title: Electrical stimulation of salivary flow in patients with Sjögren's syndrome.
abstract: Patients with the salivary component of Sjögren's syndrome (SS) develop chronic xerostomia, which causes oral symptoms and functional impairment in approximate proportion to its severity. The purpose of this double-blind study was to determine whether an electrical stimulus applied to the tongue and hard palate by a battery-operated device (SAL II, Biosonics, Inc.) could stimulate salivary flow in subjects with generally severe SS. Twenty-nine patients with the salivary component of SS (diagnosed as the presence of focal chronic sialadenitis in a labial salivary gland biopsy specimen with a focus score of greater than 1 focus/4 mm2) were randomly assigned active or placebo devices, which they used for three minutes, three times a day for four weeks. Whole saliva flow rates were measured at weeks 0, 2, and 4 by collection of whole saliva both before and after stimulation with the device. Twenty-four subjects completed the study. The change in mean post-stimulation flow rate from week 0 to week 4 was greater for the 13 subjects using an active device (0.08 +/- S.D. 0.08 g/2 min, to 0.24 +/- 0.33 g/2 min) than for the 11 subjects using a placebo device (0.11 +/- 0.15 g/2 min, to 0.08 +/- 0.18 g/2 min) (p = 0.04). However, the magnitude of the mean difference was small, because three subjects using active devices responded and others did not. Only five subjects, all using active devices, reported a subjective increase in the amount of their saliva. The results of this study indicate that some SS patients with residual salivary flow show a significant response to electrical stimulation, but others with low or absent whole saliva flow rates do not respond.
authors.affiliation: Department of Stomatology, School of Dentistry, University of California, San Francisco 94143-0512.
authors.forename: M
authors.initials: M
authors.lastname: Steller
authors.forename: L
authors.initials: L
authors.lastname: Chou
authors.forename: T E
authors.initials: TE
authors.lastname: Daniels
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011897:Random Allocation; D012472:Salivation; D012636:Secretory Rate; D012859:Sjogren's Syndrome / Q000503:physiopathology / Q000628:therapy*