Chemosensory dysfunction, Oral disorders and Oral health-related quality of life in patients with primary Sjögren’s syndrome: comparative cross-sectional study

Abstract

Background: The aim of this study was to evaluate chemosensory function and oral disorders in patients with primary Sjögren's syndrome (pSS) and to compare these findings with those of age-and gender-matched healthy controls. Methods: This comparative cross-sectional study included 58 patients with primary Sjögren's syndrome (pSS) and 55 age-and gender-matched healthy controls. Olfactory and gustatory function, burning sensations in the tongue (BST) and halitosis were assessed. Oral health-related quality of life (OHRQoL) was evaluated using the short-form Oral Health Impact Profile (OHIP-14). Results: Patients with pSS had significantly lower self-reported visual analogue scale (VAS) smell score (8.6 ± 2.2 vs. 9.6 ± 0.7, p = 0.016) and VAS taste score (8.5 ± 2.1 vs. 9.5 ± 0.7, p = 0.014) than healthy controls. A greater proportion of patients with pSS had anosmia (3.8% vs. 0.0%) or hyposmia (36.5% vs. 13.2%) and ageusia for basic tastes: sweetness (34.0% vs. 7.5%), sourness (10.6% vs. 0.0), saltiness (10.0% vs. 5.7%) or bitterness (19.1% vs. 1.9%) as evaluated using Sniffin Sticks test and taste stripts, respectively. A higher proportion of pSS patients complained of dysgeusia (52.6% vs. 9.4%, p < 0.0001) and BST (45.6% vs. 0.0%, p < 0.0001), while similar number of patients with pSS and controls reported halitosis (31.6% vs. 28.3%, p = 0.434). The mean OHIP-14 score was significantly higher in patients with pSS (6.8 ± 7.0 vs. 2.3 ± 8.5, p < 0.001) indicating patients' poorer OHRQoL compared with controls. Conclusions: The majority of patients with pSS had impaired chemosensory function and indicators of oral health in comparison with the age-and gender-matched healthy controls. Further studies of oral hygiene habits and dietary intake of these patients are needed to ensure better management of oral health problems in patients with pSS.

Olfactory dysfunction in primary Sjogren’s syndrome and its correlation with dry eye

“…Patients with pSS had a mild impairment in smell sense compared to the control group (median 10/12 and 11/12, respectively, p = 0.007) and median gustatory and VAS scores were lower in patients with pSS (median 20 and 7, respectively) than the healthy subjects (median 26 and 8, respectively) (p < 0.05). A recent study by Šijan Gobeljić et al 20 showed that patients with pSS had significantly lower self-reported VAS smell score (8.6 ± 2.2) and VAS taste score (8.5 ± 2.1) than healthy controls (9.6 ± 0.7, p = 0.016 and 9.5 ± 0.7, p = 0.014, respectively). Using Sniffin Sticks test and taste strips, 3.8% of patients were shown to have anosmia with scores between 0-5, 36.5% had hyposmia with scores between 6-9, 34.0% had ageusia for sweetness, 10.6% for sourness, 10.0% for saltiness and 19.1% for bitterness.…”

“…In the study of Rusthen et al 15 , mean odour VAS score and odour identification were 6.7 and 8.8 in pSS patients and 8.3 and 10.7 in healthy subjects (p < 0.05) and 12.9% of the patients were classified as anosmic. In the meta-analysis of Al-Ezzi et al 16 20 showed that patients with pSS had significantly lower self-reported VAS smell score (8.6 ± 2.2) and VAS taste score (8.5 ± 2.1) than healthy controls (9.6 ± 0.7, p = 0.016 and 9.5 ± 0.7, p = 0.014, respectively). Using Sniffin Sticks test and taste strips, 3.8% of patients were shown to have anosmia with scores between 0-5, 36.5% had hyposmia with scores between 6-9, 34.0% had ageusia for sweetness, 10.6% for sourness, 10.0% for saltiness and 19.1% for bitterness.…”

One year in review 2021: Sjögren's syndrome

“…Interestingly, prevalence of anti-SSA antibodies was lower in SFN group and a strong association with dysautonomic features was observed in the same group (77). Some Authors hypothesised that the neurosensory threshold dysfunction observed in these patients, rather than the sicca syndrome, may be associated with chemosensory impairment of taste and smell (51,63). Similarly, a recent study demonstrated that limitation in swallowing and mastication complained by SS patients may be also associated to an impaired tongue strength and masticatory muscle activity examined by electromyography, as well as to temporomandibular disorder (78).…”

“…The authors speculated that IL-21+ Tfh and Tph cells under control of ICOS costimulatory pathway played a key role in promoting ectopic lymphoid structures (ELS) and B-cell mucosa-Associated lymphoid tissue (MALT) lymphomas (MALT-L). (50)(51)(52). However, feeling of ocular and oral dryness is not always associated to a real reduction of lacrimal and salivary flow or to its severity.…”

Dysgeusia

“… 174 The mechanisms proposed to explain dysgeusia associated with SS include systemic inflammation, interaction with genetic pathways that influence gustation, an increase in the taste threshold, and small fiber neuropathy. 175 , 176 Possibly due to the fact that sweet taste is independent of salivation, there was minimal alteration of the sweet taste in patients with SS. 177 , 178 Other dysgeusia-associated disorders include autoimmune encephalitis, myasthenia gravis, systemic lupus erythematosus, multiple sclerosis, and Parkinson disease.…”