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Diseases of the Oral Cavity and Salivary Glands

1
Maria M. Soltero‐Rivera, DVM, DAVDC and Alexander M. Reiter, Dipl.Tzt., Dr.Med. Vet., DAVDC, DEVDC 2
1 VCA San Francisco Veterinary Specialists, San Francisco, CA, USA
2 School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA

A history of ptyalism or drooling saliva, perioral +/− ocu­ buds reject potentially toxic materials. The gingival cre­
lonasal discharge, anorexia, weight loss, unkempt hair vicular fluid is believed to cleanse the gingival sulcus,
coat, vocalizing when eating, pawing at the mouth, improve adhesion of the epithelium to the tooth via
rubbing the face on the furniture or carpeting, bruxism, plasma proteins, possess antimicrobial properties, and
chattering, and/or hesitation to have the head or face exert antibody activity to protect the gingiva. The nor­
touched should prompt the clinician to perform a thor­ mal bacterial flora of the oral cavity plays a role in the
ough intraoral and extraoral examination. Oral and sali­ innate resistance by preventing colonization and growth
vary gland diseases can have various presentations, and of foreign microbes.
often the duration of clinical signs along with the distri­ There are four major pairs of salivary glands: mandib­
bution of the lesions can aid in determining the etiology ular, sublingual, parotid, and zygomatic. Minor salivary
of the condition (Table 50.1). Histologically, oral lesions glands can be found on the palate, alveolar, labial and
can range in appearance from areas of ulceration to vesi­ buccal mucosa, tongue, and along some of the ducts of
cles to even proliferation of tissues, whether it is through the major salivary glands. Cats have an additional pair of
hyperplasia, neoplasia or granulation tissue formation, mixed salivary glands found on the lingual aspect of the
to areas of necrosis. Salivary gland enlargement follows a mandibular first molar tooth, known as the linguomolar
spectrum, with the noninflamed form, known as gland. Secretory cells can be predominantly serous, pre­
sialadenosis, followed by sialadenitis and finally necrotiz­ dominantly mucous, or mixed. The secretory cells of the
ing sialometaplasia. Neoplasia can also occur in the salivary glands form acini, surrounding a central drain­
salivary glands. It is important to keep in mind that some ing space that empties into the intercalated, striated, and
systemic diseases can manifest with oral lesions. excretory ducts, successively. These ducts play a major
Additionally, some systemic diseases that lead to immu­ role in determining the composition of saliva. Saliva
nosuppression can predispose patients to oral disease. cleanses the mouth, maintains tooth integrity, dilutes
noxious materials, contains antibodies and antimicrobi­
als, maintains the pH in the oral cavity, and plays a role in
Healthy Oral Tissues the formation of the bolus of food and initial digestion,
and Salivary Glands depending on the species. The ducts and acini are
surrounded by connective tissue carrying blood vessels
The masticatory and lining mucosa are the primary tis­ and nerves.
sues affected by oral inflammation. The epithelium of
the masticatory mucosa is moderately thick and fre­
quently ortho‐keratinized. It is inextensible and well Gingivitis and Periodontitis
adapted to withstanding abrasion. The epithelium of the
lining mucosa is thicker than that of masticatory mucosa Periodontal disease is commonly seen in dogs and cats
and is nonkeratinized. The surface is flexible and the characterized by inflammation of the supporting struc­
submucosa is elastic, allowing it to stretch. Taste buds, tures of the tooth. Ninety‐six percent of 109 adult cats,
gingival crevicular fluid, and normal bacterial flora play with a mean age of 6.2 +/− 5.2 years, showed evidence
a role in protecting the oral cavity from insults. Taste of gingival inflammation in one study. A recent study

Clinical Small Animal Internal Medicine Volume I, First Edition. Edited by David S. Bruyette.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
Companion website: www.wiley.com/go/bruyette/clinical