Methods: pSS patients seen in the Oral Medicine Clinic at TUSDM were retrospectively studied. The pSS patients were divided into two groups based on self-documented history of GERD (pSS-GERD and pSS-control). Whole unstimulated salivary flow (USF) and stimulated salivary flow (SSF) were previously measured. TSL was evaluated using a modified erosive tooth wear examination.
Results: pSS-GERD patients (n=31; mean age 59.3; 94.1% female; 82.4% Caucasian) had mean USF=0.08627ml/min, mean SSF=0.9133ml/min and 58.1% demonstrated TSL. pSS-control patients (n=34; mean age 56.65; 96.8% female, 83.9% Caucasian) had a mean USF=0.01951ml/min, mean SSF=0.6324ml/min and 41.2% demonstrated TSL . Using the Mann-Whitney U test, it was determined that the USF (p=0.04), SSF (p=0.045), and TSL (p=0.014) were significantly higher in pSS-GERD group.
Conclusions: This retrospective study demonstrated that pSS-GERD patients had significantly more unstimulated salivary flow and stimulated salivary flow than pSS-control. Additionally, pSS-GERD patients showed significantly higher amounts of TSL by acid erosion than pSS-control patients. Although pSS-GERD patients have higher salivary flow, the amount of saliva may have been insufficient to protect the teeth from TSL by erosion. Our findings may suggest that the cause of excessive gastric refluxate could also be affecting the salivary gland function through possibly a common neural stimulus. Another possibility is that GERD medications may be affecting salivary flow. Future studies are needed to understand the systemic symptoms of pSS and their effect on salivary function and TSL.