The Intraoral and Extraoral Exam
Salivary Flow and Consistency

Salivary flow and consistency will vary with each patient.  Some abnormal findings must be noted such as frothy saliva or thick ropy saliva.  Xerostomia should be suspected based on information collected from the medical/dental histories.  Sometimes the patient’s perception of dryness must be assessed as well.  The patient may voice a concern of overall oral dryness, while the actual flow of saliva appears normal.  The mixture of serous and mucous saliva affects the perception of dryness as well.  When problems arise with the parotid gland, the flow from Stensen’s duct will be diminished.  Milking the salivary glands from the tail toward the mid line assists the clinician in visually assessing the Stensen’s duct orifice found next to the maxillary first molar.

Gauze should be used to dry the floor of the mouth and visually asses the flow from the Wharton’s duct orifice and other ducts of both the sublingual and submandibular glands (Figure 58 and 59).