Sjogren’s Syndrome is an autoimmune condition where the body’s immune system mistakenly attacks its own healthy cells and tissues. This systemic disorder primarily targets the exocrine glands, which produce moisture throughout the body. Salivary glands are frequently affected, leading to symptoms from reduced saliva production. This article explores how Sjogren’s Syndrome impacts these glands, the symptoms that arise, diagnostic approaches, and management strategies.
How Sjogren’s Syndrome Affects Salivary Glands
Sjogren’s Syndrome involves an autoimmune response where immune cells infiltrate and attack the salivary glands. This leads to chronic inflammation within the glandular tissue. The immune attack targets acinar cells, which produce saliva, and ductal cells that transport it.
Over time, this persistent inflammation damages glandular architecture. Functional tissue is gradually replaced by fibrous tissue, impairing the glands’ ability to secrete adequate saliva. This reduces functional secretory cells, leading to diminished salivary flow.
The impairment extends to the entire exocrine system, but major salivary glands like the parotid, submandibular, and sublingual glands are profoundly affected. Their compromised function results in a significant decrease in saliva output, a hallmark feature of the syndrome. This reduction impacts oral health and comfort.
Identifying Salivary Gland Symptoms
The most common symptom from salivary gland involvement is xerostomia, or dry mouth. Individuals may experience persistent dryness, leading to difficulty speaking or swallowing food, especially dry items. An altered sense of taste and an increased need to drink water, particularly at night, are also common.
Beyond dryness, physical changes can occur, such as swelling of the parotid or submandibular glands, which may be tender. Reduced saliva production compromises saliva’s natural cleansing and protective functions, leading to other oral issues. This includes increased susceptibility to mouth sores or ulcers.
The lips may become dry, cracked, and prone to fissuring at the corners. The lack of saliva’s buffering and remineralizing effects contributes to a higher incidence of dental caries, or cavities. Fungal infections, such as oral thrush, are also more frequent due to the altered oral environment.
Diagnosis of Salivary Gland Involvement
Diagnosing salivary gland involvement involves objective tests assessing gland function and tissue changes. A common initial step is measuring the unstimulated salivary flow rate, where saliva is collected over a set period to quantify reduced output. A low flow rate indicates impaired function.
Another diagnostic procedure is a minor salivary gland biopsy, usually from the inner lip. This examines tissue under a microscope for focal lymphocytic sialadenitis, the characteristic infiltration of lymphocytes in glandular tissue. This microscopic finding helps confirm the autoimmune attack.
Imaging techniques also provide insights. Sialography, a radiographic procedure using contrast dye, can reveal patterns indicative of ductal damage and gland atrophy. Salivary gland ultrasonography is a non-invasive method to assess gland size and homogeneity. Blood tests can indicate autoimmune activity through specific antibodies, supporting the overall Sjogren’s Syndrome diagnosis.
Treating Salivary Gland Issues
Managing salivary gland issues focuses on alleviating dry mouth symptoms and preventing complications. Artificial saliva products provide temporary relief by moistening oral tissues. These products mimic saliva’s protective effects.
For individuals with some residual salivary gland function, prescription saliva stimulants can be effective. Pilocarpine and cevimeline are commonly prescribed medications that stimulate salivary glands, increasing saliva flow. These medications are taken orally.
Maintaining rigorous oral hygiene is important to prevent dental decay and infections. This includes brushing teeth twice daily with fluoride toothpaste, flossing regularly, and using fluoride rinses or gels. Regular dental check-ups are recommended to monitor for cavities and gum disease.
Dietary modifications can help reduce irritation. Avoiding acidic, spicy, or sugary foods and beverages prevents irritation to dry oral tissues and reduces cavity risk. Sipping water frequently and using humidifiers, especially at night, helps maintain oral moisture. For gland swelling or suspected infection, antibiotics may be prescribed.