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Oral Manifestations of Sjogren's Syndrome

Sjögren's (SHOW-grins) syndrome is an autoimmune disease that attacks the exocrine glands (i.e., moisture-producing glands) of the body, specifically the lacrimal and salivary glands. It is classified among such diseases as rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis.

The oral component of Sjogren's syndrome remains a problematic clinical presentation of this condition and, from the patients perspective, is perhaps the most annoying and difficult of all associated symptoms.
The oral aspects of primary Sjogren's syndrome consist of mucosal atrophy (80% to 95%), salivary gland enlargement(approximately 30 %),

recurrent parotitis, reduced salivary flow rate (xerostomia)
and an increased incidence of dental caries.

The oral manifestations therefore of Sjogren's syndrome may include xerostomia with or without salivary gland enlargement, candidiasis, dental caries and taste dysfunction. As a result of Sjogren's syndrome, the major problem within the oral cavity relates to understanding the role of saliva and what its presence as an important biologic fluid subserves. We have chosen to define six major protective functions afforded by the presence of saliva which include:

* coating and lubrication of the oral mucous membranes
* physical debridement or mechanical cleansing of the oral cavity
* maintenance of an essentially neutral pH in the mouth by virtue of its inherent buffer capacity
* maintenance of tooth structure by way of specific components within saliva
* a remineralization and tooth-protective function
* Finally, saliva contains numerous compounds including antibodies and proteins that subserve an antimicrobial function, which includes protection against bacteria, fungi as well as some viruses.

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