Primary Sjögren Syndrome: A review for health professionals

Abstract

Primary Sjögren Syndrome (PSS), also known as autoimmune epithelitis, it is an autoimmune disease with a large clinical features spectrum, from local exocrinopathy to multiple systemic manifestations. The main symptoms are xerostomia and xerophthalmia, often accompanied by systemic changes those affects parenchymal organs. The frequently associated clinical signs of PSS in the oral cavity are: loss of brightness, dryness, pale and thin appearance of oral mucosa, fissures and lobulations in the lingual dorsum, angular cheilitis and filiform papillae atrophy. And the clinical symptoms are: glossodynia (mouth burning), dysgeusia (distortion or decreased taste), speech and swallowing the bolus difficulties, dry cough, difficulty in fixing dental prostheses. It is known that genetic, hormonal and environmental factors seem to be related to the development PSS, which is associated with increasedHLA-B8 / DR3 halotype frequency. The inflammatory target in the disease is primarily the epithelium of the lacrimal and salivary glands and, therefore, some authors named the destruction of the glandular parenchyma in PSS, whose initial mechanisms may be related to the breakdown of homeostasis in glandular architecture (cell-cell and cellextracellular matrix structures) as autoimmune epithelitis. One of the main characteristics of this disease is the destruction of the salivary glands parenchyma, consequently decreasing salivary flow and xerostomia. The dentist plays an important role within the multidisciplinary team, with meticulous instructions on oral hygiene, non-cariogenic diet advice, prescription lubricating agents and constant evaluation of dental restorations to give the patients a better health wellbeing. *Correspondence to: Ricardo Hsieh, DDS, PhD, Avenida Doutor Enéas de Carvalho Aguiar, NO. 500, Prédio II, 2o Andar, São Paulo, SP, Brazil – CEP: 05403-000, Tel: +551130617064/+5511966369564; E-mail: r.hsieh@usp.br