Monday, October 18, 2010

Sjogren's Syndrome and Dry Mouth

Image found on NYC Dentist Blog.

So - my much anticipated and angst-ed taping of the WEGO webinar on Sjogren's Syndrome and dry mouth takes place this week. I've been reviewing and re-reviewing the script. Thank heavens that I can do this from the privacy of my generously sized closet, where hopefully nobody can hear me blabbering while pulling on various items of clothing and agonizing in front of the mirror then tossing everything in a giant heap of sleeves and clothes hangers and pants legs. My closet is so completely trashed. Ah, well.....

As I have been reviewing the materials for the webinar, which is very good information btw, it occurred to me that even though I have posted before about saliva and dry mouth, it's probably a good time to bring up the subject again, especially since it's been in the forefront of my mind lately.

My previous post, Sjogren's vs Saliva, is an overview of Sjogren's related dry mouth. You can read it here, and it's also listed among the other informational and non-silly (for the most part) posts on my sidebar. The material was taken from the excellent book, The New Sjogren's Syndrome Handbook edited by Steven Carsons, MD, and Elaine K. Harris.

The diminished capacity of special glands to produce saliva has potential for major issues for overall health, as demonstrated by the information in this chart:

Image found here

As you can see above, saliva affects many functions of the body, including the ability to taste. The sense of taste, so vitally important when facing a slab or chocolate cake or a tall cool mango margarita, is facilitated by saliva components water and a zinc protein called gustin, along with normally functioning taste buds. 

A great discussion regarding saliva and taste was featured in this month's Moisture Seeker newsletter entitled The "Best Of" published by the Sjogren's Syndrome Foundation. (It's easy to become a SSF member. Their website has a plethora of really good resources, facilitates valuable autoimmune research, and you can conveniently join online). Here's the taste and saliva question from among the many excellent questions and answers included in this amazing issue and it's response by Phillip C. Fox, DDS:

Q: Without saliva, almost everything I eat tastes bland. Is there a way I can regain some of my sense of taste so that I can enjoy food the way I used to before I got Sjogren's? 

A: Research has shown that Sjogren's syndrome patients have an increased incidence of taste disorders - both diminished taste (hypogeusia), loss of taste (ageusia), and altered or abnormal taste (dysgeusia). A great deal of the problem comes from a deficient of saliva. Flavors in food need to be in solution to be fully tasted; that is one of the important functions of saliva. Saliva also helps protect the mucous and oral structures, including the taste buds. Finally, saliva helps carry food and flavors across the tongue and the taste buds where it can be tasted. Without adequate saliva, there are many ways that taste can suffer. 

A full evaluation is recommended since it has been reported that taste may also be affected by medications and by a number of medical conditions. Clinical examination and diagnostic procedures may identify other potential causes for taste complaints such as nasal polyps, viral infection, oral candidiasis, neoplasia, malnutrition, metabolic disturbances, or chemical and physical trauma. Also, complaints of taste loss need to be differentiated from alterations in flavor perception, which is primarily related to your sense of smell.

There is no specific treatment for the taste disorders found in Sjogren's syndrome. However, using liquids to wet the food in your mouth may help increase the taste. You can also try increasing the seasoning on foods and see if it improves the taste. However, be careful not to use excessive amounts of sugar or salt which can have negative health consequences. Since a reduction in salivary flow may concentrate electrolytes in the saliva, resulting in a salty or metallic taste, drinking plenty of fluids while eating may help reduce dysgeusia.

Although it is controversial, some authors recommend zinc supplements in cases of taste problems. Using an over-the-counter preparation like Z-BEC, one tablet per day, will assure that you are receiving adequate amounts of zinc.  

Want to read more from the "BEST OF" issue of the Moisture Seekers? Become a Sjogren's Syndrome Foundation member! Each issue is available online to all registered members.

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