Sjogren’s syndrome is an autoimmune disease- where the body’s cells that offer protection(immunity) attack body’s own cells, this affects several organs of the body producing wide range of symptoms. Early diagnosis and patient’s understanding of this ailment goes a long way in improving quality of life. It can affect multiple organs including the gut and the central nervous system. This disease is much more common in women.
Symptoms of Sjogren’s disease vary in severity, there is a triad of – dry eyes, dry mouth, fatigue and joint problems. Some patients present with brain fog, memory loss, headaches, vaginal dryness, gut disturbances like heart burn, irritable bowel, deranged liver function tests, skin rashes- photophobia.
Let’s break this up–
What are the oral symptoms of Sjogren’s syndrome? How does it affect oral health?
Sjogren’s syndrome patients typically complain of dry mouth- reduced salivary secretion- difficulty in speaking, swallowing, chewing, wearing of dentures, oral ulcers, dryness and cracking of lips. Some patients may also have loss of taste and smell.
Reduced saliva results in halitosis – Bad breath, increases the chances of tooth decay. Saliva is a natural lubricant in our mouth, it is a cleanser washing away food remnants, bacteria and also has several protective proteins which helps to protect the lining of the mouth. Reduced saliva also results in a disbalance of microbes in the mouth; favoring fungal overgrowth which often presents as a curd-like patch on the tongue or insides of the cheek- called as thrush.
How is Sjogren’s syndrome Diagnosed ?
Diagnosis of SS may be challenging as this conditions has a presentation in different individuals. Its symptoms overlap with presentation of menopause, and other conditions like Rheumatoid arthritis, lupus , fibromyalgia et al.
A complete history and verbalization of all symptoms to the dentist/physician/ophthalmologist will help in early diagnosis of this condition. A Rheumatologist- Specialist in auto immune disorder is likely to correctly diagnose and better manage the disease.
Tests
1)Blood tests to look for autoimmune markers – SSA (Ro), or SSB(La) or both.
2)Eye test– For tear production- Schirmer Test, Rose Bengal Dye test.
3)Salivary gland analysis– Amount of saliva produced can be assessed by Sialometry, Imaging of the salivary gland is done to see its architecture and anatomy- Sialography and Scintigraphy – (Injection of tracer dye followed by an Xray). A salivary gland biopsy is considered – usually from the lower lip to aid in diagnosis of this condition.
How can your dentist contribute to make you feel better?
Regular dental checkups go a long way in ensuring oral hygiene, and early detection of tooth decay. A dental decay caught at an early stage can prevent you from having a root canal or a tooth removal. The alternative treatment to these is conservative- protecting your natural enamel and tooth tissue, less expensive and also many patients are less anxious with these simple remedies.
Dentist Recommendations to manage symptoms of SS
1)Take regular sips of water to overcome mouth dryness. Keep a bottle of water always handy by your bedside at night and with you during day time.
2)Artificial saliva substitutes containing caboxymethy cellusose are available both as paste forms and also as oral sprays to wet mouth. Ask your dentist for these formulations.
3)White patches in the mouth- Thrush can be kept in abeyance by topical anti- fungal preparations.
4)Regular dental checkups, twice daily brushing and flossing help.
5)Do not change your tooth paste frequently, many tooth pastes cause dry mouth. Do not use alcohol-based mouth washes.
6)Avoid alcohol, smoking, carbonated drinks too much coffee or tea.
The diagnosis of any ailment often impacts our mental and needless to say our physical health. Educating oneself about the condition and putting that knowledge to good use will help one to cope with this condition. Consultation with rheumatologist, dentist and eye specialist will help deal with presentation of this condition.
As, Kofi Annan rightly said and I quote “Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family.” This disease may seem overwhelming on diagnosis; oral discomfort can be definitely and effectively managed with dentist help and home care tips.
Cheers;
Keep smiling Always
Dr Preeti L Anand MDS., PGCOI.