What is Sjögren’s Syndrome?

Sjögren’s syndrome is characterized by the body’s immune system mistakenly attacking its own For more information or to schedule an exocrine glands, which include saliva and tear appointment, please contact us. glands. Although Sjögren’s occurs in all age groups and in both sexes, the average age of onset is in the late 40s, and 90% of those affected are female. UF Health Oral Medicine Clinic UF College of Dentistry Recently, children with Sjögren’s syndrome have Tel: 352-273-6741 been reported. Sjögren’s syndrome belongs to Fax: 352-294-8064 a family of autoimmune disorders that include rheumatoid arthritis. Rheumatology and Clinical Immunology UF College of Medicine Common Signs & Symptoms Tel: 352-273-5340 Oral Health Care for Fax: 352-392-8483 Symptoms vary from person to person but some Patients With of the most common symptoms of Sjögren’s are Pediatric Rheumatology Clinic dry eyes (keratoconjunctivitis sicca) and dry mouth College of Medicine Sjögren’s Syndrome (xerostomia). Tel: 352-294-5252 Fax: 352-294-8068 Sjögren’s affects saliva production in two ways: 1) Generally decreasing the amount of saliva your body produces and 2) Altering the proteins and components that are normally produced.

Symptoms may include but are not limited to: u A dry, gritty, or burning sensation in the eyes u Difficulty talking, chewing, or swallowing u A sore or cracked tongue Information provided by u A dry or burning throat Center for Orphaned Autoimmune Disorders u A change in the sense of taste or smell UF College of Dentistry Patient information from the u Increased dental decay ufhealth.org/COAD u Joint or muscle pain UF Health u Digestive problems More resources are available at the Oral Medicine Clinic u Dry nose or dry skin Sjögren’s Syndrome Foundation: u Fatigue sjogrens.org P.O. Box 100414 From one third to one half of patients may have Gainesville, Fl. 32610 diffuse, firm enlargement of the major salivary on (352) 273-6741 the cheeks or under the chin. If you experience this, consult your physician as this may indicate a serious condition, such as a lymphoma. Sjögren’s Syndrome Managing Signs & Symptoms

Tooth Decay or Dental Caries Oral Yeast Infections Many artificial tears are also available. It is important Because saliva has minerals that prevent cavities, Oral yeast infections appear as red or white patches to note that eyedrops without preservatives need to patients are at an increased risk for tooth decay due in the mouth or at corners of the mouth and may be used if you use it more than four times a day. to lowered saliva production. In order to prevent cause a burning sensation and altered taste. They tooth decay, one must maintain excellent oral appear at increased rates in patients with Sjögren’s Saliva and Tear Stimulation by Prescription Drugs hygiene and be monitored by a dentist. Adequate due to low level of saliva. Research shows that plain, The two drugs currently approved for use in the oral care, use of fluoride products and saliva sugar-free yogurt can prevent and even treat oral U.S. are cevimeline hydrochloride (Evoxac®) stimulants, as well as proper diet will aid in reducing yeast infections. Prescription anti-fungal mouth and pilocarpine hydrochloride (Salagen®). susceptibility to dental decay. rinses, lozenges, creams, and systemic medication Both medications are available in generic form. are also available through your dentist or physician Pilocarpine is a potent stimulator of exocrine Below is more information about products that can if necessary. secretion and has been indicated for this use for help manage Sjögren’s symptoms: over 80 years with proven effectivity. Cevimeline is a Dental Implants vs. Dentures newer drug used to treat Sjögren’s. This drug works Fluoride Products For some patients, conventional dentures similarly to pilocarpine with different dosages and Over-the-counter alcohol-free rinse containing can be intolerable for people with dry mouth. frequencies, depending on your physician/dentist neutral sodium fluoride can be used following your Conventional crown and bridge work may also be recommendations. Cevimeline and pilocarpine dentist’s instruction. Daily use of a prescription- more susceptible to decay due to decreased saliva. have some contraindications for its use. Therefore, based fluoride product, such as Prevident gel or Therefore, implant-retained dentures or other professional consultation with a physician or dentist Prevident 5000Plus toothpaste at bedtime following implant-supported dental prosthetics, or single- is necessary prior to taking either drug. brushing and flossing may be recommended. tooth implants may be a viable treatment option The use of these products for children requires a with your dentist’s recommendation. However, consultation with a dentist first. someone who is severely immune-suppressed or In general, Sjögren’s patients should: has a history of bisphosphonate therapy should u Remain well hydrated to help minimize Toothpastes use extreme caution. Bisphosphonate-related symptoms. Many OTC varieties containing fluoride are available. osteonecrosis (loss of bone cells) of the jaw after u Avoid liquids high in sugar and acid, like soft Patient should avoid using toothpastes with surgical procedures in the mouth is a growing drinks, because they speed up tooth decay. abrasivesas that can sometimes be too harsh for concern. u Avoid alcohol and caffeine; they can irritate routine use. the tissues of the mouth and promote Dry Mouth and Dry Eyes dehydration. Mouthwash/Mouthrinse u Try Sugar-free candies and chewing gum When choosing a mouthwash, it is important Saliva and Tear Substitutes which stimulate saliva production. Xylitol is a to avoid alcohol-containing rinses which can Many over-the-counter saliva or tear substitutes naturally occurring sweetener which does not sometimes irritate and dry the mouth. Biotene® are available. Saliva or tear substitutes are not long contribute to dental decay so candy or gums is an OTC antimicrobial alcohol-free mouthwash lasting and must be used frequently throughout with xylitol is recommended. that can also be used. A mouthrinse containing the day. Some common ones are: Biotene rinse and 0.12% chlorhexidine gluconate, such as Peridex® products, Oral Balance moisturizing gel and oral With adequate management and care, adverse or PerioGard®, can be prescribed to reduce harmful rinse, Mouth Kote dry mouth spray, Oasis mouth oral concerns related to Sjögren’s syndrome can bacteria for short term management of gingivitis or moisturizing spray, XyliMelts discs, and TheraBreath be minimized and a better overall quality of life aphthous ulcers. These should only be used under oral rinse. can be maintained. the care of a dentist for prescribed periods.