Saliva Protection and Transmissible Diseases
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Saliva Protection and Transmissible Diseases provides a review of saliva protection, raising debate on micro-organisms potentially transmissible in saliva, and also considering the evidence on diseases that may be transmitted by kissing. Saliva is a complex body fluid essential to health, especially mastication, swallowing and speech, and hyposalivation can lead to dysfunction and even infection. More serious pathogens, such as herpes viruses and papillomaviruses can be conveyed by kissing, as can potentially lethal micro-organisms present in some saliva, such as meningococci, fungal organisms and Ebola viruses.
- Stipulates the defensive roles of saliva, an important topic not previously reviewed in-depth in literature
- Provides awareness that saliva also transmits infectious agents that can produce serious or even lethal diseases
- Gives understanding that kissing may be an at-risk practice
Crispian Scully
Professor Scully was a Director of the WHO Collaborating Centre for Oral Health-General Health; King James IV Professor at the Royal College of Surgeons of Edinburgh and Emeritus Professor, University College London (UCL). He was a Specialist in Oral Medicine, in Special Care Dentistry and in Oral Surgery. He was a Founder member of European Association for Oral Medicine and a Founder member of the UK Academy of Medical Sciences. He has the distinction of Commander of the British Empire (CBE) and he has been awarded several University Doctorates (Athens, Granada, Helsinki, Pretoria, Santiago de Compostela). Professor Scully was an Editor of Oral Diseases, and Medicina Oral Cirugía Oral Patología Bucal Associate Editor and was on the Editorial Boards of Acta-Oto-Laryngologica and Dental Update. He founded and was Editor of Oral Oncology. Professor Scully has presented continuing education programmes throughout the world and has published over 1000 scholarly works and 45 books (34 authored and 11 edited).
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Saliva Protection and Transmissible Diseases - Crispian Scully
route.
Chapter 1
Infection Transmission by Saliva and the Paradoxical Protective Role of Saliva
Abstract
Saliva is produced by both major (parotid and submandibular and sublingual) and minor (located in the mouth) glands, with different constituents and properties between the two groups. In the mouth saliva is a colorless, odorless, tasteless, watery liquid containing 99% water and 1% organic and inorganic substances and dissolved gases, mainly oxygen and carbon dioxide. Salivary constituents can be grouped into proteins (e.g., amylase and lysozyme), organic molecules (e.g., urea, lipids, and glucose mainly), and electrolytes (e.g., sodium, calcium, chlorine, and phosphates). Cellular elements such as epithelial cells, leukocytes and various hormones, and vitamins have also been detected. The composition of saliva is modified, depending on factors such as secreted amount, circadian rhythm, duration and nature of stimuli, diet, and medication intake, among others.
Keywords
Saliva; infection; transmission; kissing; protective; agglutinins; defensins; histatins; mucins
1.1 Saliva Composition and Secretion
Saliva is produced by both major (parotid and submandibular and sublingual) and minor (located in the mouth) glands, with different constituents and properties between the two groups. In the mouth saliva is a colorless, odorless, tasteless, watery liquid containing 99% water and 1% organic and inorganic substances and dissolved gases, mainly oxygen and carbon dioxide. Salivary constituents can be grouped into proteins (e.g., amylase and lysozyme), organic molecules (e.g., urea, lipids, and glucose mainly), and electrolytes (e.g., sodium, calcium, chlorine, and phosphates).¹ Cellular elements such as epithelial cells, leucocytes and various hormones, and vitamins have also been detected. The composition of saliva is modified, depending on factors such as secreted amount, circadian rhythm, duration and nature of stimuli, diet, and medication intake, among others.
Despite this heterogeneous composition, from the functional point of view saliva has to be considered as a unique biological fluid, and not as the sum of its biochemical components.²,³
Salivary secretion and maintenance of a film of saliva on oral surfaces is dependent upon nerve-mediated, reflex salivary gland secretion mainly stimulated by taste. The afferent arm is mainly activated by stimulation of chemoreceptors (located in the taste buds) and mechanoreceptors (located in the periodontal ligament).⁴ Olfaction, mental processes, and stretch of the stomach are weak stimuli. Impulses affecting secretion depending on the emotional state are carried by afferent cranial nerves V, VII, IX, and X to the CNS salivary nuclei (salivation center) in the medulla oblongata. The efferent part of the reflex is mainly parasympathetic. The cranial nerve VII provides control of the submandibular, sublingual, and minor glands, whereas the cranial nerve IX controls the parotid glands. The flow of saliva is enhanced by sympathetic innervation, which promotes contraction of muscle fibers around the salivary ducts.⁵ Autonomic nerves also have an important role in both gland development and function.⁶ A dry mouth is a common experience where there is