376 Unstimulated Salivary Flow is Decreased in Burning Mouth Patients

Thursday, March 22, 2012: 2 p.m. - 3:15 p.m.
Presentation Type: Poster Session
R. POON, University of Toronto, Toronto, ON, Canada, N. SU, Norman Bethune College of Medicine, Jilin University, Changchun, China, V. CHING, York University, Toronto, ON, Canada, M. KHAOULI, Athabasca University, Athabasca, AB, Canada, M. DARLING, Dept. of Pathology, Division of Oral Pathology, University of Western Ontario, London, ON, Canada, and M. GRUSHKA, University of Florida, Toronto, ON, Canada
Objectives: To investigate the salivary flow in burning mouth syndrome(BMS)patients,Sjogren’s Syndrome(SS)patients and control subjects.

Methods: A retrospective study was conducted by reviewing charts of all patients who presented to an Oral Medicine&Orofacial Pain clinic between 2009 and 2010. Patients who reported burning mouth pain or dry mouth were asked to expectorate at rest for five minutes into a graduated cylinder for collection of unstimulated and stimulated salivary flow. Fifteen patients presenting with jaw issues(ie.temporomandibular joint disorder) had salivary flows collected for control data. Data were analyzed with ANOVA,Tukey,and Levene’s tests for significance(p≥0.05).ANOVAs were done both unadjusted and adjusted for age since control subjects were younger than BMS and SS patients.  

Results: Mean age of BMS subjects was 60.9±12.6;of control subjects was 49.3±9.5;and of SS patients was 53.8±13.1. Forty-five patients(93.33 % women)with BMS, 12 patients with SS(100% female)and 15 control subjects(100% female)had unstimulated and stimulated salivary flow measured.In a comparison of groups(p<.001age unadjusted and adjusted)unstimulated flow was significantly higher in BMS than in SS and significantly lower in BMS than in control subjects(p<.05).Stimulated saliva flow was not significantly different in BMS subjects than control subjects and flow was significantly higher in the BMS than in the SS patients(p<.05).Salivary uptake scans,which were done for those BMS patients with the lowest unstimulated salivary flows,were reported as normal.  

Conclusions: Unstimulated flow in BMS was significantly higher than in SS but significantly lower than in control subjects.In view of the normal salivary uptake scans suggesting no salivary tissue damage in BMS subjects,these results suggest the possibility of autonomic dysregulation in BMS including a change in sympathetic or parasympathetic tone.This possibility may explain other symptoms frequently reported in BMS,including decreased pain with rest and increased pain and with stress.

Keywords: Autonomic dysregulation, Oral medicine, Saliva and Salivary dysfunction
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