How Treating Sjögren’s Syndrome Can Improve Dry Mouth Symptoms

As an autoimmune disease that detracts from the body’s ability to produce moisture, Sjögren’s syndrome is one of the most common causes of dry mouth. There is currently no cure for Sjögren’s syndrome, but treatments such as oral electrostimulation via the SaliPen, saliva substitutes, and medications can help alleviate some of its symptoms. Often, when these treatments are successful, dry mouth becomes more manageable or completely disappears. 

Several studies are currently underway to achieve more effective treatment of Sjögren’s syndrome. In this blog post, we’ll take a deeper look at the condition, the current studies, and the available treatments designed to alleviate the primary symptom of Sjögren’s syndrome: dry mouth.  

What is Sjögren’s Syndrome?

Sjögren’s syndrome is an autoimmune disorder in which the body’s immune system attacks moisture-producing glands, leading mainly to dry eyes and dry mouth, the latter of which entails a slew of complications, such as burning throat, lips, and tongue, difficulty chewing and swallowing, and increased gum disease and oral infections. 

 

The exact cause of Sjögren’s syndrome is unknown, but medical researchers believe it involves a combination of genetic, environmental, and immune system factors. 

 

The National Center for Biotechnology Information (NCBI) estimates that Sjögren’s syndrome affects anywhere between .5% to 1% of the global population, which ranges between 400,000 and 3.1 million people. 

 

Symptoms typically appear in adults between the ages of 45 and 55, and about half of those diagnosed with Sjögren’s syndrome also have rheumatoid arthritis or other tissue diseases. New research also shows a strong connection between Sjögren’s syndrome and psoriasis, but the exact correlation is still unknown. 

 

There is currently no cure for Sjögren’s syndrome — treatment options today mainly focus on symptom relief. 

 

Current Sjögren’s Syndrome Studies

As there is no cure for Sjögren’s syndrome and its symptoms significantly detract from the quality of life of those who have it, international research is ongoing. Sjögren’s syndrome symptoms can be so debilitating that researchers found an increased risk of suicide attempts in those who suffer from the disease. 

 

For this reason, continued research is crucial. Currently, several promising studies show insight into the mechanism behind the disease and treatments. 

• Novel Cell Therapy

Dr. Sara McCoy, who specializes in caring for patients with Sjögren’s syndrome, has started an FDA-approved clinical trial in partnership with PACT, the University of Wisconsin’s Program for Advanced Cell Therapy. 

 

This experimental treatment method for Sjögren’s syndrome entails extracting cells from the patient’s bone marrow, activating them, and injecting them into the salivary glands. The goal is for the new cells to improve salivary gland function, thereby minimizing dry mouth symptoms. Participants will receive treatment and be monitored for two years. 

• Confirming the Efficacy of Medication Therapy

Evoxac (cevimeline hydrochloride) is an FDA-approved medication to treat dry mouth in people with Sjögren’s syndrome. It works by stimulating the salivary glands to produce more saliva, thereby alleviating the pain and discomfort of dry mouth. However, even though the drug received FDA approval, its effectiveness has been questionable, as study results have been inconsistent. 

 

However, a recent meta-analysis of three clinical trials has shown that Evoxac significantly improves salivary flow and eases symptoms of dry mouth in people with Sjögren’s syndrome. The researchers did note that its efficacy is based on different factors, including dosage, severity, and medical history. 

• Study Challenges Traditional Understanding of Sjögren’s Syndrome

 

A new study from Brazil shows that half of the women who have Sjögren’s syndrome also have bone erosion. This is the first large-scale observational study of its kind to assess joint and bone involvement in people with Sjögren’s syndrome. According to the researchers, the findings challenge the “traditional view of [Sjögren’s] as a non-erosive disease.”

• Case Study: The Successful Treatment of Two Autoimmune Diseases

In a first, doctors in India found that primary Sjögren’s syndrome and myasthenia gravis (MG) — both autoimmune diseases rarely reported as occurring together — were successfully treated with a rituximab-based induction regimen. 

 

Rituximab is a synthetic antibody typically used to treat certain types of cancer and autoimmune diseases such as rheumatoid arthritis, lupus, and more. Its success in alleviating the symptoms of MG and Sjögren’s syndrome shows promise, but the authors of the case study wrote that further research is needed to clinically evaluate the drug’s efficacy for the simultaneous treatment of two concurrent autoimmune diseases. 

• Closer to Understanding the Mechanism Behind Sjögren’s Syndrome

 

Researchers at NYU College of Dentistry and NYU Grossman School of Medicine found that 

impaired regulatory T cells may cause Sjögren’s disease in both mice and humans. They identified a defect in regulatory T cells and an overactivation of the cells that produced an inflammatory response called interferon gamma, the main cause of dysfunctioning salivary glands in mice. 

 

The researchers treated the mice with baricitinib, an existing rheumatology arthritis drug, and found that it suppressed salivary gland dysfunction and inflammation, marking it as a potential treatment for Sjögren’s syndrome. Further research in humans is necessary, but the current results are promising. 

 

Current Sjögren’s Syndrome Treatments

Current treatment approaches to Sjögren’s syndrome focus on symptom relief, which typically includes dry eyes, dry mouth, and joint pain. 

 

General Sjögren’s syndrome treatments include:

• DMARDs (disease-modifying anti-rheumatic drugs) such as hydroxychloroquine, which help regulate abnormal autoimmune responses.
• NSAIDS (nonsteroidal anti-inflammatory drugs), which reduce inflammation and come in prescription and OTC (over-the-counter) forms.  

 

For dry eyes, treatment options include:

• Prescription or OTC eye drops/artificial tears.
• A minor surgical procedure to seal the tear ducts that drain tears from the eyes, helping them retain moisture. In this procedure, collagen or silicone plugs are placed into the ducts to help preserve the tears.

For dry mouth, treatment options typically include:

• Electrostimulation: Electrostimulation via a device like the SaliPen delivers small electrical pulses to the oral cavity, stimulating the salivary glands to produce more saliva. 
• Prescription medication: Drugs such as pilocarpine and cevimeline can also stimulate the salivary glands to produce more saliva, but sometimes have adverse side effects. 
• Artificial saliva: Artificial saliva provides immediate and temporary relief for dry mouth, and comes in various forms such as sprays, gels, mouthwashes, lozenges, and more. 

 

Medical research supports the use of a “multi-modal therapy strategy” — i.e., concurrent multiple treatments — for the successful treatment of Sjögren’s syndrome symptoms.

 

FAQS

What are the main symptoms of Sjögren’s syndrome?

Dry mouth, dry eyes, and joint pain are the main symptoms of Sjögren’s syndrome. 

 

Is Sjögren’s syndrome the only disease that causes dry mouth?

No, several diseases are known to cause dry mouth, including diabetes and Alzheimer’s. Additional dry mouth causes include treatment for head and neck cancer, injury, anxiety, salivary stones, salivary gland inflammation, stroke, and breathing through the mouth (as opposed to nose). Dry mouth treatment is highly dependent on the cause of the condition. 

 

Is there a cure for Sjögren’s syndrome?

Not yet, but there are several treatment options that can relieve its painful symptoms, including NSAIDS, DMARDS, artificial tears, artificial saliva, and more. 

 

What dry mouth treatments are available?

Electrostimulation via the SaliPen, prescription medication, and saliva substitutes are all viable dry mouth treatments. In some cases, a combination of all three is the most effective. Speak to your healthcare provider to craft the most effective, personalized dry mouth treatment plan. 

 

Where can I purchase the SaliPen?

You can purchase the SaliPen here.