Histological and Functional Features of Salivary Glands in Rheumatic Patients with Oral Sicca Symptoms

Abstract

Dryness of the mouth with decreased production of saliva is not an uncommon finding among patients seeking medical advice. These oral sicca symptoms have been attributed to, e.g. drug side effects. Another important pathogenetic factor of xerostomia is Sjögren's syndrome (SS), where chronic inflammation of the salivary glands alone or as a part of a systemic disease is a major manifestation.

Oral complaints are frequently the presenting symptoms of SS. In addition to complaints of dry mouth, many patients present with changes in taste sensations, difficulties in eating dry food (“the cracker sign”), soreness or difficulties in adaptation to dentures. In advanced sialadenitis the saliva is frothy and the mucosa may appear dry and glazed, and interference with speech will occur. Still a direct causal relationship between oral sicca symptoms and chronic salivary gland inflammation has not been proven.

In the diagnosis of SS 2 of the 3 clinical criteria keratoconjunctivitis sicca, xerostomia and/or another connective tissue disease usually are to be fulfilled (1, 2). Recently, new criteria have been proposed in which focal sialadenitis is included (3).

Few data are available on the prevalence of focal sialadenitis and objective signs of mouth dryness in rheumatic patients. Thus, it is unclear to what extent rheumatic patients with subjective oral sicca symptoms display focal sialadenitis as a sign of underlying SS. The purpose of our study has been to find out how often sicca symptoms in patients with defined rheumatic disorders are to be explained by focal sialadenitis in minor labial salivary glands.