The management of Sjogren's syndrome in dental practice

Background. Sjogren's syndrome, or SS, is a multisystem inflammatory disord er of the exocrine glands with a wide range of extraglandular involvement. Symptoms of dry eyes and xerostomia, although not invariably present, are c haracteristic features of SS. An increased risk of oral and dental diseases is a prominent consequence of SS. Types of Studies Reviewed. The author reviewed recent medical and dental st udies that have advanced our understanding of the causes and treatment of S S. She particularly focused on studies addressing the diagnosis and treatme nt of the oral component of the disease. Results. Sjogren's syndrome is a widely underdiagnosed disease. A delay in the diagnosis of SS may have a significant physical, psychological and econ omic impact on the affected person. The pathogenesis of SS appears to invol ve a number of factors: immunological, genetic, hormonal and possibly infec tious. Successful management of SS requires a multidisciplinary approach, a nd the dentist plays an essential role in the diagnosis and treatment of th e disease. Oral Implications. Impairment of salivary function in SS increases the risk of developing oral diseases. Effective management of oral health comprises enhancement of salivary output (cholinergic agonist drugs such as pilocarp ine or cevimeline) and prevention and treatment of dental caries, oral cand idiasis and allergic mucositis. Finally, periodic evaluation of various cli nical and laboratory parameters is needed to monitor disease status.