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A Diminished Sense of Taste with Sjögren’s

Posted on Fri, Feb 08, 2019

Research has shown that Sjögren’s 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 deficiency 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 mucosa 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 also may 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 Sjögren’s. 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.

by Philip C. Fox, DDS

This article was first printed in The Moisture Seekers, SSF's patient newsletter for members. 

 

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Topics: Dry Mouth, Saliva, Thrush, Oral Candidiasis (Thrush), Sweling in the mouth, Loss of Taste

Sjogren's & The Importance of Saliva

Posted on Tue, Oct 28, 2014

Dryness from Sjögren’s may affect any organ in the body that secretes moisture, because the body’s immune system is mistakenly attacking its own moisture-producing glands. Almost every Sjögren’s patient experiences some degree of dry mouth, which is caused by a decrease in both the quantity and quality of saliva.

Saliva plays an immensely important role in the oral cavity, which is why proper dry mouth care and attention is critical for a person’s overall oral health. If dry mouth persists for months or years, the decreased salivation can lead to many oral complications such as severe and progressive tooth decay, oral infections (particularly fungal), difficulty swallowing, or a combinations of these. Dr. Rhodus explains more below about the importance of saliva:

Saliva

"A human being normally produces approximately 1.5 liters of saliva per day. There is a typical diurnal circadian rhythm in the production of that saliva with one peak in the mid-morning followed by a relative decrease until the second peak occurs around early evening.

Saliva flow normally is decreased at night. Saliva is produced by several glands: the submandibular glands (which lie bilaterally just under the posterior jaw) produce most of the quantity of saliva (45%) and it is a mixed fluid with both mucous (thick, stringy fluid) and water but containing most of the proteins; the paired parotid glands (which are in the mid-face just in front of the ears) produce primarily serous (or watery) fluid and accounts for about 35% of the total quantity; the sublingual glands (again in a pair just beneath the anterior tongue) are much smaller and contribute only about 10% of the total volume; and finally there are hundreds of small minor salivary glands in the lips, palate and throat which contribute a relatively small, but important portion of natural salivary flow.

The normal quantity of saliva naturally provides necessary oral lubrication and moisture to assure comfort and function for the individual, but saliva does much more than that. At least equally as important as this volume of saliva, if not more so, is the composition of saliva, which is rich in constituents which have potent digestive, coating, protective, antimicrobial, antiacid, lubricative and homeostatic properties. Saliva is much more than water. In fact, saliva contains approximately 60 important, protective constituents including: immunoglobulins,electrolytes, buffers, antimicrobial enzymes, digestive enzymes and many others, all of which make saliva an essential contributor to the health and homeostasis of the oral cavity. This is the reason that water or artificial salivas are a poor substitute; none of them have the rich composition of ones own natural saliva."

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This post is the introduction from "The Importance of Silvia" article written by Nelson L. Rhodus, DMD, MPH, FICD, that was first published in The Moisture Seekers, SSF's member newsletterSSF members can click here to read the full article on the members section of the website.

Topics: Sinuses, Sicca, Dry Mouth, Symptoms, Sjogren's, Saliva, Burning mouth

Top 10 Tips for Combating Gastroesophageal Reflux

Posted on Tue, Jun 17, 2014

describe the imageWhile the exact reasons are unknown, many patients with Sjögren’s suffer from gastroesophageal reflux disease (GERD). This can cause a wide variety of symptoms that can be mistaken for other conditions. Symptoms may include persistent heartburn and/or regurgitation of acid, stomach pain, hoarseness or voice change, throat pain, sore throat, difficulty swallowing, sensation of having a lump in the throat, frequent throat clearing and chronic cough (especially at night time or upon awakening).

Tips for combating gastroesophageal reflux in the throat:

1. Avoid lying flat during sleep. Elevate the head of your bed using blocks or by placing a styrofoam wedge under the mattress. Do not rely on pillows as these may only raise the head but not the esophagus.

2. Don’t gorge yourself at mealtime. Eat smaller more frequent meals and one large meal.

3. Avoid bedtime snacks and eat meals at least three-four hours before lying down.

4. Lose any excess weight.

5. Avoid spicy, acidic or fatty foods including citrus fruits or juices, tomato-based products, peppermint, chocolate, and alcohol.

6. Limit your intake of caffeine including coffee, tea and colas.

7. Stop smoking.

8. Don’t exercise within one-two hours after eating.

9. Promote saliva flow by chewing gum, sucking on lozenges or taking prescription medications
such as pilocarpine (Salagen®) and cevimeline (Evoxac®). This can help neutralize stomach acid and reduce symptoms. Check the SSF's Product Directory (free of charge to all SSF members) to see the products available.

10. Consult your doctor if you have heartburn or take antacids more than three times per week. A variety of OTC and prescription medications can help but should only be taken with medical supervision.

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The SSF thanks Soo Kim Abboud, MD for authoring this Reflux and Your Throat Patient Education Sheet. Dr. Abboud is an Assistant Professor with the Department of Otolaryngology, Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.

Topics: Dry Mouth, Symptoms, Sjogren's, Treatment, Top 5 Tips, Saliva, Gastroesophageal Reflux, Chronic Cough, Heartburn

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