Non-Syndromic Non-Familial Agenesis of Major Salivary Glands: A Report of Two Cases with Review of Literature
An 18-year-old female patient was referred to the Out Patient Department with complaints of dry mouth and carious teeth. Other medical and family history were unremarkable. Extra-orally no abnormality was detected, except for the inability to palpate the parotid and submandibular salivary glands. However, her lips were dry and scaly. Intra-oral examination revealed signs of xerostomia, reduced salivary flow, dry erythematous oral mucosa, and extensive chipping of teeth, particularly incisors and canines []. Wharton and Stenson papillae were absent. The patient claimed no problems with ocular or lacrimal secretions. Sialometry showed a salivary flow rate of 0.08 mL/min. Haematological examination findings were within normal limits.\nPanoramic radiography revealed extensive destruction of teeth, particularly incisors and canines []. Ultrasonography was unable to visualize any of the major salivary glands. MRI scan was performed, which confirmed the agenesis of all the major salivary glands [Figure and ].\nConsultation with an ophthalmologist, ENT surgeon, and dermatologist ruled out any other abnormality while there was no abnormality visible in the minor salivary gland biopsy.\nFor both the patients, the treatment was directed toward symptomatic relief and restoration of functional status of the teeth, and prophylactic prevention of further dental breakdown. Patients were given sialogogues (pilocarpine) and sugarless chewing gums. Both the patients were advised topical fluoride applications and fluoride toothpastes. The damaged teeth were restored with esthetic restorations and sealants. A non-cariogenic diet and proper brushing with soft bristled tooth brush was advised.