The Effect of Chewing Gum, Exercises of the Tongue, Lip, Jaw on Salivation, Xerostomia, Dysphagia in Sjögren's Syndrome
Condition: Sjögren's Syndrome; Xerostomia; Dysphagia; Salivary Flow Rate
MeSH terms: Sjogren's Syndrome; Deglutition Disorders; Xerostomia; Syndrome
Study type: Interventional

Summary: 
      Sjögren's syndrome (SS) is a chronic, systemic and autoimmune disease characterized by
      inflammation, fibrosis and dysfunction of exocrine glands such as tear and salivary glands.
      SS is defined as primary SS when it progresses alone without any other rheumatic disease
      finding, while the definition of secondary SS is used in the presence of another accompanying
      autoimmune disease. One of the most disturbing symptoms of SS is hyposalivation, xerostomia
      and dysphagia due to hypofunction of salivary glands. While xerostomia is the patient's
      subjective perception of dry mouth, hyposalivation is also evaluated objectively by salivary
      flow rate measurement methods. Studies have reported that 0.9% to 64.8% of patients with SS
      experience xerostomia and 32% to 72% of them experience dysphagia. It was planned as a
      randomized controlled study to examine its effect on dysphagia.
    

Detailed description: 
      Sjögren's syndrome (SS) is a chronic, systemic and autoimmune disease characterized by
      inflammation, fibrosis, and dysfunction of exocrine glands such as tear and salivary glands.
      One of the most disturbing symptoms of SS is hyposalivation, xerostomia, and dysphagia due to
      the hypofunction of salivary glands. While xerostomia is the patient's subjective perception
      of dry mouth, hyposalivation is also evaluated objectively by salivary flow rate measurement
      methods (Pinto, 2021). Studies have reported that 0.9% to 64.8% of patients with SS
      experience xerostomia and 32% to 72% of them experience dysphagia (Orellana et al, 2016).

      With the reduction of saliva, patients may experience difficulties in tasting, chewing,
      swallowing, speaking, and using prosthesis in patients using prostheses (Pinto, 2021). All
      these negatively affect the quality of life in patients with SS and their treatment is of
      great importance (Milin et al, 2016; Pinto, 2021). The treatment of dry mouth in patients
      with SS consists of pharmacological and non-pharmacological stimulation of the salivary
      glands and the use of artificial saliva preparations (Ramos_casals et al, 2020).
      Pharmacological methods used in patients with SS have been shown to reduce dry mouth, but
      these methods are mostly recommended in severe cases (Ramos_casals et al, 2020; Depinoy et
      al, 2021). In cases where pharmacological methods are not used, non-pharmacological methods
      such as taste stimulation (lozenge) and mechanical stimulation (gum) are also recommended in
      the control of dry mouth (Ramos_casals et al., 2020). It is known that chewing gum increases
      saliva secretion in studies conducted for different patient groups. used in the treatment of
      xerostomia in patients with SS, but no study has been found examining the relationship
      between chewing gum and salivation, xerostomia, and dysphagia in patients with SS
      (Ramos_casals et al, 2020). In the literature review, no study was found in which the effects
      of the tongue, lip, and jaw exercises on salivation, xerostomia, and dysphagia were evaluated
      in any patient group. This study was planned to examine the effects of chewing gum and
      tongue, lip, and jaw exercises on salivation, xerostomia, and dysphagia in patients with SS.
    

Intervention name(s): Tongue, lip, chin exercise group
Intervention type(s): Behavioral
Intervention description(s): In order to evaluate the effect of chewing gum and tongue, lip and chin exercises on salivary flow rate, xerostomia and dysphagia, both intervention groups will work in a determined time frame daily.
Other intervention name(s): gum chewing group
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: experimental research
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Xerostomia,Hyposalivation,Mouth Dryness,Sjögren's syndrome