Oral and Dental Manifestations of Sjögren’s Syndrome: Current Approaches to Diagnostics and Therapy

Abstract

Saliva plays a detrimental role in oral health and disease. The quality and the quantity of saliva are determined by the glands it is secreted from, the sampling method, and whether secretion is stimulated or not (stimulated or resting saliva). Mucin-rich saliva lubricates the oral tissues, and lactoferrin, peroxidase, histatin, and a range of other substances provide anti-microbial, anti-viral, and anti-mycotic properties. Symptoms related to xerostomia as in Sjogren's syndrome (SS) are burning sensation of the oral mucosa and tongue, impaired taste, dry lips, oral soreness and ulcers, difficulties in speaking and chewing dry foods, and difficulties in wearing removable dentures. Clinically, the mucosa is dry and sticky and the examination mirror may adhere to the buccal mucosa. In addition depapillation of the tongue, explosive development of cavities (dental caries), and fungal/yeast infections (oral candidiasis) of the mouth and pharynx may occur. An objective measure of oral dryness can be achieved by sialometry of unstimulated and/or stimulated whole saliva. The possibility of using saliva as a fluid for biomarkers and its potential benefit in SS patient diagnosis and patient follow-up are elaborated. Finally, current approaches to relief of xerostomia and prevention/treatment of dry mouth-induced complications such as dental caries and oral candidiasis are presented.