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Vol. 11. Num. 6.
Pages 333-406 (November - December 2015)
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Vol. 11. Num. 6.
Pages 333-406 (November - December 2015)
Review Article
DOI: 10.1016/j.reumae.2015.03.014
Oral Involvement in Patients With Primary Sjögren's Syndrome. Multidisciplinary Care by Dentists and Rheumatologists
Afectación oral en el paciente con síndrome de Sjögren primario. Manejo multidisciplinar entre odontólogos y reumatólogos
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Rosa María López-Pintora, Mónica Fernández Castrob,
Corresponding author
monfercas@yahoo.es

Corresponding author.
, Gonzalo Hernándeza
a Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, Spain
b Servicio de Reumatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
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Tables (6)
Table 1. Diagnostic Criteria for Primary Sjögren's Syndrome Proposed by the American-European Consensus Group.
Table 2. Diagnostic Criteria for Primary Sjögren's Syndrome Proposed by the American College of Rheumatology and Sjögren's International Collaborative Clinical Alliance.
Table 3. Drugs Associated With the Presence of Xerostomia.
Table 4. Oral Signs and Symptoms in Patients With Primary Sjögren's Syndrome.
Table 5. Therapeutic Strategies to Increase Salivary Flow According to Severity of Oral Dryness in Patients With Primary Sjögren's Syndrome.
Table 6. Secondary Effects and Contraindications of Pilocarpine.
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Abstract

Primary Sjögren's syndrome is a chronic systemic autoimmune disease that causes destruction of lacrimal and salivary glands. The most common and earliest symptoms are oral and ocular dryness. Dry mouth makes talking difficult, tasting and chewing properly, impairing quality of life of these patients. The most common oral signs and symptoms are hyposialia with or without xerostomia, tooth decay, fungal infections, traumatic oral lesions, dysphagia, dysgeusia, and inflammation of salivary glands. There are different therapeutic strategies, depending on the severity of each case, and the increase in the amount of saliva, to reduce the number of cavities and oral infections. It is particularly important to establish a close relationship between the dentist and the rheumatologist in order to make an early and correct diagnosis, promoting appropriate dietary and hygiene measures, as well as to treat and prevent potential oral complications.

Keywords:
Sjögren syndrome
Dry mouth
Xerostomia
Cavities
Saliva flow
Oral candida infection
Resumen

El síndrome de Sjögren primario (SSp) es una enfermedad autoinmune sistémica crónica, que cursa con destrucción del tejido glandular lagrimal y salival. Sus síntomas más frecuentes y tempranos son la sequedad oral y ocular. La sequedad oral dificulta que el paciente hable, deguste y mastique correctamente, lo que disminuye la calidad de vida del enfermo. Los signos y síntomas orales más frecuentes son la hiposialia con o sin xerostomía, la caries dental, las infecciones fúngicas, las lesiones orales traumáticas, la disfagia, la disgeusia y la inflamación de las glándulas salivales. Existen distintas estrategias terapéuticas en función de la gravedad de cada caso que aumentan la cantidad de saliva y disminuyen el número de caries e infecciones orales. Por ello, es de especial importancia establecer una relación cercana entre el dentista y el reumatólogo que permita hacer un diagnóstico temprano y correcto, fomentar las medidas dietéticas e higiénicas adecuadas, tratar y prevenir las posibles complicaciones orales.

Palabras clave:
Síndrome de Sjögren
Sequedad oral
Xerostomía
Caries
Flujo salival
Candidiasis oral

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