Oral involvement in primary Sjogren syndrome

Background. In small studies, investigations have described oral features and their sequelae in primary Sjogren syndrome (PSS), but they have not provided a full picture of the aspects and implications of oral involvement. The authors describe what is, to their knowledge, the first large-scale evaluation to do so. In addition, they report data regarding utilization and cost of dental care among patients with PSS. Methods. The authors surveyed patients with primary Sjogren syndrome as identified by their physicians (PhysR-PSS), patient-members of the Sjogren's Syndrome Foundation (SSF-PSS) and control subjects who did not have PSS. They made comparisons between the three groups. Results. Subjects were 277 patients with PhysR-PSS, 1,225 patients with SSF-PSS and 606 control subjects. More than 96 percent of those in the patient groups experienced oral problems. An oral complaint was the initial symptom in more than one-half of the patients. Xerostomia-associated signs and symptoms were common and severe, as evidenced by scores on an inventory of sicca symptoms. These patients' rate of dental care utilization was high, and the care was costly. Conclusions. Oral and dental disease in PSS in extensive and persistent and represents a significant burden of illness. Clinical Implications. Oral symptoms and signs are common in patients with PSS. Early recognition of the significance of these findings by or specialists could accelerate diagnosis and minimize oral morbidities.