Significance of unilateral submandibular gland excision on salivary flow in noncancer patients

Objectives/Hypothesis: Normal salivary flow is important for maintaining good oral hygiene. Lack of normal flow predisposes to an increased incidence of dental caries and symptomatic xerostomia. The submandibular glands are responsible for 70% of resting salivary flow. Removal of the submandibular gland is most commonly performed for sialolithiasis, chronic sialoadenitis, or as part of a neck dissection. The effect of unilateral gland resection for benign disease on resting salivary flow has not been well examined in the literature. Study Design: Case controlled study involving patients who had undergone a unilateral submandibular gland resection matched with normal control subjects. Method: Stimulated and unstimulated salivary flow rates in surgical and control subjects were measured in a controlled setting. Results: Unstimulated salivary flow rates were 0.805 mL/min in the control group and 0.405 mL/min in the surgical group (P = .01). Stimulated salivary flow rates were not significantly different between the two groups (P > .05). Fifty- seven percent of patients in the surgical group and 14% in the control group had xerostomia (P < .05). Conclusion: Unilateral submandibular gland excision results in a decreased rate of resting salivary flow and an increase in subjective xerostomia.