Kang Jeong-Hyun, Kho Hong-Seop
Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Institute on Aging, Seoul National University, Republic of Korea.
Arch Oral Biol. 2021 Oct;130:105213. doi: 10.1016/j.archoralbio.2021.105213. Epub 2021 Jul 22.
The aim of the present study was to review the existing phenomena which could affect subjective oral dryness and to consider the possibility that neural processing is involved in the perception of oral dryness.
A comprehensive review of scientific literatures relevant to contributing factors of dry mouth symptoms including salivary parameters related with oral dryness and role of neural mechanisms in perception of dry mouth symptoms was conducted.
Several previous reports suggested the possibility of neural processing mechanisms in perception of oral dryness. The decreased pain threshold in the oral cavity of rats with dry tongue and complaints of subjective oral dryness in patients with burning mouth syndrome, of which lacked an actual decrease in salivary output and mucosal wetness, could support this idea. Sensory changes in the oral mucosa and oral dryness may have a bi-directional influence that patients with oral dryness would be more subject to neuropathic pain in the oral mucosa, and those with neuropathic pain in the oral cavity could have complaints associated with higher levels of dry mouth symptoms.
A bi-directional influence between sensory change in the oral mucosa and subjective oral dryness could be assumed. We suggest the administration of neuropathic pain medications for controlling subjective oral dryness in patients without objective sign of hyposalivation.
本研究旨在回顾可能影响主观口腔干燥的现有现象,并探讨神经加工过程参与口腔干燥感知的可能性。
对与口干症状相关因素的科学文献进行全面综述,包括与口腔干燥相关的唾液参数以及神经机制在口干症状感知中的作用。
先前的几份报告提出了神经加工机制参与口腔干燥感知的可能性。舌干大鼠口腔疼痛阈值降低,以及灼口综合征患者主诉主观口腔干燥,但唾液分泌量和黏膜湿润度并无实际降低,这些都支持了这一观点。口腔黏膜的感觉变化与口腔干燥可能存在双向影响,即口腔干燥患者更容易出现口腔黏膜神经病理性疼痛,而口腔存在神经病理性疼痛的患者可能会主诉更严重的口干症状。
可以推测口腔黏膜感觉变化与主观口腔干燥之间存在双向影响。我们建议对无唾液分泌减少客观体征的患者使用神经病理性疼痛药物来控制主观口腔干燥。