MODERN EXPERIENCE IN DENTAL MANAGEMENT AND PREVENTION OF SALIVARY-GLAND DISEASES IN MIDDLE-AGED ADULTS

Abstract

In adults aged 35–60 years, salivary-gland pathology arises from a multifactorial interplay of endocrine, metabolic, autoimmune, radiation-related and infectious- inflammatory factors. Although numerous therapeutic options are available, unified interdisciplinary protocols for treatment and prevention remain insufficiently elaborated.The purpose of the study was systematise current clinical and experimental evidence on dental treatment and prevention of salivary-gland diseases in a middle-aged cohort and to identify effective and safe management algorithms. Materials and methods. A targeted narrative review (2014–2024) was performed in accordance with PRISMA-ScR guidelines. Searches were conducted in PubMed, Scopus, Web of Science, Google Scholar and national repositories. Thirty sources meeting the relevance criteria (metabolic, systemic, radiation-induced, infectious- inflammatory and neoplastic lesions; adult population 35–60 years) were analysed. Study design, therapeutic interventions and clinical endpoints (salivary-flow rate, oral-hygiene indices, relapse frequency, quality-of-life measures) were extracted. Research results. Experimental melanin administration under omeprazole-induced hypergastrinaemia normalised the protease–inhibitor balance in salivary glands, reducing proteolytic activity by 15% (p < 0.05). In sialosis associated with hepatobiliary disease, addition of the antidysbiotic hepatoprotector “Lysozyme-Forte” increased the antioxidant–pro-oxidant index and improved salivary-flow rate by 22% versus control. A combined therapeutic-preventive package with propolis ultraphonophoresis achieved 100% clinical remission of sialosis in nontoxic goitre after six months.A differentiated algorithm for radioiodine-induced sialoadenitis management (long-acting glucocorticoids, sialoendoscopy, substitution therapy) lowered the incidence of grade II–III xerostomia and prevented progression of caries and periodontal disease over one year. Laser therapy for chronic parotitis shortened pain and swelling after 1–2 sessions and yielded stable remission in 85% of patients. Conclusions. Treatment efficacy in middle- aged adults with salivary-gland diseases increases when pathogenetically grounded multimodal regimens combining systemic, local and physiotherapeutic approaches are applied. Promising avenues include melanin as a protease modulator, antidysbiotic hepatoprotectors, minimally invasive sialoendoscopy and photobiomodulation. Further randomised trials are required to standardise protocols and evaluate long-term safety.