Dental caries and dental health behavior of patients with primary Sjo¨gren syndrome

Abstract

This comprehensive study was carried out to describe and analyze the oral health status, perceived oral health problems, patients' costs, and oral health behavior in a group of patients with primary Sjögren syndrome (PSS). In particular, the objective of this report was to assess whether Sjögren syndrome patients had more dental caries experience than a control group. Data were collected by means of interviews and clinical oral examinations. The study comprised 53 patients with PSS and a control group of 53 persons matched by age. Among the younger patients the number of decayed, missing, or filled teeth (DMFT) was 22.3, compared with 18.8 among controls (P< 0.05). In parallel, the DMFT in the old-age PSS patients was 26.2, against a DMFT of 22.1 for controls (P< 0.001). On average, the young patients had seven teeth missing, whereas two missing teeth were found among controls (P < 0.01). PSS patients had more frequent dental visits--every 3-4 months (40%)--than controls (19%). In parallel, 78% of the PSS patients brushed their teeth more than twice daily, compared with 28% of the control group. The PSS patient group reported having had more teeth extracted, more trouble with their teeth during lifetime, and higher expenses for dental treatment than controls. In spite of the more regular oral health care practices than the general population, PSS patients had experienced more dental caries and more radical dental treatment. It is suggested that the National Health Insurance should give emphasis to preventive care to patients with PSS.

New Treatment Guidelines for Sjögren's Disease

“…Study subjects with SD have significantly more dental caries, tooth extractions, and higher lifetime dental costs then do controls. 15 SD patients who lose their dentition often have problems with denture wear and find that dental implants provide the only viable long-term alternative. Most patients in the United States lack sufficient dental insurance to cover these expenses and pay most costs out-of-pocket.…”

Cost-effectiveness landscape analysis of treatments addressing xerostomia in patients receiving head and neck radiation therapy

“…64 Amifostine significantly decreases xerostomia by 22%–27% up to 12 months post-RT. 36,119 However, amifostine has many detrimental side effects, the major one being nausea/vomiting, 41 mandating the concomitant use of a nausea-preventing drug. Still, 21% of patients drop out of amifostine treatment regimens due to the side effects.…”

“…34 Therefore, it is expected that higher dental care costs are a direct consequence of xerostomia and that these costs accumulate over time with persistence of hyposalivation and diet change. In the case of Sjögren syndrome-induced xerostomia, Christensen et al 36 demonstrated higher expenses for dental treatment in patients with primary Sjögren syndrome than controls. However, cost of dental care for patients who underwent H&N cancer therapy has not been specifically evaluated, even in studies focusing on the cost of care for H&N. 37,38 Edentulous xerostomia patients may experience extreme discomfort wearing dentures, denture sores, and denture dislodgement (causing social discomfort) because saliva plays a major role in adhesion, cohesion, and surface tension of a denture.…”

Two cases of cervical abscess in rheumatoid arthritis patients

“…Some RA patients also have Sjögren's syndrome. 2 Consequently, RA patients often display latent oral infections such as decayed teeth and periodontitis. Factors involved in many of these oral cavity infections may include steroid use, degradation of motor ability, and the effect of reduced mobility resulting from arthralgia in preventing patients from readily attending dental hospitals.…”