Oral hygiene in scleroderma: The effectiveness of a multi-disciplinary intervention program

Purpose. To investigate whether oral hygiene improves after persons with scleroderma received structured oral hygiene instructions and facial and hand exercises. Methods. Seventeen persons with scleroderma received a baseline dental evaluation including an examination for decayed or missing teeth, calculus, sites that bleed upon probing, measures of oral aperture, and the Patient Hygiene Performance Index. Upper extremity functioning including strength, joint motion, and dexterity were also measured. Participants received a structured home program consisting of patient education on brushing and flossing techniques, hand and facial exercises, adapted dental appliances, and a 6-month supply of dental products. Results. At the end of the 6-month intervention, there was a significant decrease (improvement) in mean PHP scores and a significant decrease in the number of teeth that bled on probing and with subgingival calculus. There were no differences in any of the upper extremity measures or oral aperture. Correlations between the upper extremity and oral measures showed associations between oral aperture and two of the dexterity measures and number of teeth with caries. Conclusion. These findings suggest that oral exercises and education regarding proper dental care may be useful in hygiene in persons with scleroderma.