An unusual pattern of dental damage with salivary gland aplasia.
BACKGROUND
Dental destruction can develop from numerous causes. Major salivary gland aplasia is an uncommon causative factor. The resulting xerostomia can lead to extensive dental demineralization.


METHODS
The author examined a 19-year-old man because of the patient's concern regarding decreased salivary volume and his dental condition. There was extensive loss of tooth structure and an astonishing pattern of dental destruction most notable on the palatal portions of the maxillary molars and premolars that is best described as "chipping." It was only after taking the patient's history, clinically examining the patient and conducting a radioisotope study that the author was able to make a confident diagnosis of the absence of four major salivary glands.


CONCLUSIONS
Dentists should be aware that salivary gland aplasia is an uncommon cause of dental deterioration. It may manifest itself not by extensive caries but by a dental chipping effect. Early recognition and a therapeutic strategy can prevent progressive dental damage.
Mandel
Louis
L
Columbia University College of Dental Medicine, Division of Oral and Maxillofacial Surgery, New York-Presbyterian Hospital, New York, NY 10032, USA. LM7@columbia.edu
D000328:Adult; D003743:Dental Enamel / Q000473:pathology*; D006801:Humans; D008297:Male; D009056:Mouth Abnormalities / Q000150:complications; D010306:Parotid Gland / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m; D013363:Submandibular Gland / Q000002:abnormalities* / Q000000981:diagnostic imaging; D019217:Tooth Attrition / Q000209:etiology* / Q000473:pathology; D014987:Xerostomia / Q000150:complications / Q000209:etiology* / Q000628:therapy
D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m