Interdisciplinary, Comprehensive Oral and Ocular Evaluation of Patients with Primary Sjögren’s Syndrome (original) (raw)

w and swallowing 11. As a result of reduced salivary secretion, these patients have a higher risk of developing caries, candidiasis, and mucositis and they may also suffer from bad breath (halitosis) and difficulties wearing dentures 12. Consequently, dry mouth often results in reduced quality of life 13. Dry eye disease (DED), defined by the 2007 International Dry Eye Workshop (DEWS), is "a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface" 14. Symptoms of DED include ocular burning and foreign body sensation, soreness, stinging, irritation, reduced visual acuity, photophobia, double vision, and ocular pain. Burden of DED can vary from mild discomfort in daily activities to incapacitation in physical functioning 14. Oral and ocular symptoms in pSS can be relieved with saliva and tear substitutes and stimulants, while involvement of the extra-glandular organs such as kidneys, lungs, skin, joints and muscles may require systemic treatment 15. The range of symptoms associated with multiple organ involvement make pSS a complex disease to handle, for patients, dentists, rheumatologists and other health workers 16. Patients with SS have a 6-fold increased risk of developing non-Hodgkin's lymphoma (NHL), and the lifetime risk of developing lymphoma is 5-10% 5. Interestingly, findings from salivary gland biopsies such as the presence of germinal centres may be a predictor for lymphoma development 17. Interdisciplinary, comprehensive evaluation of pSS including rheumatological examinations, and detailed examinations of dry mouth and dry eyes together with histopathological investigations may therefore have an important role in subgrouping the patients, and in turn benefit the choice of treatment strategies. Furthermore, detailed knowledge about the interplay between symptoms and findings of oral and ocular dryness is lacking. The aim of this study was to comprehensively investigate oral and ocular symptoms and findings in pSS patients and to perform comparisons with age-and gender-matched healthy and sicca control groups. A further aim was to explore possible correlations between oral and ocular findings in the pSS group.