The association between oral dryness and use of dry-mouth interventions in Sjögren’s syndrome patients

Abstract

Objective Sjögren’s syndrome patients use different dry-mouth interventions for the relieve of their oral dryness. Recently, it was shown that patients with dry-mouth complaints have regional differences in perceived intra-oral dryness. Therefore, the aim of the present study was to investigate whether the use of dry-mouth interventions is related to the perceived regional oral dryness. Materials and methods A cross-sectional study was performed among Sjögren’s patients. Volunteers could anonymously administer various questionnaires, including the Regional Oral Dryness Inventory (RODI), Xerostomia Inventory (XI), Bother Index (BI) and a list of dry-mouth interventions. Results Sjögren’s syndrome patients use a wide variety for the relieve of oral dryness. “Drinking water’’ and “moistening the lips’’ were used most frequently. Dry-mouth interventions, “drinking water’’, “rinsing of the mouth”, and “drinking small volumes” had significant associations with the RODI-scores of the posterior palate, and anterior and posterior tongue, respectively. On the other hand, “using mouth gel’’ had a significant association with the RODI-scores of the inside cheeks. Conclusion Sjögren’s syndrome patients are more likely to use mouth gels when their inside cheeks were experienced as most dry, while they drank water, rinsed their mouth or drank small volumes if the posterior palate, and anterior and posterior tongue were considered as dry. It can be concluded that intra-oral dryness affects dry-mouth perception and thereby also the use of the various dry-mouth interventions. Clinical relevance The therapeutic choice of dry-mouth interventions by Sjögren’s syndrome patients seems to some extent to be related to dryness at specific intra-oral regions.

Preferences of Sjögren’s syndrome patients regarding potential new saliva substitutes

“…This overrepresentation is in line with the female to male ratio of Sjögren’s syndrome, which varies between 20:1 and 9:1 [ 17 ]. The average age and the severity of oral dryness in the current study are also comparable with other studies that included Sjögren’s syndrome patients with dry-mouth complaints [ 7 , 18 ]. The average age in these previous studies varied between 61.7 ± 14.0 and 64 ± 10 years.…”

“…The average age in these previous studies varied between 61.7 ± 14.0 and 64 ± 10 years. As for the severity of xerostomia, the mean XI-scores in these previous studies were between 44.0 ± 37.0–49.8 and 45.0 ± 38.0–48.5 [ 7 , 18 ]. In summary, this suggests that the respondents in the current study form a good representation of Sjögren’s syndrome patients in the Dutch population.…”

“…by the use of lozenges and chewing gums, systemic pharmacotherapy, or electrostimulation of the salivary glands [ 4 – 6 ]. However, in case of an advanced disease process, when the salivary function is irreversibly impaired, saliva substitutes such as mouth sprays, gels, and mouthwashes can be applied for the relief of oral complaints [ 6 , 7 ]. A substantial number of Sjögren’s syndrome patients is using or has used a saliva substitute in the past.…”

“…A substantial number of Sjögren’s syndrome patients is using or has used a saliva substitute in the past. In a recent study, this percentage varied between 42.9 and 45.5% for the use of a mouth gel, while for the use of a mouth spray it varied between 25 and 27.4% [ 7 , 8 ].…”

The Future of Targeted Treatment of Primary Sjögren's Syndrome: A Focus on Extra-Glandular Pathology

“…Salivary hypofunction leads to xerostomia in pSS patients. Dysphonia, dysphagia, stomatopyrosis (burning mouth), dysgeusia (altered taste), teeth erosion and oral infections are common problems caused by xerostomia [60].Current treatment include oral swabs, lip moisturizers, topical saliva substitutes, muscarinic agonists, scheduled use of ice water, electrostimulation and acupuncture [71,72].Though not life-threatening, dysphagia and awakening from sleep due to oral dryness are debilitating consequences of xerostomia [73] which beg the advancement of drug therapies beyond symptom relief [74].This section reviews the possible molecular targets that should be investigated.…”