Answers to Questions on Sjögren’s Syndrome

Dentistry Today

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Sjögren’s syndrome is an autoimmune disease; other common autoimmune disorders are Lupus and rheumatoid arthritis. With Lupus the body attacks the kidneys, while with rheumatoid arthritis the body attacks the joints. With Sjögren’s syndrome the body attacks the salivary and lacrimal (tear) glands, causing reduced saliva and tear production. With reduced salivary flow, oral health problems may occur, but are preventable with treatment. There is no clear cause of Sjögren’s syndrome, but it has been linked to a virus such as that which causes Epstein-Barr syndrome. Sjögren’s syndrom is usually diagnosed in post-menopausal women at a ratio of 9:1 women to men, and affects an estimated 2.4 million people in the United States, second only to rheumatoid arthritis. Currently, there is no cure for the disease, and treatment is palliative; antifungals, lozenges, fluoride varnish and self-applied fluoride in trays, artificial saliva, and lubricants for night dryness. There are prescriptions to increase salivary flow, such as Pilocarpine or Cevimeline, and chewing sugar-free gum can also help. Decay in Sjögren’s patients may occur on incisal cusp tips and at the root surface. It’s thought that the lack of saliva may reduce remineralization activity due to a more constant low oral pH. Other parts of the body that may be affected are tear production (causing dry, itchy eyes), the thyroid, kidneys, and skin. A reduced salivary flow will be noted in patients when your mirror sticks to the oral mucosa or the cheek, or when there is no pooling of saliva in the floor of the mouth. Patients may report having difficulty swallowing crackers and a burning sensation in the oral cavity. High decay rates may also indicate a low salivary flow in adults. A 5-year research study is currently being done in the US and 5 other countries to identify the cause. 

(Source: Dimensions of Dental Hygiene, November 2007)