Salivary Function, Symptoms, and Psychological Distress linked to Xerostomia Severity, finds study

A new study published in the Journal of Oral Rehabilitation showed that in patients with xerostomia alone, salivary gland function is the primary factor influencing xerostomia intensity. In patients with concurrent oral burning pain and/or dysesthesia, psychological distress and symptom severity are more important factors.

A common complaint, xerostomia is defined by a subjective feeling of dry mouth that is frequently linked to systemic disorders, drugs, age, and hypofunctioning salivary glands. Nevertheless, not every xerostomia patient has quantifiable decreases in salivary flow, indicating complex processes. A small percentage of people also have dysesthesia and/or burning pain in their mouths, which are symptoms that are similar to neuropathic diseases and burning mouth syndrome.

In these situations, in addition to glandular malfunction, altered sensory processing, psychological distress, and central pain modulation may be significant factors. Since diagnostic interpretation and treatment approaches may vary, it is clinically crucial to distinguish between xerostomia alone and xerostomia with accompanying sensory complaints. Thus, this study examined how the intensity of xerostomia is affected by mouth burning pain and/or dysesthesia.

396 individuals with dry mouth as their primary symptom were examined in this retrospective analysis. Patients were split into two groups: those with xerostomia only (n = 146), and those who also had dysesthesia and/or burning pain in their mouths (n = 250). Salivary flow rate measures, psychological assessments, Candida culture tests, and extensive questionnaires were used to gather data. To determine the variables associated with the severity of xerostomia, multiple linear regression analyses were employed.

The self-reported severity of xerostomia-related symptoms or behaviors did not vary significantly across the two groups. In patients with xerostomia alone, objective factors, like a greater degree of Candida colonization and a lower stimulated whole salivary flow rate, were mostly linked to the intensity of symptoms.

Salivary flow rates, on the other hand, showed a much weaker correlation with the severity of xerostomia in patients who also had concomitant oral burning pain and/or dysesthesia. The severity of xerostomia was most significantly correlated with the intensity of taste disturbances, oral pain, and psychological distress.

Overall, salivary gland function and symptom severity are highly correlated in those with isolated xerostomia. Yet, psychological variables and the severity of these concomitant symptoms have a bigger impact than salivary gland function alone when xerostomia coexists with mouth burning pain and/or dysesthesia.

Source:

Hwang, Y.-J., & Kho, H.-S. (2026). Xerostomia in patients with and without concomitant oral burning pain and/or dysesthesia. Journal of Oral Rehabilitation, joor.70168. https://doi.org/10.1111/joor.70168