Physiological Factors Affecting Salivary Flow Rate,Oral Sugar Clearance,and the Sensation of Dry Mouth in Man

Abstract

This paper discusses methods for collection of both whole saliva and individual gland secretions, the normal ranges of salivary flow rate, the effects of physiological variables which influence flow rate, and the role of saliva in oral sugar clearance. The physiological basis for the sensation of dry mouth is discussed, and a new concept is advanced which states that the sensation of dry mouth will occur when the salivary flow rate is less than the sum of the rates of water absorption and evaporation from the mouth. In a study of the effects of anticholinergic agents on salivary flow, the subjects experienced the sensation of dry mouth when the normal flow rate of unstimulated saliva was reduced by from 40 to 50%.

Get full access to this article

View all access options for this article.

References

ANDERSSON

(1972): The Flow Rate, pH and Buffer Effect of Mixed Saliva in Schoolchildren, Odont Revy 23: 421–428.

ANDERSSON

; ARVIDSSON

; CROSSNER

C.-G.

; HOLM

A.-K.

; MANSSON

; and GRÁHNEN

(1974): The Flow Rate, pH and Buffer Effect of Mixed Saliva in Children, J Int Assoc Dent Child 5: 5–12.

BATES

J.F.

and ADAMS

(1968): The Influence of Mental Stress on the Flow of Saliva in Man, Arch Oral Biol 13: 593–596.

BLOCK

P.L.

and BROTTMAN

(1962): A Method of Submaxillary Saliva Collection without Cannulization, NY State Dent J 28: 116–118.

BECKS

and WAINWRIGHT

W.W.

(1943): Human Saliva XIII. Rate of Flow of Resting Saliva of Healthy Individuals, J Dent Res 22: 391–396.

CAMNER

and BAKKE

(1980): Nose or Mouth Breathing? Environ Res 21: 394–398.

CHRISTENSEN

C.M.

and NAVAZESH

(1984): Anticipatory Salivary Flow to the Sight of Different Foods, Appetite 5: 307–315.

CROSSNER

C.-G.

(1984): Salivary Flow Rate in Children and Adolescents, Swed Dent J 8: 271–276.

DAWES

(1969): The Effects of Flow Rate and Duration of Stimulation on the Concentrations of Protein and the Main Electrolytes in Human Parotid Saliva, Arch Oral Biol 14: 277–294.

10.

DAWES

(1970): Effects of Diet on Salivary Secretion and Composition, J Dent Res 49: 1263–1272.

11.

DAWES

(1974): Rhythms in Salivary Flow Rate and Composition, Int J Chronobiol 2: 253–279.

12.

DAWES

(1981): Factors Influencing Protein Secretion in Human Saliva, Front Oral Physiol 3: 125–137.

13.

DAWES

(1983): A Mathematical Model of Salivary Clearance of Sugar from the Oral Cavity, Caries Res 17: 321–334.

14.

DAWES

(1984): Stimulus Effects on Protein and Electrolyte Concentrations in Parotid Saliva, J Physiol Lond 346: 579–588.

15.

DAWES

and CHEBIB

F.S.

(1972): The Influence of Previous Stimulation and the Day of the Week on the Concentrations of Protein and the Main Electrolytes in Human Parotid Saliva, Arch Oral Biol 17: 1289–1301.

16.

DAWES

; CROSS

H.G.

; BAKER

C.G.

; and CHEBIB

F.S.

(1978): The Influence of Gland Size on the Flow Rate and Composition of Human Parotid Saliva, J Can Dent Assoc 44: 21–25.

17.

DAWES

and WOOD

C.M.

(1973): The Contribution of Oral Minor Mucous Gland Secretions to the Volume of Whole Saliva in Man, Arch Oral Biol 18: 337–342.

18.

DREIZEN

; BROWN

L.R.

; DALY

T.E.

; and DRANE

J.B.

(1977): Prevention of Xerostomia-related Dental Caries in Irradiated Cancer Patients, J Dent Res 56: 99–104.

19.

EDGAR

W.M.

and JENKINS

G.N.

(1981): Can Salivary Function in Man be Enhanced by Increased Mastication?, J Dent Res 60(Sp Iss B): 1172 (Abstr. No. 132).

20.

ENFORS

(1962): The Parotid and Submandibular Secretion in Man, Acta Otolaryngol (Suppl 172).

21.

ERICSON

(1968): The Parotid Gland in Subjects with and without Rheumatoid Arthritis, Acta Radiol (Suppl. 275).

22.

ERICSON

(1971): The Importance of Sialography for the Determination of the Parotid Flow. The Normal Variation in Salivary Output in Relation to the Size of the Gland at Stimulation with Citric Acid, Acta Otolaryngol 72: 437–444.

23.

ERICSON

; HEDIN

; and WIBERG

(1972): Variability of the Submandibular Flow Rate in Man with Special Reference to the Size of the Gland, Odont Revy 23: 411–420.

24.

Fox

P.C.

; VAN DER VEN

P.F.

; SONIES

B.C.

; WEIFFENBACH

J.M.

; and BAUM

B.J.

(1985): Xerostomia: Evaluation of a Symptom with Increasing Significance, J Am Dent Assoc 110: 519–525.

25.

GANDARA

B.K.

; IZUTSU

K.T.

; TRUELOVE

E.L.

; ENSIGN

W.Y.

; and SOMMERS

E.E.

(1985): Age-related Salivary Flow Rate Changes in Controls and Patients with Oral Lichen Planus, J Dent Res 64: 1149–1151.

26.

GANONG

W.F.

(1985): Review of Medical Physiology, 12th ed. Los Altos, CA: Lange Medical Publications, p. 532.

27.

HEFT

M.W.

and BAUM

B.J.

(1984): Unstimulated and Stimulated Parotid Salivary Flow Rate in Individuals of Different Ages, J Dent Res 63: 1182–1185.

28.

HEINTZE

and BIRKHED

(1984): Influence of a Single Intake of Various Test Meals on Secretion Rate, Buffer Effect, and Electrolytes of Human Stimulated Whole Saliva, Caries Res 18: 265–268.

29.

HEINTZE

; BIRKHED

; and BJORN

(1983): Secretion Rate and Buffer Effect of Resting and Stimulated Whole Saliva as a Function of Age and Sex, Swed Dent J 7: 227–238.

30.

HOLMES

J.H.

(1964): Changes in Salivary Flow Produced by Changes in Fluid and Electrolyte Balance. In: Salivary Glands and Their Secretions, Sreebny

L.M.

, and Meyer

, Eds., New York: MacMillan, pp. 177–195.

31.

JENKINS

G.N.

and DAWES

(1966): The Psychic Flow of Saliva in Man, Arch Oral Biol 11: 1203–1204.

32.

KAABER

(1973a): Studies on the Permeability of Human Oral Mucosa. V. The Inflow of Water through Dehydrating Oral Mucosa, Acta Odontol Scand 31: 101–108.

33.

KAABER

(1973b): Studies on the Permeability of Human Oral Mucosa, VI. The Mucosal Transport of Water, Sodium and Potassium under Varying Osmotic Pressure, Acta Odontol Scand 31: 307–316.

34.

KERR

A.C.

(1961): The Physiological Regulation of Salivary Secretions in Man. Oxford: Pergamon Press.

35.

LAGERLÖF

and DAWES

(1984): The Volume of Saliva in the Mouth Before and After Swallowing, J Dent Res 63: 618–621.

36.

LAGERLÖF

and DAWES

(1985): The Effect of Swallowing Frequency on Oral Sugar Clearance and pH Changes by Streptococcus mitior in vivo After Sucrose Ingestion, J Dent Res 64: 1229–1232.

37.

MANDEL

I.D.

; ZENGO

; KATZ

; and WOTMAN

(1975): Effect of Adrenergic Agents on Salivary Composition, J Dent Res 54: B27–B33.

38.

MANSSON

and SANDBERG

(1975): Salivary Stimulus and Swallowing Reflex in Man, Acta Otolaryngol 79: 445–450.

39.

MASON

D.K.

and CHISHOLM

D.M.

(1975): Salivary Glands in Health and Disease. Toronto: W.B. Saunders Co. Ltd.

40.

McKEOWN

K.C.

and DUNSTONE

G.H.

(1959): Some Observations on Salivary Secretion and Fluid Absorption by Mouth, Br Med J 2: 670–672.

41.

MILES

T.S.

and DELLOW

P.G.

(1971): The Oral Absorption of Water, Can J Physiol Pharmacol 49: 796–800.

42.

NAVAZESH

and CHRISTENSEN

C.M.

(1982): A Comparison of Whole Mouth Resting and Stimulated Salivary Measurement Procedures, J Dent Res 61: 1158–1162.

43.

NIINIMAA

(1983): Oronasal Airway Choice During Running, Resp Physiol 53: 129–133.

44.

NIINIMAA

; COLE

; MINTZ

; and SHEPHARD

R.J.

(1981): Oronasal Distribution of Respiratory Airflow, Resp Physiol 43: 69–75.

45.

PARVINEN

and LARMAS

(1981): The Relation of Stimulated Salivary Flow Rate and pH to Lactobacillus and Yeast Concentrations in Saliva, J Dent Res 60: 1929–1935.

46.

PEDERSEN

; SCHUBERT

; IZUTSU

; MERSAI

; and TRUELOVE

(1985): Age-dependent Decreases in Human Submandibular Gland Flow Rates as Measured under Resting and Post-stimulation Conditions, J Dent Res 64: 822–825.

47.

PROCTER

D.F.

(1977): The Upper Airways. 1. Nasal Physiology and Defense of the Lungs, Ann Rev Resp Dis 115: 97–129.

48.

SAHAKIAN

B.J.

(1981): Salivation and Appetite: Commentary on the Forum, Appetite: J for Intake Res 2: 386–389.

49.

SCHNEYER

L.H.

; PIGMAN

; HANAHAN

; and GILMORE

R.W.

(1956): Rate of Flow of Human Parotid, Sublingual and Submaxillary Secretions during Sleep, J Dent Res 35: 109–114.

50.

SCHUBERT

(1987): Iatrogenic Causes of Salivary Gland Dysfunction, J Dent Res (in press).

51.

SHANNON

I.L.

(1966): Climatological Effects on Human Parotid Gland Function, Arch Oral Biol 11: 451–453.

52.

SHANNON

I.L.

(1967): A Formula for Human Parotid Fluid Collected without Exogenous Stimulation, J Dent Res 46: 309.

53.

SHANNON

I.L.

(1972): The Biochemistry of Human Saliva in Health and Disease. In: Salivary Glands and Their Secretion, Rowe

N.H.

, Ed., Ann Arbor: University of Michigan Press, pp. 94–121.

54.

SHANNON

I.L.

and CHAUNCEY

H.H.

(1967): A Parotid Fluid Collection Device with Improved Stability Characteristics, J Oral Therap Pharmacol 4: 93–97.

55.

SHANNON

I.L.

; SUDDICK

R.P.

; and DOWD

E.J.

Jr. (1974): Saliva: Composition and Secretion, Monographs in Oral Science, Vol. 2. Myers

H.M.

, Ed., Basel: Karger, p. 93.

56.

SIEGEL

I.A.

(1984): Permeability of the Rat Oral Mucosa to Organic Solutes Measured in vivo, Arch Oral Biol 29: 13–16.

57.

SIEGEL

I.A.

; IZUTSU

K.T.

; and WATSON

(1981): Mechanisms of Nonelectrolyte Penetration Across Dog and Rabbit Oral Mucosa in vitro, Arch Oral Biol 26: 357–361.

58.

SPEIRS

R.L.

(1984): Secretion of Human Lip Mucous Glands and Parotid Glands in Response to Gustatory Stimuli and Chewing, Arch Oral Biol 29: 945–948.

59.

SQUIER

C.A.

and HALL

B.K.

(1985): The Permeability of Skin and Oral Mucosa to Water and Horseradish Peroxidase as Related to the Thickness of the Permeability Barrier, J Invest Dermatol 84: 176–179.

60.

TRUELOVE

, L; BIXLER

; and MERRITT

A.D.

(1967): Simplified Method for Collection of Pure Submandibular Saliva in Large Volumes, J Dent Res 46: 1400–1403.

61.

van HOUTE

and RUSSO

(1986): Effect of Swallowing Frequency on the pH of a S. mutans Cell Mass and Enamel Demineralization Test, J Dent Res 65(Sp Iss): 305, Abst. No. 1225 (AADR).

62.

WEAST

R.C.

(1978): CRC Handbook of Chemistry and Physics, 59th ed., West Palm Beach, FL: CRC Press, Inc., p. E41.