| Description |
Xerosomia contributes to an increased caries rate, mucositis, candidiasis, decreased prosthesis retention, diminished gestation, difficulty with speech, and dysphagia. An extended duration of swallowing time, as a measure of swallowing dysfunction, has been associated with dry mouth in general and with Sjögren's syndrome specifically. No difference in swallowing duration was demonstrated in a study of healthy volunteers across a wide rage of salivary flow rates. This study further investigated the relationship between diminished salivary flow and swallow time. A sample of 123 patients with hyposalivation of four difference etiologies (Sjögren's syndrome, radiation, sicca, and idiopathic), plus 35 normal controls, was included in the study. Parotid flow rates and submandibular-sublingual flows rates for both stimulated and unstimulated saliva were measured and recorded. The duration of the oropharyngeal swallow was measured by ultrasound imaging from the initiation of the swallow to the completion of the movement of the hyoid from rest position to maximal anterior and superior position and back to rest for three consecutive dry swallows and for three wet swallows were used for statistical analysis. A correlation of little strength (r=.20 to -28), but differing from zero at a statistically significant level, was demonstrated between the salivary flow rate scores and the duration of the swallow times for the average of dry swallows (except the submandibular-sublingual flow score) and the average of we swallows. The duration of the oropharyngeal phase of the swallow differed significantly between each diagnostic group (Sjögren's syndrome, radiation, indiopathic, and sicca) and the normal controls for one to three of the three swallowing measurers used. Differences were demonstrated for all three swallowing measures for Sjögren's group. The duration of the oropharyngeal phase of the swallow differed significantly between the quartile of individuals with the lowest salivary flow scores and that with the highest for the first dry swallow and the average of the wet swallows (p<0.04). The relationship between salivary flow and swallowing function in a complex interaction not well understood. A more complete understanding of the role of salivary flow in dysphagia will promote the designing of interventions to diminish the impact on nutrition quality of life. |
