A potential cause of dry mouth, dry skin and dry eyes
With our upcoming dental event in Whelehans on Friday July 10th where you can get free dental consultations, I thought this week I would discuss a common cause of dry mouth which ultimately can lead to dental problems. It is called Sjögren syndrome. For a free consultation with a dental expert on July 10th, call Whelehans at 04493 34591.
Sjögren syndrome remains undiagnosed in many people. Sjögren syndrome is an autoimmune condition in which the body’s white blood cells attack other cells in the body. The cause is unknown. It was first discovered by Swedish ophthalmologist Henrik Sjögren in the 1930’s. Sjögren is pronounced “SHOW-gren”. I discussed Sjögren syndrome in the Topic a few years ago so this time I revisit it with some updates.
The main symptoms of Sjögren syndrome are dry eyes and dry mouth and enlargement of the parotid glands (salivary gland located in the cheeks just in front of the ears). Dry eyes and mouth occur in 95% of cases. Fatigue and joint and muscle pains are other debilitating features in many who have the condition.
Research has identified many factors (eg. immunological, genetic, hormonal and inflammatory) that may be involved in causing it. It is thought to affect 3-4% of adults. It increases with age and usually starts in the 30s and 40s; the average age of onset is the late 40s and it often doesn’t occur until after menopause in many cases. It is nine times more common in women than men.
Link with other conditions
It is reckoned that in 60% of cases, Sjögren syndrome occurs with or is linked to other the inflammatory autoimmune conditions (eg) Rheumatoid arthritis, Systemic lupus erythematosus, Fibromyalgia, Scleroderma. Because it is mixed up with other conditions, it is estimated that the average length it takes for diagnosis is 10 years. Rheumatoid arthritis is a severe inflammatory condition that causes swelling, pain and deformities in the joints; it tends to run in families. Systemic lupus erythematosus (better known as lupus) is nine times more common in women; it can cause inflammation in all organs in the body leading to fever, joint pain, muscle pain, fatigue and damage to all major organs if not controlled; lupus is rarer in Europe and more common in people of Afro-Caribbean decent. Fibromyalgia is a chronic pain disorder characterised by extreme tiredness and fatigue. Scleroderma is an inflammatory condition that affects the skin leading to hard skin and skin lesions; it can go on to damage other organs if not controlled.
Symptoms of Sjögren syndrome
Whilst dry eyes and dry mouth are common features of Sjögren syndrome, most people who develop these symptoms do not have the disease; for example, dry eyes and dry mouth affects about 30% of older people and the majority of cases are not due to Sjögren syndrome. Dry mouth and eyes can also caused by many medicines such as tri-cyclic anti-depressants, antihistamines, decongestants, beta blockers (for blood pressure and heart conditions), codeine type painkillers, diuretics (fluid reducing medicines used for blood pressure and heart problems) etc. Therefore, before a patient is diagnosed, it must be checked that they are not taking one of these medicines that could be causing dry eyes and mouth.
Dry eyes leads to itchy eyes, grittiness and soreness and can lead to damage to the cornea if not controlled.
Dry mouth may not be immediately obvious and the person may not complain of dryness but of an unpleasant taste, insatiable thirst, difficulty eating dry food such as cream crackers and soreness.
Dry mouth can lead to:
- Swallowing problems and dysphagia (the feeling of something getting stuck in the throat on swallowing)
- Loss of taste
- Tooth decay and gum disease
- Sore or cracked tongue
- Difficulty talking
- Thrush (fungal infection) in the mouth.
Severe fatigue occurs in about half of people with Sjögren syndrome and many find this feature of the disease is the most troublesome. Many with the condition need to sleep more but many do not feel refreshed upon awakening. The exact cause of this fatigue is not fully understood but hypothyroidism (low thyroid levels) is frequently linked with Sjögren syndrome so may contribute to it.
Dry skin is a common feature of Sjögren syndrome; dry skin can lead to itchiness and irritation of the skin or a “burning” of the skin in some cases. Other symptoms of Sjögren syndrome include glandular swelling, dryness of the airways (lead to dry cough and chest infections), swelling of the parotid (salivary) glands that can be painful in some cases, swelling of other salivary glands located under the jaw or in the neck area, muscle ache and aching joints and Raynaud’s phenomena (coldness in the extremities of the body such as hands and fingers). Sjögren syndrome can also cause peripheral neuropathy which is damage to the nerve endings in the extremities such as fingers and toes; peripheral neuropathy can cause numbness, tingling, itching, pins and needles etc.
To be continued….next week I will discuss the treatment of Sjögren syndrome.
For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591.