Lupus is a chronic autoimmune disease where the body’s immune system mistakenly attacks its own healthy tissues and organs, leading to widespread inflammation. This condition can manifest in various parts of the body, including the oral cavity. Understanding how lupus impacts oral health is important for individuals managing the disease, as it can affect everything from the salivary glands to the teeth and gums.
Direct Oral Manifestations of Lupus
Lupus directly affects the mouth through specific lesions. Oral ulcers are a common manifestation, appearing as red areas with a white halo or radiating white lines, often on the roof of the mouth, inside the cheeks, or on the lower lip.
These sores can indicate active disease or a lupus flare.
Discoid lupus erythematosus (DLE) is another form, presenting as well-demarcated, red, or ulcerated lesions, sometimes with white keratotic borders. These typically appear on the lips, hard palate, and buccal mucosa, and can sometimes develop before skin lesions.
The immune system’s misdirected attack on oral tissues leads to chronic inflammation. Lupus can also be associated with Sjögren’s syndrome, an autoimmune condition targeting moisture-producing glands.
When Sjögren’s syndrome co-occurs with lupus, it primarily affects the salivary glands, causing xerostomia or dry mouth. This reduction in saliva production compromises salivary function and increases oral health risks.
Indirect Oral Health Considerations
Oral health issues in individuals with lupus often arise indirectly from the disease or its treatments. Medications prescribed for lupus, such as corticosteroids and immunosuppressants, can have systemic side effects impacting the oral cavity.
Corticosteroids may increase susceptibility to infections like oral thrush and impair healing. Immunosuppressants can lead to drug-induced gingival overgrowth, where gum tissues enlarge.
Dry mouth, whether from Sjögren’s syndrome or medication side effects, significantly contributes to dental problems. Reduced saliva flow diminishes the mouth’s natural cleansing and protective functions, increasing the risk of tooth decay and gum disease.
People with lupus may also experience a general susceptibility to infections and slower wound healing. This vulnerability means minor oral issues can become more persistent or severe, requiring careful management.
Proactive Oral Care and Management
Maintaining optimal oral health for individuals with lupus requires a proactive and collaborative approach. Regular dental check-ups, ideally every six months, are important for early detection of oral issues.
Inform your dental team about a lupus diagnosis and all current medications. This information guides appropriate care.
Daily oral hygiene practices should be thorough. This includes brushing at least twice a day with a soft-bristled toothbrush and flossing daily to prevent plaque buildup and gum inflammation.
For managing dry mouth, strategies include drinking plenty of water, using saliva substitutes, or sucking on sugar-free candies or gum to stimulate saliva flow.
Fluoride rinses strengthen tooth enamel and prevent decay. Antimicrobial rinses may reduce the risk of oral infections. Avoiding irritating foods, like spicy or acidic ones, can reduce discomfort from mouth sores.
Communication between the patient’s rheumatologist and dentist is important for integrated care. Dentists should know the patient’s lupus activity and medication regimen, as this influences dental treatment planning and potential risks.
Rheumatologists should be informed of any persistent oral symptoms or dental concerns. Discuss strategies for managing specific oral symptoms, such as topical treatments for ulcers, with your dental professional.
Early detection of changes in oral tissues, even if painless, and seeking prompt evaluation for new or worsening symptoms, is important for comprehensive oral health management in lupus.