Salivation and Lacrimation Dependencies in Dryness Symptomatic and Asymptomatic Individuals

Objectives: Xerostomia is dryness in the mouth which may be associated with a change in the composition of saliva, or reduced salivary flow. Dry eye syndrome is a common disorder of a tear film caused by insufficient tears production or excessive evaporation. It may result from local or systemic diseases as well as from external factors. Both of the syndromes could be serious clinical problems causing patients complaints. Schirmer test is a commonly used ophthalmic diagnostic procedure in tearing (lacrimation) assessment and can be also used to assess salivation.
The study aimed to determine whether dry eye (not resulting from Sjögren's syndrome) is associated with concomitant xerostomia in patients with particular systemic diseases, if dry eye is associated with xerostomia in apparently healthy individuals and whether in asymptomatic patients insufficient tear production and hyposalivation can occur.
Methods: The study group consisted of 642 adults aged 18-82 years (405 females and 237 males). The patients’ assessment consisted of individual medical history (systemic disorders, medications, lifestyle), clinical examination and eye and mouth Schirmer test. The study group was divided with regards to the presence of systemic diseases and dryness symptoms.
Results: In the entire study group as well as in all subgroups the statistically significant linear correlation was observed between the results of the Schirmer test in eye and in mouth. This linear correlation was confirmed for apparently healthy individuals and for patients with systemic diseases. The Schirmer test results were decreasing with age and were lower in females.
Conclusions: Dry eye syndrome and concomitant xerostomia is not always associated with systemic disorders but also may occur in apparently healthy individuals. The lack of dry eye and dry mouth symptoms does not exclude insufficient tearing and salivation. Performing eye and mouth Schirmer test together could be the useful tool in the screening for systemic diseases.