There is a debilitating disease that affects at least one million people in the U.S., mostly women. It is one of those diseases that we just don’t hear a lot about. And while not life threatening, it certainly affects your comfort, happiness, and your dental health. It’s called Sjögren’s syndrome.
Sjögren’s syndrome is an autoimmune disease. I know you’ve heard that term before, and let’s define it. We have an immune system, composed mainly of white blood cells called “lymphocytes,” that protect us from disease. Lymphocytes step up their activity when we are attacked by infections, viruses, and injuries. When the lymphocytes have done their job in a normal condition, the body has a braking mechanism to stop the lymphocytes. In an autoimmune disease, the braking system is gone and the lymphocytes go out of control. They attack the body. In the case of Sjögren’s syndrome, the lymphocytes attack the salivary glands and the glands that produce tears. In addition, these lymphocytes produce autoantibodies that also damage the salivary and tear systems and may damage other organs of the body including the joints, lungs, kidneys, nerves, thyroid, liver, and brain.
Sjögren’s syndrome often accompanies other rheumatic diseases such as rheumatoid arthritis, systemic lupus, scleroderma, and polymyositis.
There may be improved awareness of Sjögren’s syndrome as a result of tennis star Venus Williams’ announcement that she had the disease when she departed the U.S. Open in September, 2011.
Primary Sjögren’s syndrome involves the eyes and the mouth. Secondary Sjögren’s syndrome means that it is part of a multiple rheumatic disease problem. The diagnosis of primary Sjögren’s syndrome includes a small biopsy of the lip, where the lymphocytic invasion can be seen under the microscope.
From a dental perspective, we’ve talked about the problems of dry mouth in previous columns. Dry mouth creates acids in the mouth, making you much more prone to decay of your teeth. This decay needs to be prevented and the best way is to keep your mouth moist and your teeth exquisitely clean. Also drop all sugars. There are a number of artificial salivas that you can purchase at the pharmacy. I also recommend to my patients that they rinse out with baking soda and water rinses every few hours. Just mix a tablespoonful of baking soda in 8 ounces of water and keep it with you all day. Rinse for 30 seconds every 3-4 hours. The baking soda will neutralize the acid. Rinses and mints with the natural sugar, xylitol, may also help as xylitol has been shown to reverse tooth decay. You’ll need more frequent dental examinations, so that if you do develop decay, it can be discovered and treated as soon as possible.
For the eyes, your doctor may recommend artificial tears and for more severe cases, ointments. Anti inflammatory medications are sometimes prescribed. For secondary Sjögren’s syndrome involving the skin, you should add skin lubricants. You may want to add a humidifier to your air conditioning system. Walking and swimming may help to keep muscles and joints flexible as well as prevent further damage.
For more information, contact the Arthritis Foundation at 800-672-0882.
Lee N. Sheldon, DMD