Early Detection of Sjögren’s Syndrome

PeriRx LLC, a company developing non-invasive, oral diagnostic technology, recently released their latest diagnostic finding that will aid in early detection of Sjögren’s Syndrome.  

Stephen M. Swanick, CEO of PeriRx LLC, believes that this technological breakthrough puts dental professionals “on the front lines with medical doctors and medical specialists in the collaborative care of the patient.”

While the PeriRx Sjögren’s Syndrome Test is still under development, the discriminatory salivary biomarkers used for detection of this disease were discovered though NIH-funded research. Furthermore, the National Cancer Institute and academic medical centers have clinically validated these biomarkers in collaborative trials.

According to the National Institutes of Dental and Craniofacial Research, Sjögren’s Syndrome typically affects patients older than 50, and nine out of 10 diagnosed cases are women. It is the most common immune deficiency after rheumatoid arthritis (RA).

Sjögren’s Syndrome, known for its major symptom of dry mouth, is a systemic chronic autoimmune disease. The immune system of individuals affected by this disorder attacks and damages moisture-producing glands causing oral and ocular complications.

One of the glands that becomes nonfunctional in patients who are affected by this autoimmune disease is the salivary gland. When this gland’s function is impaired, patients present symptoms of xerostomia, commonly known as dry mouth. The decrease in saliva causes an increased risk of developing oral complications like dental caries and oral diseases.

Additionally, patients with Sjögren’s Syndrome face symptoms of dry eye, joint pain, tissue and organ inflammation, throat dryness, digestive problems, neurological complications and chronic fatigue.

While there is not a cure for Sjögren’s Syndrome, dentists can recommend a variety of treatments for symptoms and prevention of further complications caused by this disease.

Dr. Jill Kramer, DDS, PhD, an oral and maxillofacial pathologist employed by the University at Buffalo School of Dental Medicine, explains that “there are no therapeutics that address the causes of Sjögren’s Syndrome. The available therapeutics target symptoms associated with the disease and aim to reduce patient discomfort by increasing salivary or lacrimal flow.”

Additionally, she explains that not all patients with Sjögren’s Syndrome exhibit symptoms of xerostomia, so “dental professionals should frequently assess the patient for xerostomia to detect deficits in flow in order to prevent or arrest carious lesions.”

Although treatments for the causes of Sjögren’s Syndrome are not available, Dr. Kramer has made recommendations for how dental professionals should be treating patients affected by this disease. She says, “Dental professionals should advise xerostomic patients to use high fluoride toothpaste daily (such as Gel-Kam ® and PreviDent 5000®) and fluoride mouthwashes that may offer additional benefit.”

Dr. Mark S. Wolff, DDS, PhD, the Associate Dean for Pre-doctoral Clinical Education at New York University College of Dentistry, offers additional recommendations for patients with Sjögren’s Syndrome. He notes that patients should “work to prevent dental caries with a diet reduced in sugar content, stimulate saliva with chewing gum, use mouth rinses like Biotene to alleviate dryness, brush teeth well and frequently, and use fluoride to reduce caries.” 

Dr. Kramer further explains that dentists “may prescribe parasympathomimetics (such as pilocarpine or cevimeline) to stimulate salivary flow.” She echoes Dr. Wolff’s sentiments that dental professionals “discourage xerostomic patients from consuming food and drink with high sugar” and says “salivary substitutes, as well as sugar-free lozenges and chewing gum can be use to stimulate flow.”

One of the greatest challenges aside from xerostomia that Dr. Kramer sees in patients with Sjögren’s Syndrome is extra-glandular manifestations: “Specifically, they may have severe fatigue, arthritis and are more prone to development of B cell lymphomas.”

The Sjögren’s Syndrome Foundation offers survival tips for patients facing the challenges of this disease. The foundations recommendations to stimulate salivary flow include eating smaller, more frequent meals and increasing liquid intake while avoiding salty, acidic, or spicy food and carbonated beverages that may cause additional irritation.

The foundation recommends using products that contain the sweetener xylitol to help prevent dental decay. For pain relief caused by mouth dryness, the foundation recommends using Vitamin E oil or moisturizing gels.

Currently, Sjögren’s Syndrome is detected on average 4.7 years after onset of symptoms because it resembles other diseases and can be secondary to RA or Lupus. With PeriRx’s Sjögren’s Syndrome Test, patients and dental professionals can both look forward to seeing early detection of Sjögren’s Syndrome by the end of 2014.