Lupus and Oral Health

As we continue our lupus blog series, we will now focus on how lupus affects oral health. Taking an active role in your dental treatments is key. It helps to learn as much as you can about lupus, since being able to spot the warning signs of a problem can help you ease the symptoms before they become severe.

How lupus affects our oral health:

Lupus happens when the body’s immune system attacks its own tissues and organs. Our own body defense cells (antibodies) start attacking normal body cells. This can affect different parts of the body including the oral cavity. This is a non-infectious disease which means that it cannot spread from one person to another.

Oral Signs and Symptoms: 

• Lupus usually presents as: Acute (over a short period of time) or Chronic (over a long period of time) soft tissue lesions.
• Most commonly it presents as oral ulcers or oral lesions that are not different from ulcers due to other causes.
• The lesions are usually red and white in color. As the lesion ages, they become more white.
• Active lesions are usually red ulcers surrounded by a white halo and white radiating lines.
• Oral ulcers present as painless, shallow, raised elevations on the hard as well as soft palate (roof of the mouth).
• These ulcers can also form on the other parts of oral mucosa like the inside of the cheeks and lower lip.
• Ulcers start as tiny macules (red patches) and later transform into erosions.
• There are numerous cases when the disease progresses to affect the salivary glands.
• Cases where salivary glands are affected the patient might experience dryness of the mouth (Sjogren’s Syndrome SS). This, in turn, can predispose the patient to multiple dental caries and gingival pathologies.
• Dry mouth is associated with red shiny tongue, with burning and difficulty swallowing.
• The initial diagnosis may require a biopsy and working with a rheumatologist to determine whether the lesions are caused by lupus.

Treatment options: 

• Pain medications like NSAIDs are prescribed for symptomatic relief.
• Oral lesions may respond to treatment with topical or intra-lesional steroids.
• Antimalarial treatment is sometimes given to treat resistant lesions.
• If the oral lesions are a part of the systemic disease, treatment for the systemic disease controls the oral lesions.
• Immunosuppressive drugs are also used in certain cases.
• For dry mouth drink plenty of water, use artificial saliva and frequent fluoride treatment.
• Lifestyle changes and stress management is also necessary.

Preparing for a dental visit:

• If you suspect lupus please let your dentist or hygienist know about your signs and symptoms during your next dental checkup.
• If you already have a diagnosis: let you dentist know about the medications you are being prescribed to treat the same.
• Also making a list of questions and potential problems before discussing your issues is a good idea.

Tips and Advice:

• Lupus is an autoimmune disease and can affect the internal organs. If you happen to suspect oral lupus and/or are facing some other symptoms, it is better to consult your general physician or dentist.
• Timely medication and lifestyle changes can prove to be very helpful.
• Always maintain a good oral hygiene so that the oral ulcers do not get infected.
• Use regular fluoridated mouthwash to prevent tooth decay.
• Plan regular checkups with your rheumatologist to track the progress of the disease.

Please read our previous blogs about lupus:

• What is Lupus: An Overview
• Understanding the Different Types of Lupus
• Lupus and Pregnancy
• Lupus and Depression

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