Evaluation of Xerostomia and salivary flow rate in Hashimoto’s Thyroiditis

Abstract

BackgroundOne of the most common causes of hypothyroidism is Hashimoto´s Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren´s syndrome.Material and MethodsHT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute.ResultsXerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant.ConclusionsThe patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions. Key words:Thyroid, salivary gland, xerostomia.

Muscarinic cholinergic receptors in minor salivary gland tissues of patients with oral lichen planus: A case‐control study

“…In order to rule out the aforementioned conditions that can cause xerostomia, patients were subjected to blood test for CBC, sFe, ferritin, zinc, B12, folic acid, TSH, T3, T4, FBS, HCV Ab, and HBs Ag. Sjogren’s syndrome was ruled out using the criteria set by the American College of Rheumatology in 2012 16,17 . (According to these criteria, Sjogren's syndrome can be ruled out if the keratoconjunctivitis sicca and the serology test are negative.)…”

“…The sum of scores was calculated to determine the severity of xerostomia for each patient (xerostomia inventory). The total score of xerostomia inventory could range from 11 (11 × 1) to 55 (11 × 5) 16,18,19 . After obtaining written informed consent, biopsy of the minor salivary glands was performed and stimulated and unstimulated saliva samples were collected.…”

“…While at rest, the patients were first asked to swallow their saliva, bend their head forward, and then spit into sterile graded plastic vials with eyes open and with minimal movement of the head/body. For collection of stimulated saliva samples, the patients were asked to chew equal pieces of mastic gum for 1 minute (around 45 masticatory cycles per 1 minute) and then spit out the gum, swallow their saliva, and spit into a vial 14,16 . The saliva samples were then centrifuged at 2000 rpm for 20 minutes.…”

Subklinik Hipotiroiditli Çocuklarda Ağız Sağlığı Durumunun Değerlendirilmesi

“…Subklinik hipotiroidi genellikle asemptomatik olmasına rağmen, hastaların bazılarında cilt kuruluğu, halsizlik, soğuk intoleransı, uyku ve hafıza bozukluğu, kilo alımı, ses kalınlaşması, gözlerde şişlik ve kas krampları gibi hipotiroid belirtileri gözlenebilmektedir 3,9-11 . Hipotiroiditli hastalarda ağız bulgularının değerlendirildiği sınırlı sayıdaki çalışmalarda tükürük fonksiyonlarının etkilendiği, diş çürüğü ve periodontal hastalıkların görülme sıklığının arttığı ve liken plenus lezyonları görüldüğü rapor edilmiştir [12][13][14][15][16] . Yapılan literatür araştırmasında, hipotiroiditli hastaların ağız sağlığının değerlendirilmesi ile ilgili az sayıda çalışma olduğu ve bu çalışmaların çoğunlukla yetişkin bireyler üzerinde gerçekleştirildiği görülmektedir [12][13][14]16…”

Xerostomia: reasons and methods of correction

“…Симптомы сухого рта подробно описаны при сахарном диабете первого и второго типов, при тире-оидите Хаши мото [31][32][33]. Кроме того, доказано частое присутствие данного синдрома у пациентов с хроническим панкреатитом, что обусловлено существующей связью функции слюнных желез с функ циями желез внутренней секреции [34].…”