Scleroderma or Systemic sclerosis


Scleroderma (systemic sclerosis) and oral health care

Scleroderma is a chronic auto-immune condition that mostly affects women.  Rather than get into too much detail about the disease we will discuss the effects it has on the mouth. Also we will show how you can reduce those negative effects.

Symptoms of Scleroderma in the oral cavity

Xerostomia is the medical term for dry mouth.

  • We have an entire post on mouth dryness here.  There is a lot of helpful information on the link.

Microstomia is the name for a limited ability to open your mouth. In scleroderma this is due to the tightening of the skin.

  • Difficulty with eating and perhaps speech.
  • Can make it difficult to insert and remove dentures and undergo routine dental care.
  • Nothing can really help with this and we just deal with any issues that arise from this.

Mouth issues

  • Flat white patches
  • Loss of attached gingival mucosa=gingival recession
  • Diffuse widening of the periodontal ligament (PDL) space are seen like below and in our radiolucent post.
  • ECR correlation may exist Arroyo-Bote 2017 JOE
Scleroderma pano with widened PDL
Ligaments attaching teeth to bone are inflamed causing teeth to be loose

Other issues that those with scleroderma also suffer from

Patients with this condition often have multiple auto-immune conditions like Sjögren’s Syndrome, systemic lupus erythematosus, and rheumatoid arthritis.  Together that makes for thin friable tissue that patients easily irritate.  This is important because these patients usually end up losing the majority of their teeth for various disease related issues.  That thin tissue makes traditional dentures difficult if not impossible to endure as the tissue is continually being rubbed raw.  I typically will reject making anything but an implant supported denture for these patients, although these can be impossible if mouth is too restricted.