Poon R, Su N, Ching V, Darling M, Grushka M
Private Practice in Oral Medicine Changchun, China.
Norman Bethune College of Medicine, Changchun, China.
Br Dent J. 2014 Oct;217(7):E14. doi: 10.1038/sj.bdj.2014.884.
Burning mouth syndrome (BMS) is a chronic condition of burning of the tongue and oral mucosa. It is often accompanied with complaints of xerostomia, although it is unknown whether the dryness is a sensory change similar to the burning sensation or due to hyposalivation. To determine whether there is change in salivary flow rate, whole salivary flows were measured in BMS patients.
A clinical ambispective study was conducted. Patients' clinical files were reviewed for stimulated and unstimulated whole salivary flow. Patients were divided into four groups based on diagnosis into Sjögren's syndrome (SS), BMS, BMS taking oral drying medications (BMS-med), and control (C). Whole stimulated (SF) and unstimulated flow (USF) measurements were collected and compared among groups. Data were analysed with ANOVA, Levene's test, Tukey's test and Games-Howell test.
Twenty SS, 22 BMS, 24 BMS-med and 15 C were included in the study. SF was significantly lower in SS (0.59 ml ± 0.36) compared with BMS (1.56 ml ± 0.65, p <0.001), BMS-med (1.44 ml ± 0.64, p <0.001) and C (2.32 ml ± 1.06, p = 0.001). USF was significantly lower in SS (0.12 ml ± 0.10) compared with BMS (0.30 ml ± 0.18, p = 0.002), BMS-med (0.27 ml ± 0.21, p = 0.022) and C (0.52 ml ± 0.26, p <0.001). SF was not significantly different between BMS and C (p = 0.172) and BMS-med and C (p = 0.096). Both BMS and BMS-med had significantly lower USF compared with C (p = 0.040 and p = 0.018 respectively). SF in BMS was not significantly affected by number of oral drying medications (p = 0.254); however, USF was significantly lower with two or more oral drying medications (0.13 ml ± 0.07) compared with one oral drying medication (0.32 ml ± 0.22) (p = 0.034).
BMS patients have statistically significant decreased unstimulated salivary flow rate with non-statistically significant decreased stimulated flow rate. Salivary flow rates in BMS patients are decreased further by medication usage whose side effects include dry mouth. This suggests that hyposalivation may play a role in causing dry mouth in BMS, which may respond to treatment with a sialogogue.
灼口综合征（BMS）是一种舌部和口腔黏膜烧灼样的慢性病症。常伴有口干主诉，不过尚不清楚这种口干是类似于烧灼感觉的感觉变化，还是由于唾液分泌减少所致。为了确定唾液流速是否有变化，对灼口综合征患者的全唾液流量进行了测量。
进行了一项临床双向性研究。查阅患者临床档案以获取刺激后和未刺激时的全唾液流量。根据诊断将患者分为四组：干燥综合征（SS）、灼口综合征（BMS）、服用致口干药物的灼口综合征患者（BMS-med）和对照组（C）。收集并比较各组刺激后（SF）和未刺激时的流量（USF）测量值。数据采用方差分析、Levene检验、Tukey检验和Games-Howell检验进行分析。
本研究纳入了20例干燥综合征患者、22例灼口综合征患者、24例服用致口干药物的灼口综合征患者和15例对照者。与灼口综合征（1.56 ml±0.65，p<0.001）、服用致口干药物的灼口综合征患者（1.44 ml±0.64，p<0.001）和对照组（2.32 ml±1.06，p = 0.001）相比，干燥综合征患者的刺激后流量显著降低（0.59 ml±0.36）。与灼口综合征（0.30 ml±0.18，p = 0.002）、服用致口干药物的灼口综合征患者（0.27 ml±0.21，p = 0.022）和对照组（0.52 ml±0.26，p<0.001）相比，干燥综合征患者的未刺激流量显著降低（0.12 ml±0.10）。灼口综合征患者与对照组（p = 0.172）以及服用致口干药物的灼口综合征患者与对照组（p = 0.096）之间的刺激后流量无显著差异。灼口综合征患者和服用致口干药物的灼口综合征患者的未刺激流量均显著低于对照组（分别为p = 0.040和p = 0.018）。灼口综合征患者的刺激后流量不受致口干药物数量的显著影响（p = 0.254）；然而，与服用一种致口干药物（0.32 ml±0.22）相比，服用两种或更多致口干药物时未刺激流量显著降低（0.13 ml±0.07）（p = 0.034）。
灼口综合征患者未刺激唾液流速有统计学意义的降低，刺激后流速有非统计学意义的降低。药物使用会进一步降低灼口综合征患者的唾液流速，这些药物的副作用包括口干。这表明唾液分泌减少可能在灼口综合征的口干症状中起作用，可能对使用催涎剂治疗有反应。
