32. Sjogren’s syndrome.

Question 1

Sjogrens syndrome

Answer 1

• Primary and secondary
• Autoimmune attack on exocrine glands
• Primary-dry mouth and dry eyes w/ no connective tissue disease(secondary has) and more severe oral and occular changes
• Secondary includes rheumatoid arthritis

Question 2

Oral effects of Sjogrens syndrome

Answer 2

• Discomfort
• Difficulties with eating or swallowing
• Disturbed taste sensation
• Disturbed quality of speech
• Predisposition to infection

Question 3

Management of sjogrens syndrome

Answer 3

* Give reassurance and help with dry mouth
* Refer to specialist if connective tissue disease is
untreated
* Check for any associated drug treatment contributing
to dry mouth
* Alleviate dry mouth
* Frequent small sips of water
* Prescribe saliva substitutes
* Control caries in dentate patients
* Avoid sweets (e.g. lemon drops)
* Suggest sugar-free gum
* Check diet for excess sugary foods
* Maintain good oral hygiene
* Fluoride applications
* Chlorhexidine (0.2%) rinses
* Monitor for mucosal candidosis
* Give antifungal mixtures (not tablets) as necessary-Fluconazole or nystatin
* Treat difficulties with dentures symptomatically
* Observe regularly for possible development of
ascending parotitis or lymphoma

Question 4

Treatment of Xerostomia

Answer 4

• Artificial saliva
• Pilocarpine-Cholinesterase inhibitor

Cholinesterase inhibitors have unpleasant side effects such as
nausea, diarrhoea and bradycardia