Sjogren's Syndrome and Dry Mouth

What is Sjogren's Syndrome?

Sjogren's Syndrome is an autoimmune disorder that affects body’s moisture-producing glands. (1) It occurs when the body’s salivary and lacrimal glands are attacked by the body’s immune cells (T cells), causing chronic inflammation in and disfunction of the glands. Between 0.2% and 1.2% of the population are affected by Sjogren Disease. (2)

How do I know I may have Sjogren's Syndrome?

Sjogren’s syndrome is most frequently associated with dry mouth and dry eye though it can affect other parts of the body including joints, thyroid, skin, lungs, kidneys, nerves etc.

Symptoms may very among individuals from mild-to severe and can plateau or worsen.

Your eyes might feel itchy, burning or painful. Your mouth may feel uncomfortable, it might be difficult to eat, swallow and or speak.  Other symptoms include joint pain, swollen salivary glands, vaginal dryness, cough that does not go away, feeling tired all the time.

What Causes it?

The exact cause of Sjogren's Syndrome is not clear, but it is believed that a combination of genetic and environmental factors (such as virus/bacteria) may play a role (1).

Who is at risk?

  • Those who already have a rheumatic disease such as rheumatoid arthritis or lupus.
  • Women are 10x more likely to have the condition (3)
  • Sjogren is usually diagnosed in people who are middle-aged (4)

What tests are there to diagnose Sjogren's Syndrome?

  • Biopsy of moisture-producing glands looking for lymphocyte infiltration.
  • Blood test which serves to detect certain antibodies. (3) (antinuclear antibody ANA and rheumatoid factor etc.)
  • Measure production of tears and saliva (5)
  • X-ray of salivary glands to make sure there is no blockage (5)

Is there treatment of Sjogren's Syndrome?

There is no current treatment to restore gland secretion. Treatment is usually aimed at managing the symptoms.

How Does Dry Mouth from Sjogren's Syndrome Affect my Teeth?

Saliva is essential to maintain a balance in the oral cavity. It is involved in tasting, chewing, swallowing, speaking, food digestion, maintenance of a neutral pH as well as teeth cleansing and remineralization. Insufficient saliva can lead to dental cavities which can progress to tooth infections and, if not treated, to tooth loss. (9)

Severe discomfort in the oral cavity may cause chewing difficulties. This makes it difficult to consume different foods which may lead to malnutrition and weight loss.

Dry Mouth Dental Management:

National Institute for Dental and Craniofacial Research (6) recommends to:

1)  Brush teeth gently at least twice per day with fluoridated tooth paste. 2)  Floss every day.

3)  Dental visits at least every 6 months. Have radiographs taken as indicated.

4)  Ask your doctor whether prescription - strength fluoride toothpaste

and fluoride varnish application is indicated for you.

5)  Treat oral and fungal infections.

6)  Reline poorly-fitting dentures.

7) Treatment of dental cavities and infections.

 

 

Diet Changes

Caffeine, spicy, acidic, fried and saturated “bad” fat foods dry out the oral mucosa and exacerbate the symptoms of decreased salivary flow. Acidic, sweet carbonated drinks or acidic candies, are known to not only cause dry mouth but also tooth erosion and cavities.  Their intake should be limited and substituted by healthier options such as non-caffeinated, non-alcoholic products and “good” fats.

Dry Mouth Diet Tips:  

  • Reducing consumption of inflammation-stimulating foods such as white bread, gluten, diary, fried foods, sugar, soda, donuts, processed foods/meats, canned foods, alcohol.
  • Consume alkaline diet rich in leafy green vegetables such as spinach, kale etc. to help neutralize acidic conditions in the mouth and to serve as a source of necessary vitamins and minerals.
  • Consume fruits rich in antioxidants such as all types of berries, pomegranate etc. will also provide the necessary vitamins and minerals to help maintain a healthy oral environment. Additionally, fruits can serve as sugar alternatives in smoothies, shakes etc. or be excellent for desert.
  • Consume healthy fats such as avocado, coconut oil, ground flaxseed and chia seed in place of fried foods.

Also, a study showed that Sjogren's patients show a high sensitivity to gluten which causes inflammation. Eliminating gluten from diet should provide improvement in symptoms (7).

Habit Changes

Alcohol and tobacco are also known to cause dry mouth. Avoid drinking not only alcoholic beverages but also using ingestible products containing alcohol such as alcohol-containing mouthwashes.

Smoking is not only a major cause of dry mouth it can also cause gum (gingivitis), jaw-bone disease (periodontitis) as well as cancer. Cessation is recommended.

 

 

 

Regular exercise has been linked to decreased lung and general inflammation. It is a recommended practice for Sjogren patients as well as the general population (8).  

Dry Mouth Mouthwash

Smile Genius Certified 100% Organic Non-Alcoholic Mouthwash 1:10 Concentrate for Dry Mouth Relief contains essential oils and vegetable-based NON-GMO glycerin which are designed to provide lubrication and relief from dry mouth. After brushing and flossing rinse with the Smile Genius 100% Organic Mouthwash for 20-30 seconds and spit. To not rinse with water afterwards to allow for the oils to coat your oral cavity. 

Organic Mouthwash

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Hydration

Hydration is not just casual sipping on water whenever we experience dry mouth or thirst. Proper hydration is a calculated intention to make sure we provide our bodies with the water that it needs to function properly. If our body does not have enough water it will not produce much saliva.

General Guidelines for Staying Hydrated:

  • Drink 2-4 liters per day on average
  • Add water to your diet,
  • Carry water with you at all times for easy access
  • Replace caloric and diet beverages (including sugar-sweetened sodas, teas, coffees, juices, milk) with water.

Other Treatment Options

There is also the possibility of prescription medications for dry mouth. Speak to your dentist/doctor whether it is something that is recommended for you.

Read more: 7 Best Dry Mouth Remedies 

What’s Next?

It is essential to see a medical professional to be evaluated and if indicated, tested for Sjogren's Syndrome as it can be associated with other conditions including multiple sclerosis, rheumatoid arthritis, celiac disease, SLE (lupus) and non-Hodgkin lymphoma (10). It is essential to see a dentist for dental prevention and management as well as the eye doctor.

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Dr. Anna

 

References

  1. What Is Sjögren's Syndrome? Fast Facts"NIAMS. November 2014. Archivedfrom the original on 4 July 2016. Retrieved 15 July 2016.
  2. Fox RI, Stern M, Michelson P (September 2000). "Update in Sjögren syndrome". Curr Opin Rheumatol12(5): 391–8
  3. Brito-Zerón, P; Baldini, C; Bootsma, H; Bowman, SJ; Jonsson, R; Mariette, X; Sivils, K; Theander, E; Tzioufas, A; Ramos-Casals, M (7 July 2016). "Sjögren syndrome". Nature Reviews. Disease Primers2: 16047. 
  4. Ng, Wan-Fai (2016). Sjogren's Syndrome. Oxford University Press. pp. 10–11. ISBN9780198736950Archived from the original on 2016-08-15.
  5. Fox R. I. (2005). "Sjögren's syndrome". Lancet366(9482): 321–331.
  6. https://www.nidcr.nih.gov/
  7. Lidén M, Kristjánsson G, Valtýsdóttir S, Hällgren R (August 2007). "Gluten sensitivity in patients with primary Sjögren's syndrome".  J. Gastroenterol42(8): 962–7. 
  8. Strömbeck BE, Theander E, Jacobsson LT (May 2007). "Effects of exercise on aerobic capacity and fatigue in women with primary Sjogren's syndrome". Rheumatology (Oxford)46(5): 868–71.
  9. Abou Neel Ensanaya Ali. Demineralization-remineralization dynamics in teeth and bone. J. International Journal of Nanomedicine 2016; 11 4743- 4763.
  10. Cohen-Brown G, Ship JA. Diagnosis and treatment of salivary gland disorders. Quintessence Int 2004;35(2):108-23.

 

 

 

2 comments

  • Xylimelts. Natural herbal tea especially lemon verbena. That’s all I’ve found effective.

    Vivienne Payne
  • Xylimelts. Natural herbal tea especially lemon verbena. That’s all I’ve found effective.

    Vivienne Payne

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