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 dicuss 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 (mouth dryness)
- I have an entire post on mouth dryness linked here. There is a lot of helpful information located there.
Microstomia (limited mouth opening due to tightening of 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.
- Flat white patches
- Loss of attached gingival mucosa=gingival recession
- Diffuse widening of the periodontal ligament (PDL) space are seen like below
- ECR correlation may exist Arroyo-Bote 2017 JOE
|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.