Treatment of Oral Dryness in Sjögren Syndrome with Moderate Salivary Gland Dysfunction
In Sjögren syndrome, the management of oral dryness is stratified according to residual salivary gland function. The approach appropriate for moderate dysfunction differs from that used in mild or severe presentations, and targeting the right intervention for this specific level of dysfunction is clinically important.
Sjögren syndrome with oral dryness and moderate salivary gland dysfunction, characterised by an unstimulated whole salivary flow of less than 0.1 mL/min and a stimulated whole salivary flow of 0.1–0.7 mL/min.
For moderate salivary gland dysfunction, evidence supports pharmacological stimulation of residual glandular activity using a muscarinic agonist — a step beyond the non-pharmacological measures reserved for mild dysfunction. The specific agent selection and how treatment is initiated are detailed in the full protocol.
DOI: 10.1136/annrheumdis-2019-216114
- In patients with moderate glandular dysfunction, pharmacological stimulation with muscarinic agonists may be considered.
- The preferred first therapeutic approach for oral dryness according to salivary gland function may be: Non-pharmacological stimulation for mild dysfunction; pharmacological stimulation for moderate dysfunction; saliva substitution for severe dysfunction.