Absence of salivary glands in children with rampant dental caries: report of seven cases

Early Childhood Caries

Early childhood caries (ECC) represents a serious problem in pediatric dentistry. Not only because of its rapidity but also because of age of affected children. This has been given different names such as “rampant caries” and “baby bottle syndrome” but now all clinical manifestations have been joined and classified as early childhood caries. The topic of this article is the prevalence, etiology, clinical manifestations and preventive measures of ECC.

A rare cause of unilateral parotid gland swelling: compensatory hypertrophy due to the aplasia of the contralateral parotid gland

In this clinical report, 3 cases, admitted to the ears, nose, throat outpatient clinic with the complaints of unilateral swelling in the parotid region and facial asymmetry, are presented. In the etiology, contralateral parotid gland aplasia with compensatory hypertrophy and sialosis was detected. With this rare condition, clinical and radiological features of this anomaly are discussed.

Dynamic sonography and CT findings of unilateral submandibular gland agenesis associated with herniated hypertrophic sublingual gland

Congenital agenesis of the submandibular gland is uncommon. We report dynamic sonography and CT findings of the unilateral submandibular gland agenesis associated with herniated hypertrophic sublingual gland tissue through the mylohyoid gap. The dynamic sonography examination applied at rest and during the modified Valsalva maneuver demonstrated hypertrophied sublingual gland prolapsing to the anterior part through the mylohyoid gap. This may be the first reported case describing dynamic sonography findings of this entity. CT confirmed the agenesis of the left submandibular gland and compensatory hypertrophy of the ipsilateral sublingual gland.

Unilateral parotid agenesis associated with pleomorphic adenoma of ipsilateral accessory parotid gland

Congenital agenesis of the parotid gland is rare, and its association with accessory parotid tissue is even rarer. We report an unusual case of unilateral agenesis of the left parotid gland associated with pleomorphic adenoma of the left accessory parotid gland. To best of our knowledge, this is only the second such published case in the literature.

Complete congenital agenesis of all major salivary glands: a case report and review of the literature

Congenital agenesis of the salivary glands is uncommon. There are documented cases of partial or unilateral aplasia of the major salivary glands associated with the lacrimal puncta, but very few reports of the absence of all major salivary glands. We report the case of a 10-year-old girl with xerostomia and extensive teeth caries. Physical examination and imaging showed total and bilateral aplasia of the parotid, submandibular, and sublingual glands, with no involvement of the minor salivary glands or the lacrimal puncta. We describe the clinical presentation, important aspects in diagnosing partial forms of the condition, and patient management.

Unilateral submandibular gland aplasia masquerading as cancer nodal metastasis

OBJECTIVE

Five reports have examined unilateral submandibular gland aplasia. The purposes of this report are to demonstrate submandibular gland aplasia leading to contralateral gland hypertrophy in the setting of oral cavity cancer and to discuss the corresponding diagnostic and management challenges.

STUDY DESIGN

This study is a case report of a 60-year-old male who presented with pain on the right side of the mobile tongue.

METHOD

This report uses literature review.

RESULTS

A 60-year-old male presented with pain on the right side of the mobile tongue. Subsequent results of punch biopsy revealed squamous cell carcinoma in situ with foci of microinvasion of the tongue. Head and neck examination revealed no abnormalities. The patient underwent a wide-local excision of the tongue lesion. Postoperative computed tomographic (CT) scan showed an asymmetric mass on the ipsilateral side of the cancer in the region of the submandibular gland. The gland was noted to be abnormally large. A diagnosis of contralateral submandibular gland aplasia was made. The patient is cancer-free at 2 years postlocal excision. Salivary gland aplasia is an extremely rare disorder and is often associated with various congenital syndromes. Unilateral submandibular gland aplasia is even rarer with ours representing the sixth reported case. Aplasia is believed to stem from a regional disturbance in early fetal development. Common symptoms can include dysphagia, dry mouth, decreased taste, and tooth decay. In the presence of a history of oral cavity cancer, unilateral submandibular gland aplasia poses a challenge during postoperative cancer follow-up.

CONCLUSIONS

Unilateral submandibular gland aplasia in the setting of oral cavity cancer poses a unique challenge for cancer follow-up. Hypertrophy of the submandibular gland on the other side can masquerade as nodal metastasis. Head and neck examination as well as CT scan can be inconclusive. Regular confirmatory tests such as fine needle aspiration biopsy and positron emission tomography/CT for cancer detection is extremely useful for detecting recurrence.

Aplasia of the parotid gland in Down syndrome

Salivary gland aplasia has not to our knowledge been previously reported in association with Down syndrome. We present a case of bilateral parotid aplasia in a patient with Down syndrome. Clinically he had aplasia of the major salivary glands and symptoms of xerostomia. Thirteen other family members over three generations were examined, and all had functional parotid glands. We reviewed publications about Down syndrome and salivary aplasia, together with the data regarding his other clinical problems and family background. His oral problems were inadequate plaque control, dental caries, and erosion of the teeth.

Unilateral agenesis of the parotid gland: a case report

Agenesis of the parotid gland is an extremely rare condition and may be partial or total, unilateral or bilateral, and may occur on its own or associated with other developmental abnormalities. We report a case of unilateral agenesis of the parotid gland without involvement of other major salivary glands together with a compensatory hypertrophy of the contralateral parotid gland.

Unilateral agenesis of the parotid gland: an unusual entity

Agenesis of the parotid gland is extremely rare with only few cases reported in the medical literature. This entity can be important to diagnose as occasionally the normal parotid gland can be mistaken for a tumor due to the facial asymmetry. In this article, we present the case of an isolated unilateral parotid gland agenesis in a young child. The entity is discussed along with important associated conditions that should be ruled out. These include amongst others first and second branchial arch anomalies, as well as the Levy-Hollister or lacrimo-auriculo-dentodigital syndrome.

Submandibular gland aplasia and progressive dental caries: a case report

When severe caries occurs in mandibular permanent incisor teeth, the clinician should consider the possibility of associated submandibular gland aplasia or salivary hypofunction. Early diagnosis of submandibular gland disease is essential, as operative problems involving restoration of mandibular incisor teeth are considerable. Furthermore, progressive severe dental caries can present a dilemma for the clinician in affected individuals, despite intensive preventive and restorative therapy. A case report describing severe progressive dental caries and enamel demineralization of the permanent mandibular incisor teeth in a young girl is presented. Further investigation revealed absence of functional bilateral submandibular salivary glands contributing to the rapid breakdown of the teeth despite intensive preventive measures.

The distribution of stimulated saliva in children

OBJECTIVES

The need for an adequate quantity of saliva to maintain oral health has been widely reported. It is not only the quantity that is important, but also how the saliva is distributed once it enters the mouth. Several studies have looked at how saliva is distributed around adult mouths. The aim of this experiment was to describe the distribution of stimulated saliva around the mouth in children.

SAMPLE AND METHODS

In order to demonstrate the distribution of saliva around the mouth under stimulated conditions, 25 child subjects were asked to chew a piece of chewing gum containing 1.5 mg erythrosin for 3 min on one side of the mouth. The distribution of dye in the mouth was recorded on standardized charts.

RESULTS

In all cases, dye was present ipsilateral to the chewing side. In 13 cases (52%) the dye did not cross the midline and of the remaining 12 children the dye only reached the contralateral canines in four of them (16%).

CONCLUSIONS

Evidence is presented which suggests that during unilateral chewing in children, saliva is not well distributed around the mouth and has a tendency to stay on the side of the mouth from where it was secreted (P < 0.01).