What is Sjögren’s syndrome?
Sjöngren’s syndrome is an autoimmune disorder that affects different parts of the body. This syndrome most often affects the lacrimal and salivary glands, causing dry mouth and eyes. It is a long-term illness that can affect daily life, but there are therapies available to help relieve symptoms.
It generally begins in adults between the ages of 40 and 60 and affects women more than men. The estimated worldwide prevalence is 61 per 100 000 people.
What causes Sjögren’s syndrome?
Sjögren’s syndrome causes a reduction in the production of tears and saliva because the glands that generate these fluids are damaged by inflammation. Sjögren’s syndrome is an autoimmune disease that has no recognized cause. However, genetic factors and perhaps viral infections can predispose people to this disease, according to some research.
Who is Most Likely to Develop Sjögren’s Syndrome?
- Age: Most patients with Sjögren’s syndrome are 40 or older. However, it can affect younger people, including children.
- Gender: Women are up to ten times more likely than males to have Sjögren’s syndrome.
- Presence of rheumatic disease: Sjögren’s syndrome is more common among those who have a rheumatic ailment, such as lupus or rheumatoid arthritis.
According to the Sjörgen foundation, symptoms can be different from person to person but may include:
- Neurological problems, concentration/memory-loss, headaches
- Dry eyes and infections
- A change in taste or smell
- Dry mouth, mouth sores, dental decay, difficulty with chewing, speech, taste, and dentures
- Swollen, painful parotid/salivary glands
- Difficulty swallowing, heartburn, reflux, esophagitis
- Recurrent bronchitis, interstitial lung disease, pneumonia
- Respiratory issues like shortness of breath, cough
- Abnormal liver function tests, chronic active autoimmune hepatitis
- Interstitial cystitis
- Dry nose, recurrent sinusitis, nosebleeds
- Irritable bowel, autoimmune gastrointestinal dysmotility
- Arthritis, joint/muscle pain
- Dry or peeling lips
- Peripheral neuropathy
- Vaginal Dryness
- Dry or burning throat
- Fatigue, vasculitis, lymphoma
- Inability to focus
- Skin sensitivity to UV light
How is Sjögren’s syndrome diagnosed?
The diagnosis is determined according to the symptoms, physical examination and blood tests, and sometimes specific studies.
Dry eyes and lips are the initial signs of the illness. Medical tests, on the other hand, are required to make a diagnosis. Some conditions or medicines might produce these symptoms.
Blood testing, eye tests, and oral tests are all used to diagnose Sjogren’s syndrome.
- Blood and urine tests: These tests look for the presence of antibodies common in Sjögren’s syndrome.
- Schirmer test: This test determines if the lacrimal glands are producing enough tears to keep the eyes moist.
- Ocular surface staining: This stain allows you to observe the eye surfaces for damage and dryness.
- Salivary gland function tests: Various tests are performed to examine the function of the glands that produce saliva. Lip biopsy is one of the studies included in this list.
- Sialometry: this study allows you to measure the flow of saliva.
- Ultrasound of the major salivary glands: This analysis reveals structural changes.
In patients with Sjogren’s syndrome, the gingiva and mucosa of the oral cavity are not protected due to decreased saliva, which leads to less lubrication of the tissues. This can cause signs such as inflammation of the oral mucosa, loosening of the mucosa, reddish mucosa, and the appearance of ulcers.
Additionally, in cases of advanced disease, patients may present with loss of papillae on the tongue.
On the other hand, patients wearing dentures may struggle to keep them in place and experience discomfort as a result of decreased saliva flow.
How is Sjögren’s syndrome treated?
Doctors, dentists, ophthalmologists, and other experts must establish a personalized treatment to attend to the various symptoms since Sjögren’s syndrome affects each patient differently. The treatment aims are to reduce symptoms, prevent disease complications (particularly in the eyes and mouth), and treat severe systemic manifestations.
Treatments to lessen symptoms include:
- Medications to stimulate the flow of saliva: Its effect is not prolonged, so several doses are required per day.
- Artificial saliva: helps to relieve dry mouth.
- Artificial tears: They can help lubricate the eyes.
- Antifungal medications: Fungus can appear in the oral cavity in some individuals with Sjogren’s syndrome. Therefore, these medicines can be prescribed to fight fungal infections.
- Non-steroidal anti-inflammatory medications (NSAIDs): are commonly used to treat mild musculoskeletal complaints as well as uncomfortable parotid edema in people with SS.
Individualized treatment is essential to manage the patient’s oral problems and prevent the oral disease that is prevalent in these patients.
Patients should consume water regularly to help lubricate the buccal tissues, improve saliva flow, and help equilibrate the oral pH to minimize the incidence of caries. Moreover, artificial saliva substitutes can help lubricate tissues and enhance oral comfort.
On the other hand, to help prevent cavities, the dentist should do regular checkups and apply fluoride.
Bayetto, K. and Logan, R. (2010), Sjögren’s syndrome: a review of aetiology, pathogenesis, diagnosis and management. Australian Dental Journal, 55: 39-47. https://onlinelibrary.wiley.com/doi/10.1111/j.1834-7819.2010.01197.x
Sjogren’s Syndrome. (2021). Retrieved 15 July 2021, from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Sjogrens-Syndrome
Understanding Sjögren’s. (2021). Retrieved 15 July 2021, from https://www.sjogrens.org/understanding-sjogrens
Sjögren’s syndrome – NHS. (2021). Retrieved 15 July 2021, from https://www.nhs.uk/conditions/sjogrens-syndrome/