Scleroderma and vasculitis have a significant, life-long effect on oral health. Long standing oral health conditions may become worse over time. Treatments may not be curative, and may only improve the patients' quality of life. A timely diagnosis can prevent tooth loss as well as any further complications associated with it.
Oral health issues associated with scleroderma, vasculitis and myositis include:
Xerostomia increases the risk of dental decay (caries), gum inflammation (gingivitis), fungal infections (e.g. thrush), oral malodor (halitosis), and can reduce or alter taste sensation. Mouth sores can also develop, especially in denture wearers. A lack of saliva can also decrease denture retention.Management
Microstomia is caused by severe sclerosis of the facial skin around the mouth, creating a limited mouth opening. It can occur in patients with scleroderma.
There is a high risk for dental problems due to limited oral access, challenging oral hygiene and dental rehabilitation.
Due to lip incompetence associated with severe microstomia, patients are more prone to develop severe xerostomia.
Periodontal (gum) disease is caused by the bacteria accumulated in dental plaque not being efficiently removed.
Periodontal disease manifests by bleeding and swollen gums, and tooth loss which can make chewing uncomfortable.
Idiopathic root resorption, or the loss or damage of the root of a tooth, is commonly found in patients with scleroderma. It can only be determined on dental x-rays, so regular dental visits are crucial.
Temporomandibular Joint Disorders include a set of conditions characterized by pain in the jaw joint, the surrounding tissues and a limitation in jaw movement.
Symptoms may include pain in the jaw muscles, pain in the neck and shoulders, chronic headaches, jaw muscle stiffness, limited movement or locking of the jaw, ear pain and pressure, painful clicking, popping or grating in the jaw joint when opening or closing the mouth, and a bite that feels "off".
Other conditions associated with Scleroderma and Vasculitis include an increased risk of fungal infections, painful mouth ulcers, dysphagia or difficulty swallowing, and dysgeusia or altered taste.
Make sure to get regular dental visits for early detection and prevention of the conditions mentioned above.
Ask for short dental appointments and schedule them for the morning when you are less tired.
Ask your dentist to select a toothbrush that is easy to use especially if you have an impaired manual dexterity due to sclerodactyly (tightness in your fingers).
Make sure to provide the list of all the medications you are currently taking as well as the medications you had taken in the past.
Valentina Lyssova, DDS
New York Dental Wellness Group