Changes in Dental Status and Saliva in Sjogrens Syndrome Patients

Objectives: The objective of this retrospective study is to determine the development of caries and changes in dental status of Sjogrens syndrome patients, a high risk population, after intervention with preventive regimens. Methods: This present study (PS) is conducted as continuation of a previous baseline study (BS) of Sjogrens syndrome (SS) patients (n=64). In PS, the records of 43 subjects were reviewed. Individual tooth surfaces of SS were examined for caries (incipient and frank) by using Pitts Diagnosis criteria by a single, calibrated examiner. Filled, missing and crowned surfaces were recorded. Whole unstimulated and stimulated salivary flows were measured. Results: At initial observation of PS, all subjects were on a caries preventive regimens with 58.3% of the total population (N=43) on sialogogues, mean age 52+/- 1.7 years (range 24-77), 91.7 % female and 8.3 % males. In BS, prior to intervention of preventive regimen(s), total reported prevalence of carious lesions was 4.99+/- 3.3 surfaces. For PS, Paired sample analysis was done, comparing first and last observations, average time interval being 45.87 months. Results show, decrease in the total root and coronal caries (incipient and frank), from 2.85+/- 3.8 to 2.09+/-2.3 surfaces. Total filled surfaces increased from 20.95+/- 14.4 to 22.46+/- 14.34, crowned surfaces increased from 27.97+/- 30.69 to 33.71+/- 33.71 and missing surfaces from 17.75+/- 23.14 to 20.58 +/-23.83. The significant increase in whole stimulated salivary flow was observed (p<.05), from 0.59+/- 0.710 ml/min to 0 .90+/- 0.89 ml/min. The quantitative unstimulated saliva remained similar at 0.07+/- 0.21ml/min and 0.06+/- 0.10 ml/min, respectively. Conclusions: The high risk nature of Sjogrens syndrome, demands an effective and rigorous preventive regimen with prescription strength fluoride, sialogogues, frequent, regular monitoring and treatment by dental professionals and excellent home care to retard carious progression and maintain homeostasis of the whole mouth.