WHOLE SALIVARY FLOW-RATES FOLLOWING SUBMANDIBULAR-GLAND RESECTION

Background. Patients with head and neck neoplasms receive therapeutic neck dissections which may include the submandibular gland unilaterall y or bilaterally. The clinical consequences of salivary gland resectio n could be reduced salivary output, altered cariogenic microflora, and increased incidence of denial caries. Methods, This investigation eva luated whole salivary flow rates of patients who had received unilater al (n = 29) or bilateral (n = 8) submandibular gland resections and co mpared them with noncancer control subjects (n = 29), Results. Unstimu lated and stimulated (paraffin) flow rates were significantly lower in both resection groups compared with those of the noncancer group, ran ging from p <.002 to p <.02. Although flow rates were lower in the bil ateral group than in the unilateral group, the differences between the se two groups were statistically significant (p <.02) only for stimula ted saliva. Xerostomia was reported by one third of the resection subj ects. Conclusions. In view of the significantly lower flow rates obser ved in the resection groups (especially for unstimulated saliva), topi cal fluoride therapy should be considered for those patients whose pas t caries activity would indicate an increased caries risk associated w ith partial loss of salivary function.