autoimmune disease of the mouth

When the body’s immunity attacks its organs, a chain of diseases and disorders may develop in an individual. Such disorders are termed as autoimmune disorders.

Autoimmune diseases affect a wide range of body tissues and organs. It is a widespread medical condition. Around 24 million people in the United States suffer from at least one autoimmune disorder.

Even though there are a variety of treatment modalities available to control the symptoms, the autoimmune disease does not have a definite cure.

People with autoimmune disease are also at risk of oral health conditions. Some of the problems may include, chronic dry mouth, burning mouth syndrome, gingival hyperplasia, and developmental deformities. (1)

Often hereditary and hormones play an essential role in improving or worsening the symptoms.

In this article, we will focus on the effects of autoimmune disease on oral health.

What do you mean by autoimmune disease?

Autoimmune disease is a medical condition that is caused by an abnormal immune response of one’s body to its organs. On a broad scale, there are around 80 types of autoimmune diseases. (2)

Generally, any part of the body can be affected by an autoimmune disease. The cause of this disease is still unknown. However, hormones and hereditary may trigger the symptoms.

General symptoms of the autoimmune disease include –

  • Low-grade fever
  • Fatigue
  • Restlessness
  • Itching or burning sensation of the skin

The prevalence of an autoimmune disease is usually high among women, and the first symptoms may appear during adulthood.

Types of autoimmune diseases and their effects on the oral cavity

There are typically eight types of autoimmune disease that have a severe impact on oral health. These diseases are as follows –

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease which causes inflammation of the joints. A wide range of body joints can be affected that may interfere with oral health. (3)

  • Involvement of the Temporomandibular joint creates pain and discomfort while chewing.
  • Involvement of joints in the hands reduces the ability to brush and floss effectively.
  • Rheumatoid arthritis is also associated with Sjogren’s syndrome which affects the salivary glands in the mouth. The symptoms include dryness of mouth and eyes, difficulty in chewing food, heavy plaque deposits on teeth and increased risk of tooth decay and periodontal disease.

Lupus erythematosus

Lupus erythematosus affects multiple organs in the body. More than half of the patients with lupus erythematosus suffer from cold sores on the lips, palate and oral mucosa. They often complain of burning sensation in the mouth. (4)

Salivary gland disease is another oral condition associated with lupus. This condition causes dry mouth. Dry mouth, in turn, increases the risk of tooth decay and periodontal problems.

Scleroderma

Scleroderma, also known as progressive systemic sclerosis, is a disease that makes the skin hard in texture. Commonly the surface of the hands and face is affected.

Scleroderma also causes the disappearance of skin folds around the mouth. Therefore, the face typically looks like a mask.

In some cases, the lips and tongue may become firm or hard. This stiffness of the mouth causes locking of the jaw and creates difficulty in opening the mouth wide.

A person who has scleroderma fails to clean the teeth present posteriorly. As the disease progresses, the mouth becomes narrower, and the lips become more rigid. Hence, it becomes difficult to maintain good oral hygiene.

Selective Immunoglobulin deficiencies

As the name suggests immunoglobulin deficiencies affect the white blood cell, especially the B cell. B-cells function by producing antibodies against bacteria or any foreign substance that has the potential to cause infection.

People suffering from immunoglobulin deficiencies become prone to bacterial infections. The most common immunoglobulin deficiency is of immunoglobulin A.

Immunoglobulin A is typically found in the saliva. People suffering from this deficiency are at risk of chronic sinusitis, chronic lung infections, and digestive problems.

Thymic hypoplasia

Thymic Hypoplasia, also called DiGeorge’s syndrome, is a genetic disorder that causes abnormal growth of thymus and parathyroid glands. Sometimes, this syndrome also causes congenital heart defects. (5)

As this syndrome affects the thymus gland, the immune system becomes deficient in T cells. This deficiency makes the patient susceptible to viral and fungal infections, especially in the mouth.

Some of the common oral conditions caused by thymic hypoplasia include –

  • Candidiasis
  • Herpes simplex
  • Cleft palate
  • Split uvula
  • Receding chin
  • Defects of the mouth and jaw

Dermatomyositis

 It is an inflammatory disease of the muscles. A typical skin rash marks it. Usually, women are affected more than men.

The muscle weakness of the head and neck caused by dermatomyositis causes difficulty in chewing and swallowing food. Children with dermatomyositis develop abnormal growths in their mouth and tongue.

X-Linked Agammaglobulinemia

X-linked or Bruton’s agammaglobulinemia is a genetic condition that commonly occurs in male children. It is caused by a defect in the function of B cells.

The primary function of B cells is to develop antibodies against bacteria and infection producing foreign substances.

The immune system of a person suffering from X-linked agammaglobulinemia cannot produce antibodies needed to fight an infection. As a result, the person develops diseases like chronic sinusitis, dental and oral infections that may worsen with time.

Ataxia Telangiectasia

Ataxia is a rare childhood disorder which causes damage to the part of the brain that controls movement and speech.

Typically, three symptoms characterize ataxia –

  • Difficulty in controlling voluntary muscles
  • Lesions in the eye and skin
  • Immune system malfunction

The malfunctioning of the immune system causes a deficiency of both B and T cells. This process makes the patient susceptible to bacterial, viral and fungal infections, especially in the mouth.

Take away message

Every year the prevalence of the autoimmune disease increases among the population. Professional treatments may subside the symptoms, but a definite cure is still not found.

Autoimmune disease can be life-threatening. If you experience any of the mentioned symptoms, contact your doctor immediately.

Early diagnosis will help to control the symptoms at an initial stage and prevent the disease from worsening the immunity.

Regular dental examinations and good oral hygiene combats and neutralizes the adverse effects of autoimmune disease on your oral health.