This project examines the function of the salivary glands and other oral tissues in individuals with alterations of normal oral function due to disease or therapeutic procedures. Major efforts have been directed at the evaluation of patients complaining of xerostomia (oral dryness). Entry into all studies is through Dry Mouth Clinic. Utilizing outpatient and impatient services, specific evaluative and diagnostic approaches have been developed to aid in establishing the extent and causes of salivary gland dysfunction in the """"""""dry mouth"""""""" patient. Criteria necessary for management decisions and new therapeutic options are being refined. Major patient groups studies include individuals with Sjogren's syndrome, an autoimmune exocrinopathy, and those with salivary hypofunction secondary to therapeutic irradiation to the head and neck region. Oral and secretory effects of a number of other systemic diseases also are evaluated. Recent treatment protocols have utilized the parasympathomimetic drug pilocarpine for salivary stimulation in the post-radiation group and steroid and non-steroidal anti-inflammatory drugs for Sjogren's syndrome patients. Clinical and laboratory studies focusing on the immunological basis of the salivary component of Sjogren's syndrome have advanced. An anti-salivary duct antibody present in serum and saliva of Sjogren's syndrome patients has been characterized. Attention has been given to the appearance of Sjogren's syndrome-like condition in a subset of HIV-1 seropositive persons. Studies show that there are distinct differences between the HIV-induced salivary gland disease and Sjogren's syndrome. In addition, our detailed studies of associated oral complaints in the salivary hypofunction group (taste, oral-pharyngeal swallow, and mucosal status) have progressed.
