Dry Mouth Sjögren’s Syndrome
The decrease in the quantity and quality of saliva, produces alterations in diet, speech articulation, infections of the oral mucosa, tooth decay and severe and constant discomfort.
Dry mouth is a symptom associated with various alterations that are often studied and treated by our speciality. Chronic nasal breathing problems, nocturnal snoring, certain drugs and treatments with radiotherapy are some of the causes of dry mouth that we can cure or alleviate from otolaryngology. On other occasions, the problem is a decrease in the quantity or quality of saliva due to diseases of the gland itself, the most frequent of which is Sjögren’s disease which is characterised by dry mouth and dry eyes.
Sjögren’s syndrome is a disease with an autoimmune mechanism in which the cells in charge of generating the immune and inflammatory response to defend us from external aggressions from germs and toxins actually attack our organism. The characteristics of this disease are that the salivary and lacrimal glands are affected. The most frequent presentation is in the form of dry eyes, dry mouth, tiredness and generalised pain. The disease still has no cure, the treatments seek to improve the patients’ quality of life by alleviating the symptoms derived from dry mouth and eyes, which is where we come in.
HOW WE DIAGNOSE IT
Answering “yes” to any of the following questions leads to a possible diagnosis of Sjogren:
1. Have you had persistent, disruptive daily eye dryness for more than 3 months?
2. Do you often have a gritty sensation in your eyes?
3. Do you use artificial tears more than three times a day?
4. Have you had a dry mouth sensation daily for more than three months?
5. Do you often drink liquids to help swallow dry food?
In addition, we will need to do other objective tests to diagnose the disease:
• Minor Salivary Gland Biopsy:
Performed as an outpatient in about 10 minutes. With a little anaesthetic, similar to that applied by dentists, on the inside of the lower lip, we will take a sample of your minor salivary gland. A anatomopathological study will then be performed on the sample to detect the characteristic alterations of this disease.
• Schirmer’s Test:
It allows us to evaluate the amount of tears we produce. We will place a strip of absorbent paper on the lower eyelid and leave it there for 5 minutes, after which we will measure the length of the moistened part of the strip.
• Unstimulated Whole Saliva Flow:
We can measure the amount of saliva we produce by collecting it in a container for 5 minutes.
A conventional blood draw will be able to detect specific markers of Sjögren’s disease.
This set of tests allows us to rule out, confirm or suspect Sjögren’s disease in a patient with symptoms of dry eyes and mouth.