Sjögren’s Syndrome Teeth Treatment Virginia Ursula Klostermyer, DDS PhD
Sjögren’s Syndrome (SS) was discovered by Henrik Sjögren (1899–1986), an ophthalmologist in Sweden, and was published in 1930 as a chronic inflammatory autoimmune disease, which destroys the white blood cells and the moisture-producing glands. As a result, patients suffer from chronic fatigue, cognitive impairment, chronic pain, and other discomforts which can eventually lead to disability.
Long-term Sjögren’s Syndrome effects organs and the body
Sjögren’s Syndrome attacks the exocrine glands. This is expressed in reduced function of the salivary (saliva producing) and the lacrimal (tear producing) glands. Patient experience a severe dry mouth (Xerostomia) and suffer from dry eyes (keratoconjunctivitis sicca). Over time, the moisture-producing glands will be so severely damaged that they are destroyed by the chronic inflammatory process.
Not only are all the glands of the body impacted by Sjögren’s Syndrome, but other organs may be influenced over time. These include kidneys, lungs, liver, pancreas, muscles (myositis), blood vessels, the biliary system and the peripheral nervous system will express symptoms of the disease.
Sjögren’s Syndrome and chronic pain
Patients with SS suffer from chronic pain, fatigue, and diminished cognitive abilities. Some patients may experience a chronic, gastritis with Gastroesophageal Reflux Disease (GERD). Most patients experience a severe dryness of the mouth. This will rapidly result in tooth decay. A healthy patient produces saliva after a meal. This rinses the teeth and buffers the oral pH back to neutral levels. With, SS the lack of saliva keeps the oral pH levels low. This in combination with gastric acids entering the mouth via GERD, tooth enamel is degraded. A thick, sticky plaque film will cover the teeth allowing bacteria to colonize and reduce pH levels. This acidic environment demineralizes the hard enamel outer layer of the tooth making it prone to cavity formation.
Oral hygiene maintenance is very important for SS patients
It is crucial that SS patients maintain a high standard of oral hygiene. This should be complemented with daily fluoride treatment. Fluoride rinses, prescription fluoride toothpaste, and saliva stimulating measures are recommended. After each meal, SS patients should rinse their mouth with water to dilute bacterial populations and buffer the pH level. Patients can try to stimulate saliva flow with sugar-free chewing gum or sugar-free saliva producing lozenges.
Teeth with signs of decay should be restored immediately, as the decay process in SS patients progresses rapidly. To achieve this, SS patients should visit their dentist frequently for cleaning and checkups.