Sialometry and sialochemistry: diagnostic tools for Sjogren's syndrome

Background-The common occurrence of xerostomia in Sjogren's syndrome (SS) a s well as the easy accessibility of saliva supports the use of sialometry a nd sialochemistry in the diagnosis of SS. Collection and analysis of whole saliva (oral fluid) is currently the routine technique for sialometry, desp ite the fact that it is rather inaccurate and impure. Objective-To assess the value of glandular sialometry and sialochemistry as diagnostic instruments in SS. Methods-In a group of 100 consecutive patients referred for diagnosis of SS , glandular secretory flow rates and a spectrum of salivary components (sod ium, potassium, chloride, calcium, phosphate, urea, amylase, total protein) were assessed. The patients were classified as positive or negative for SS according to the revised European classification criteria. Results-Patients with SS differed clearly from those who tested negative fo r SS, showing lower submandibular/sublingual (SM/SL) flow rates and an appr eciably changed salivary composition of parotid and SM/SL saliva. Besides c hanges in salivary flow rate and composition, distinct sialometric profiles were observed, characteristic of either early or late salivary manifestati on of SS, or of the xerogenic side effects of medication. Conclusions-Glandular sialometry and sialochemistry are not only useful too ls for differentiating SS from other salivary gland disease in clinical pra ctice, but they also have great potential as diagnostic criteria for SS, sh owing distinct sialometric and sialochemical changes as well as profiles. B eing simple, safe (non-invasive), and sensitive (early disease detection), they have three major advantages over other oral tests for SS.