Orofacial manifestations of systemic sclerosis

Abstract

Systemic sclerosis (SSc) is a multisystem disease of unknown aetiology characterised by microangiopathy, dysregulated immune function and tissue remodelling, which commonly involves the oral cavity. Orofacial manifestations of SSc contribute greatly to overall disease burden and yet are regularly overlooked and under-treated. This may reflect a pre-occupation amongst rheumatology clinicians on potentially life-threatening internal organ involvement, but is also a consequence of insufficient engagement between rheumatologists and dental professionals. A high proportion of SSc patients report difficulty accessing a dentist with knowledge of the disease and there is recognition amongst dentists that this could impact negatively on patient care. This review shall describe the clinical features and burden of orofacial manifestations of SSc and the management of such problems. The case is made for greater collaborative working between rheumatologists and dental professionals with an interest in SSc in both the research and clinical setting.

Impact of systemic sclerosis oral manifestations on patients’ health‐related quality of life: A systematic review

“…This systematic study showed that the correlation between oropharyngeal features and quality of life of SSc patients was statistically significant. The findings provided by our literature review were in accordance with very recent reviews that studied oral manifestations and their treatments …”

“…The findings provided by our literature review were in accordance with very recent reviews that studied oral manifestations and their treatments. 1,44,45 46 showed that patients were very concerned about their facial features. They also emphasised the issue of depression, which is an integral part of the overall management of these patients as there seems to be a strong link between facial appearance and feelings of depression and isolation.…”

“…47 Concerning oral management, recommendations were published in 2011, 48 and recent reviews describe in details oral manifestations of systemic sclerosis and existing treatments. 44 Early multidisciplinary management based on the collaboration between different specialists can prevent many oropharyngeal complications that worsen patients' quality of life. Indeed, some orofacial manifestations might enable an early diagnosis of SSc.…”

Review article: pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis

“…There are numerous oral cavity alterations related to SSc involvement . Fibrosis and tethering of the perioral skin leads to decreased oral aperture.…”

Gastrointestinal Involvement in Systemic Sclerosis: Overview, Neglected Aspects, Malnutrition, Body Composition and Management

“…There are numerous SSc-related alterations of the oral cavity [35]. Pathognomic fibrosis results in characteristically reduced oral aperture (microstomia), thickening of the sublingual fraenulum and widening of periodontal ligaments [36].…”