Today we’re going to learn about Sjogren’s syndrome oral health and steps you can take to protect your teeth and gums. But before we delve into the matter, let’s talk about Sjogren’s Syndrome.
Introduction to Sjögren’s Syndrome
Sjögren’s syndrome is an autoimmune disorder that affects the body’s moisture-producing glands like the salivary and tear glands. This causes symptoms of dry eyes and dry mouth and can negatively affect your oral health. Sjögren’s syndrome mostly affects middle-aged women, with 9 out of 10 Sjögren’s patients being female. The condition can occur at any age though, including childhood.
Sjögren’s syndrome is considered a systemic disease because it can affect organs and body systems beyond the eyes and mouth. However, the hallmark symptoms remain dry eyes and dry mouth due to impaired gland function. According to a 2014 study, the prevalence of primary Sjögren’s syndrome ranges from 0.01 to 0.72% of the population).
How Sjögren’s Syndrome Affects Saliva Production
Sjögren’s syndrome is an autoimmune disease that attacks the body’s exocrine glands, including the salivary glands. This leads to significant reductions in saliva and tear production. The hallmark symptom of Sjögren’s is dry mouth, also known as xerostomia. With Sjögren’s, the salivary glands become inflamed and damaged, impairing their ability to produce saliva. This results in chronic feelings of dry mouth.
Saliva plays a critical protective role in oral health. Having minimal saliva in the mouth due to Sjögren’s syndrome can allow bacteria to grow, leading to increased risk of tooth decay and fungal infections. Lack of saliva also makes chewing and swallowing food more difficult. According to the National Institutes of Health, nearly all patients with primary Sjögren’s syndrome report symptoms of dry mouth.
Without adequate saliva to lubricate and rinse the teeth and gums, Sjögren’s patients face heightened risk of cavities, gum disease, mouth sores, and other dental problems. Ensuring proper oral hygiene is especially important for Sjögren’s patients due to reduced saliva production.
Dry Mouth and Sjogren’s Syndrome Oral Health Complications
Sjögren’s syndrome dramatically reduces saliva production, resulting in a chronic dry mouth condition known as xerostomia. Saliva is critical for oral health, and without adequate saliva flow, Sjögren’s patients experience uncomfortable dry mouth symptoms and an increased risk of dental problems.
Common dry mouth symptoms caused by Sjögren’s syndrome include:
- Chapped or cracked lips
- Burning or tingling sensation in the mouth
- Difficulty chewing, speaking, and swallowing
- Dry, sticky, or burning tongue
- Mouth sores or infections
- Bad breath
With decreased saliva production, Sjögren’s patients are also at higher risk for complications like gum disease, tooth decay, and oral fungal infections. Dry mouth creates an environment favorable to bacteria growth, acid damage, and irritation.
Specifically, Sjögren’s patients may experience:
- Increased dental cavities due to lack of saliva’s buffering capacity and remineralization properties
- Gingivitis and periodontitis as saliva is not present to wash away plaque and acids
- Oral thrush or candidiasis fungal infections in the mouth
Left untreated, dry mouth can seriously impact oral health over time. That’s why managing symptoms and dental care are so important for Sjögren’s patients.
Other Sjogren’s Syndrome Oral Health Problems
In addition to dry mouth, Sjögren’s syndrome can lead to several other oral health issues including:
Tooth decay – With less saliva to wash away food and neutralize acids, cavities can develop more frequently (https://pearlypros.com/category/cosmetic-dentistry/oral-health-tips/).
Gum disease/infections – Dry mouth allows bacteria to grow, increasing risk of gingivitis, periodontitis and other infections (https://m.facebook.com/kabanidental/posts/4169354456419345/).
Fungal infections – Candida fungus thrives in the dry mouth environment.
Mouth sores – Lack of protective saliva causes sensitive tissue in mouth to crack and ulcerate.
Loss of taste – Saliva helps stimulate taste buds. Reduced saliva flow can diminish the sense of taste.
Importance of Saliva for Oral Health
Saliva is critical for maintaining good oral health. It serves several key functions:
Lubricates and Protects Tissues – Saliva acts as a lubricant for the mucous membranes in the mouth and throat. This helps protect against friction that can cause irritation or damage. The lubricating properties of saliva also keep the mouth comfortable and aid in functions like talking and swallowing.
Neutralizes Acids – Saliva contains minerals like calcium and phosphate that help neutralize acids in the mouth. Acids are produced when plaque bacteria metabolize sugars and attack tooth enamel. Saliva helps restore a neutral pH balance to prevent acid erosion of enamel.
Contains Minerals That Strengthen Enamel – Saliva provides a constant source of calcium, phosphate, and fluoride ions that are essential for re-mineralizing and strengthening tooth enamel. Minerals in saliva help protect teeth from bacterial acids and also aid in repairing early tooth decay.
With reduced saliva production, these protective factors are diminished. This puts Sjögren’s patients at a much higher risk of gum disease, tooth decay, and other problems.
Managing Dry Mouth
There are several methods Sjögren’s syndrome patients can use to help manage dry mouth symptoms and increase comfort:
- Sipping cool water – Keeping hydrated by frequently sipping cool water can help provide relief and moisture.
- Saliva substitutes – Artificial saliva sprays or gels can serve as saliva substitutes to coat and lubricate the mouth. Some examples are Biotene, Oasis, and Xerolube.
- Alcohol-free mouth rinses – Swishing with alcohol-free oral rinses without irritating ingredients can help moisten the mouth. Some options are Biotene, ACT Total Care, and Crest Pro-Health rinses.
- Chewing gum – Chewing sugar-free gum stimulates saliva production and can help keep the mouth moist. Look for brands containing xylitol.
- Moisturizing sprays and gels – Moisturizing oral sprays and gels provide quick, temporary relief. Products like Mouth Kote and Oasis moisturizing gels can coat and hydrate the mouth.
Patients should work with their dentist to determine the best dry mouth remedies based on their symptoms. Using a combination of methods throughout the day provides the most effective relief.
Source: https://sjogrens.org/sites/default/files/inline-files/Sjogrens-DryMouth.pdf
Daily Sjogren’s Syndrome Oral Health Recommendations
Maintaining good oral hygiene is essential for Sjögren’s patients to prevent cavities, gum disease, and other dental problems. Here are some tips for keeping your mouth healthy on a daily basis:
Brush gently with a soft-bristled toothbrush. Use gentle, circular motions when brushing and avoid scrubbing aggressively on your teeth and gums. This helps prevent abrasions or irritation of the soft tissues.
Use a fluoride toothpaste. Fluoride helps strengthen enamel and prevent cavities, which is very important for those with dry mouth. If your mouth is very dry, look for toothpastes specially formulated for dry mouth.
Floss once daily. Flossing removes plaque and food particles between teeth that brushing misses. Be very gentle when flossing if you have inflamed gums.
Ask your dentist about fluoride treatments. In-office fluoride treatments or prescription high-concentration fluoride gels can help protect your teeth by strengthening weakened enamel.
Don’t forget to brush your tongue to help freshen breath. End each day with a thorough brushing and flossing to keep your mouth clean while sleeping.
Seeing the Dentist Regularly
It is critical for Sjögren’s patients to see their dentist regularly, every 6 months, so they can monitor symptoms and get preventive treatments.
During dental checkups, patients should discuss any dry mouth symptoms, cavities, tooth sensitivity, gum recession, and other issues with their dentist. Getting exams twice a year allows dentists to track changes in oral health over time.
The dentist may recommend more frequent cleanings or fluoride treatments to help prevent cavities in Sjögren’s patients. They can also advise patients on proper brushing techniques for sensitive teeth and receding gums.
Other preventive dental treatments that may help Sjögren’s patients include dental sealants to protect teeth from decay and prescription strength fluoride toothpaste or varnish.
Finding a dentist experienced in treating Sjögren’s patients can provide specialized care and advice. Research local dentists to find one familiar with dry mouth management and preventive dental care.
With routine exams and treatments, Sjögren’s patients can minimize oral health issues despite reduced saliva. Seeing the dentist regularly is key to maintaining dental health.
Sjogrens Syndrome Oral Health Considerations
There are some special dental considerations for Sjögren’s syndrome patients to be aware of.
Toothpaste for Dry Mouth
Using a toothpaste made specifically for dry mouth can help Sjögren’s patients protect their teeth. These toothpastes are formulated to be extra gentle and to help stimulate saliva production. They also contain ingredients like xylitol and calcium to help strengthen tooth enamel and neutralize mouth acids.
Finding Support for Oral Health
Living with Sjögren’s syndrome and dealing with the oral health complications can feel overwhelming at times. However, there are excellent resources and support systems available to help you manage your oral health:
- Connect with national and local patient foundations like the Sjögren’s Syndrome Foundation (SSF). The SSF provides education, awareness, and support programs to empower patients. Joining local support groups can also help you connect with other patients facing similar challenges.
- Build a collaborative relationship with your dentist so you can work as a team to protect your oral health. Make sure to discuss all your symptoms openly and get specialized guidance for your unique needs.
- Ask your dentist to coordinate with your rheumatologist for a more integrated treatment approach.
- Consider getting a second opinion if you feel your oral health needs are not being adequately addressed.
- Stay on top of regular dental visits and cleanings every 6 months.
You don’t have to manage Sjögren’s oral health complications alone. By utilizing available resources and being your own advocate, you can maintain better dental and gum health.
Medical Disclaimer
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this article is for general information purposes only and does not replace a consultation with your own doctor/health professional
