ability to detect serious illness is the early stages are being explored. Saliva gland implants are innovations that may be on the horizon with the possibility of coaxing these small glands to produce the hormones needed for healing. 8
Science is improving and with new studies and research, lowly saliva is being elevated. However, it will take time to develop innovations and methodologies around this member of the royal court of body fluids. In the mean time, your patients will welcome hydrating rinses.
About the Author
Dorothy is an entrepreneur, writer, speaker and thought leader. Having contributed over 70 articles to dental magazines internationally, her message is one of continuous improvement, both in the delivery of science and team cohesion. Her programs have been described as being “edutainment”, as they are both educational and entertaining, and her business, Innovation Advancement, www.innovationadvancement.ca is the medium where she delivers her message of Creating Tomorrow Today. Dorothy can be reached at firstname.lastname@example.org.