Xerostomia and Salivary Gland Hypofunction in Patients with Oral Lichen Planus Before and After Treatment with Topical Corticosteroids

Abstract

Background:Oral lichen planus and mouth dryness are common pathoses, yet not entirely understood. These two conditions may be associated, with a few studies investigating the relationship between mouth dryness and oral lichen planus providing conflicting results. None of the studies have explored the specific impact of disease treatment on mouth dryness.Objective:The purpose of this observational before and after comparison study was to examine the effect of treatment of oral lichen planus with topical corticosteroids on mouth dryness.Methods:Nineteen subjects with oral lichen planus were evaluated for the severity of xerostomia using a xerostomia inventory and a visual analogue scale. Stimulated and unstimulated whole salivary flow rates, unstimulated salivary pH and buffering capacity were also measured. All subjects were evaluated before and after treatment with topical corticosteroids.Results:All subjects reported xerostomia before treatment with topical corticosteroids, with 79% reporting a significant improvement (P = 0.03) after treatment. Topical corticosteroid treatment was not associated with statistically significant differences in stimulated or unstimulated salivary flow rates, unstimulated salivary pH or buffering capacity.Conclusion:The results of this study suggest that treatment of oral lichen planus with topical corticosteroids may decrease the severity of dry mouth symptoms.

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

“…The unstimulated and stimulated saliva flow rates were significantly lower in OLP patients compared with controls, and the severity of xerostomia was significantly higher in OLP patients compared with controls. These findings, in line with the results of some previous studies, highlighted the presence of xerostomia and decreased salivary flow rate in OLP patients 5,8,21,22 . A previous study showed that altered composition of saliva (Mucin 5b) in OLP patients may lead to xerostomia 5 …”

Comment on “Xerostomia and Salivary Gland Hypofunction in Patients with Oral Lichen Planus Before and After Treatment with Topical Corticosteroids”

“…The recently published research article “Xerostomia and Salivary Gland Hypofunction in Patients with Oral Lichen Planus Before and After Treatment with Topical Corticosteroids” by Hala Al-Janaby, et al . [ 1 ] was studied with great interest. The article concluded that treatment with topical corticosteroids in patients with oral lichen planus could result in improving the symptoms of xerostomia.…”

“…Salivary gland dysfunction: objective evidence of alterations (qualitative and/or quantitative) in saliva output. Dysfunction may include a decrease (hypofunction) or an increase (hyperfunction) of the saliva output (Mahvash Navazesh 2017) are commonly observed in patients with oral lichen planus [ 1 ], the results of the above study could significantly impact the management and treatment of those patients.With respect to the results presented in the article, the followings are of concern:…”

“…This approach has not been adopted for most of the participants in the study. It should also be mentioned that some patients could develop symptoms of lichenoid reactions (LR) instead, and therefore, the results of the study could not be applicable to OLP, especially when considering the completely different etiopathogenesis of lichenoid reactions [ 1 ].…”

“…If the reduced salivary flow rate and development of xerostomia are associated with the medications that participants were taking, which is very likely, the results of the study could not be directly associated with the treatment of OLP and its effects on the salivary flow rate and xerostomia. It is even possible that by excluding participants who had taken medications to reduce salivary flow rate, the flow rate after treatment with TC in OLP patients varies much, as the factor that causes mouth dryness was present before and after treatment [ 1 ].…”